- 期刊
- OpenAccess
使用高擬真臨床技能測驗評估兒科住院醫師新生兒急救技巧及團隊領導能力
Using High Fidelity Simulation Clinical Skill Testing to Evaluate the Neonatal Resuscitation Skill and Leadership of Pediatric Residents
摘要
台灣新生兒科醫學會自1996年開始新生兒高級救命術（Neonatal Resuscitation Program, NRP）的推廣。本院所有住院醫師於第一年皆須接受NRP訓練及認證，之後每兩年重新認證一次。我們利用高擬真模組（High fidelitysimulation mannequins）教案測試第二年及第三年住院醫師NRP之技巧以及急救過程中團隊領導的能力。方法：本院新生兒科醫師團隊設計一個住院中突發性新生兒衰竭的教案，經過前測以及團隊討論後，確定評估要點以及評分標準，於2014年七月兒童醫學部的年度OSCE考試中使用。結果：十三位住院醫師參與此站測試。八位（61.5%）通過此站。平均分數為78.6．最常見的錯誤是壓胸及換氣的比例，其次為改善正壓換氣的步驟。第二年住院醫師在此兩項的表現比第三年住院醫師好。所有的醫師可以帶領急救過程並且和標準護士有良好的配合。84.6%（11／13）的人可以在過程中指導標準醫學生正壓換氣，只有7.7%（1／13）的人在急救結束後往上呈報。38.5%（5／13）的人忘記告知家屬發生的事件。結論：經由此次的測驗，發現在確認並改善正壓換氣的步驟如檢查換氣之有效性及面罩罩緊，在過程中帶領資淺人員以及急救後的溝通，需要於NRP訓練課程中再次加強。
並列摘要
Neonatal Resuscitation Program (NRP) has been adopted by Taiwan Neonatology Society since 1996. All the residents of our Pediatric department receive the NRP training in the first year. They have to be recertified for NRP every 2 years after then. We use High fidelity simulation mannequins script to test the NRP skill and leadership during of the 2nd and 3rd year residents. Method: A sundden neonatal collapse script was developed by our neonatologist team. A check list and criteria of success were developed after pre-test and team discussion. This script was included in our annular OSCE test for residents in 2014. Result: Thirteen residents attended this test. Eight (61.5%) of them passed this station. The average score was 78.6. The most common error was the correct ratio of chest compression and ventilation, followed by techniques for improving the positive ventilation. The performance of the 2nd year residents was better than the 3rd year ones. All the participants could lead the resuscitation process and work with the standard nurse. Eightyfour point six percent(11/13) of them could teach the standard student for positive ventilation. Only 7.7%(1/13) of them remembered to report this episode to supervisor. Thirty eight point five percent(5/13) forgot to inform the family. Conclusion: The techniques for improving the positive ventilation, the skill for leading the resuscitation, teaching the correct skills and the communication after resuscitation needs to be emphasize during NRP training course.
延伸閱讀
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- 蔡淳娟、沈靜茹（2016）。發展嬰幼兒急重症跨團隊合作能力之高擬真評量。台灣擬真醫學教育期刊，3(2)，13-20。https://doi.org/10.6582/JTSSH.2016.3(2).02
- 楊子孟、王嘉地、林宏榮、郭雅薇、周淑蓮、黃首詠、林銘薰（2012）。團隊急救復甦訓練新模式－以高擬真模擬情境考驗提升團隊合作效能。醫療品質雜誌，6(6)，70-76。https://doi.org/10.30160/JHQ.201211.0014
- 陳海玉（2016）。導入團隊資源管理對急診醫護人員實施高級心臟救命術認知之探討〔碩士論文，義守大學〕。華藝線上圖書館。https://www.airitilibrary.com/Article/Detail?DocID=U0074-0508201607401500
- 陳怡妃（2021）。Evaluation of High-Fidelity Simulation Pedagogy on Nursing Students’ Learning Effectiveness in Health Assessment Course -An Example Of Cardiovascular System Assessment〔碩士論文，國立臺灣大學〕。華藝線上圖書館。https://doi.org/10.6342/NTU202104088