Simulation training to improve 911 dispatcher identification of cardiac arrest

模拟训练提高911调度员心脏骤停识别能力

• 批准号: 8549164
• 负责人: HENDRIKA W. MEISCHKE
• 金额: $ 32.36万
• 依托单位: UNIVERSITY OF WASHINGTON
• 依托单位国家: 美国
• 财政年份: 2012
• 资助国家: 美国
• 起止时间: 2012-09-30 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8549164
• 关键词: Simulation; training; improve; 911; dispatcher

DESCRIPTION (provided by applicant): Simulation training to improve 911 dispatcher identification of cardiac arrest Every day, 9-1-1 dispatchers make front-line acute patient care safety decisions, resulting in life or death outcomes. For example, in the critical first few minuts following a cardiac arrest 9-1-1 dispatchers have been trained to provide instructions to bystanders over the phone. Telephone- assisted CPR (T-CPR) has significantly increased survival from cardiac arrest. However, dispatchers do not recognize approximately 30% of cardiac arrest cases, and as a result, many patients pass away who might have been resuscitated. Given the current low survival rates for cardiac arrest in most communities, increasing T-CPR could have an enormous impact nationwide. Identifying cardiac arrest over the phone is challenging. There is no physical patient, only a voice (often a hysterical one at that). There is no medical record. Callers may be relaying information second-hand. Callers may not speak English well. The primary cardiac arrest screening question asked of all callers to 9-1-1 ("Is the patient breathing?") is often answered affirmatively by callers because of the presence of agonal respirations. Although research has found that the frequency with which dispatchers handle cardiac arrests calls is associated with quicker recognition of cardiac arrest (and significantly improved patient survival rates), in general dispatchers encounter only a handful of cardiac arrest calls a year. We propose to increase this vital experience through simulated phone calls for dispatchers at 9-1-1 call centers for a study period of one year. The use of phone-based simulations to improve patient safety has not received a great deal of attention in the literature even though many phone-based emergency systems have a very direct impact on patient care and health outcomes. .We propose a randomized controlled trial to test processes and outcomes of the use of simulated cardiac arrest calls on: 9-1-1 dispatchers' ability to identify cardiac arrests during simulations and in actual calls Secondary aims are to evaluate 1) a dose-response effect of frequency of participation in the simulations for skill acquisition and performance levels , 2) the impact of presence or absence of immediate feedback on performance levels, and 3) the impact of participation in the simulations on provision of T-CRP. To be able to conduct this study as well as disseminate the findings nationwide, we will partner with Emergency Medical Services division of Public Health Seattle-King County, and several call centers in the Pacific Northwest.

描述（由申请人提供）：旨在改进 911 调度员对心脏骤停的识别的模拟培训 每天，9-1-1 调度员都会做出一线急性患者护理安全决策，从而导致生死攸关的结果。例如，在心脏骤停后的关键最初几分钟内，9-1-1 调度员经过培训，可以通过电话向旁观者提供指示。电话辅助心肺复苏 (T-CPR) 显着提高了心脏骤停的存活率。然而，调度员无法识别大约 30% 的心脏骤停病例，因此，许多本来可以复苏的患者去世了。鉴于目前大多数社区心脏骤停的存活率较低，增加 T-CPR 可能会在全国范围内产生巨大影响。通过电话识别心脏骤停具有挑战性。没有实际的病人，只有一个声音（通常是歇斯底里的声音）。没有医疗记录。呼叫者可能正在传递二手信息。打电话的人可能英语说得不好。由于存在临终呼吸，向所有拨打 9-1-1 的呼叫者询问的主要心脏骤停筛查问题（“患者是否呼吸？”）通常会得到呼叫者的肯定回答。尽管研究发现调度员处理心脏骤停呼叫的频率与更快地识别心脏骤停（并显着提高患者存活率）有关，但一般来说调度员每年只会遇到少数心脏骤停呼叫。我们建议通过为期一年的研究期，通过 9-1-1 呼叫中心调度员的模拟电话呼叫来增强这一重要体验。尽管许多基于电话的应急系统对患者护理和健康结果具有非常直接的影响，但使用基于电话的模拟来提高患者安全性并没有在文献中受到足够的关注。我们提出一项随机对照试验来测试使用模拟心脏骤停呼叫的过程和结果： 9-1-1 调度员在模拟和实际呼叫期间识别心脏骤停的能力次要目标是评估 1) 剂量-参与模拟的频率对技能获取和绩效水平的响应效果，2) 存在或不存在即时反馈对绩效水平的影响，以及 3) 参与模拟对提供 T-CRP 的影响。为了能够进行这项研究并在全国范围内传播研究结果，我们将与西雅图-金县公共卫生部门的紧急医疗服务部门以及太平洋西北地区的几个呼叫中心合作。