Using Military & Aviation Simulation Experience to Impr*

使用军事

基本信息

批准号：
7009718
负责人：
JEANNE-MARIE GUISE
金额：
$ 24万
依托单位：
OREGON HEALTH & SCIENCE UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2005
资助国家：
美国
起止时间：
2005-09-01 至 2007-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7009718
关键词：
clinical research computer simulation cooperative study curriculum education evaluation /planning emergency health services health care personnel performance health education health services research tag human subject obstetrics rural health

项目摘要

DESCRIPTION (provided by the applicant): Labor and delivery units are high-risk, high-cost environments in which decisions, mistakes, and delays can have tragic consequences. In our nation's rural hospitals, staff must possess the skills and resources needed to manage obstetric emergencies despite the infrequency of these events. The goal of this project is to bring simulation technology and team performance training, proven in aviation, the military, anesthesia, and other limited areas of medicine, to improve the process of obstetric care and promote safety in rural communities. More than 75 infants die each day in the United States. JCAHO estimates that 2/3 of cases of neonatal death or permanent disability during childbirth are attributable to human factors such as communication errors and almost half due to issues of staff competency. Rural hospitals with limited resources and few providers face considerable challenges in providing emergency obstetric services as required by the Emergency Medical Treatment and Labor Act (EMTALA). This demanding structure requiring nurses and support staff to maintain skill levels and clinical competency in obstetrics despite limited hands-on experience, offers the ideal setting to improve safety through obstetric team simulations. Crew resource management (CRM) (AHRQ Evidence Report number 43, Chapter 44) and medical simulations (AHRQ Evidence Report number 43, Chapter 45), have been recommended by the IOM, JCAHO, and AHRQ as safe practice interventions to reduce errors and risks associated with the process of care. This proposal combines crew resource management and simulation expertise from NASA and the U.S. military, educational and research expertise from academia, and the safety focus of all three to bring simulations where they are desperately needed: to the frontline of clinical care in rural America. Specifically, we aim to test whether simulation of obstetric emergencies and team performance training (CRM) will improve the process of care and patient safety in rural hospital settings through the following AIMS: I. Develop and test standardized Curricula for simulated Obstetric emergency Response Drills & Safety-CORDS II. Implement and evaluate CORDS in rural settings III. Explore the ability of IT to create a statewide safety culture and to expand the reach of simulations. The results of this project will: 1) provide a toolkit that can be used across the country to improve the process of care and promote safety, 2) demonstrate how to use IT and simulated education to support a statewide safety culture and 3) model how to utilize and evaluate the effectiveness of simulations to maintain technical skill levels and enhance the process of care and safety in rural healthcare systems.

描述（由申请人提供）：分娩和分娩单位是高风险、高成本的环境，其中的决策、错误和延误可能会造成悲惨的后果。在我们国家的乡村医院，工作人员必须拥有处理产科紧急情况所需的技能和资源，尽管这些事件很少发生。该项目的目标是引入在航空、军事、麻醉和其他有限医学领域经过验证的模拟技术和团队绩效培训，以改善产科护理流程并促进农村社区的安全。美国每天有超过 75 名婴儿死亡。 JCAHO 估计，2/3 的新生儿死亡或分娩期间永久残疾的病例可归因于沟通错误等人为因素，近一半是由于工作人员能力问题造成的。资源有限且提供者很少的乡村医院在按照《紧急医疗和劳动法》（EMTALA）的要求提供紧急产科服务方面面临着相当大的挑战。这种要求很高的结构要求护士和支持人员在实践经验有限的情况下保持产科的技能水平和临床能力，为通过产科团队模拟提高安全性提供了理想的环境。 IOM、JCAHO 和 AHRQ 已推荐船员资源管理 (CRM)（AHRQ 证据报告第 43 号第 44 章）和医学模拟（AHRQ 证据报告第 43 号第 45 章）作为减少错误和风险的安全实践干预措施与护理过程相关。该提案结合了美国宇航局和美国军方的机组人员资源管理和模拟专业知识、学术界的教育和研究专业知识，以及这三者的安全重点，将模拟带到了迫切需要的地方：美国农村临床护理的前线。具体来说，我们的目标是通过以下目标来测试产科紧急情况模拟和团队绩效培训 (CRM) 是否会改善乡村医院环境中的护理流程和患者安全： I. 开发和测试模拟产科紧急反应演习和安全的标准化课程-CORDS 二.在农村环境中实施和评估 CORDS 三．探索 IT 创建全州安全文化并扩大模拟范围的能力。该项目的成果将：1) 提供一个可在全国范围内使用的工具包，以改善护理流程并促进安全，2) 展示如何使用 IT 和模拟教育来支持全州安全文化，以及 3) 建立模型利用和评估模拟的有效性，以维持技术技能水平并增强农村医疗保健系统的护理和安全流程。