Using Military & Aviation Simulation Experience to Impr*

使用军事

• 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
• 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; 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

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）：人工和交货单位是高风险，高成本的环境，在这些环境中，决策，错误和延迟可能会带来悲惨的后果。在我们国家的乡村医院中，尽管这些事件的频率不足，但工作人员必须拥有管理产科紧急情况所需的技能和资源。该项目的目的是携带模拟技术和团队绩效培训，即在航空，军事，麻醉和其他有限的医学领域，以改善产科护理的过程并促进农村社区的安全。 在美国，每天有75名婴儿死亡。 JCAHO估计，分娩期间新生儿死亡或永久残疾病例的2/3归因于人为因素，例如沟通错误，几乎是由于员工能力问题而导致的一半。资源有限的农村医院在按照《紧急医疗和劳工法》（EMTALA）要求提供紧急产科服务方面面临巨大挑战。这种苛刻的结构要求护士和支持员工，尽管手上经验有限，但仍需要护士和支持人员在产科中保持技能水平和临床能力，这为通过产科团队模拟提供了理想的环境来提高安全性。机组人员资源管理（CRM）（AHRQ证据报告编号43，第44章）和医疗模拟（AHRQ证据报告编号43，第45章）已由IOM，JCAHO和AHRQ推荐，作为减少与护理过程相关的错误和风险的安全实践干预措施。该提案结合了NASA和美国军方，学术界的教育和研究专业知识的工作人员资源管理和模拟专业知识，以及所有三者的安全重点，以将模拟迫切需要：到美国农村临床护理的前线。具体而言，我们旨在测试对产科紧急情况和团队绩效培训（CRM）的模拟是否会通过以下目的改善农村医院环境中的护理和患者安全过程： I.开发和测试用于模拟产科应急训练和安全性的标准化课程 ii。在农村环境中实施和评估绳索 iii。探索它创建全州安全文化并扩大模拟范围的能力。 该项目的结果将：1）提供一个可以在全国范围内使用的工具包来改善护理和促进安全过程，2）演示如何使用它并模拟教育来支持全州安全文化，3）模型如何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性。