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How to Effectively Teach Interventions for Sepsis

败血症，身体对感染的极端和威胁危及生命的反应，可以导致脓毒性休克，多种器官衰竭和死亡，如果没有提前识别并及时管理。

全球每年，败血症影响超过3000万人，导致多达600万人死亡。1具有最高风险的人包括：2
  • Adults older than 65 years of age
  • Children younger than 1 year of age
  • 免疫系统弱化的人
  • People with chronic medical conditions, such as diabetes, lung disease, cancer, and kidney disease
3.million newborns and 1.2 million childrensuffer from sepsis globally each year.3.

Experts recommend using simulation training to train for high-acuity patient situations as it can enhance a learner’s know-how, build confidence, and provide a creative learning environment to boost retention.4.在培训医疗保健专业人员来检测和治疗怀疑患有败血症的患者时，模拟可以高效。

具体而言，模拟可以帮助教育者在以下领域：

早期发现和诊断败血症

在旨在教授SEPSIS干预的模拟中，提供商使用模拟器反复练习可以优化临床结果的诊断和治疗程序。学习者可以“排练”在现实世界的情景中鉴定败血症的早期症状 - 特别是那些可能无法反映明确的败血症诊断的败血症。

有些组织选择遵循三种不同败血症案例的进展：5.

标准败血症

一种容易展示败血症的迹象和症状的非复杂情景。

将脓毒症/肺炎与流感区分开来

teaches learners to maintain a high sensitivity for sepsis patients while limiting false positives.

Septic shock

提供积极治疗和理解脓毒症休克的细微差别的机会。

With simulation learning, healthcare professionals have the opportunity to refine their skills using simulation technology – without putting patients at risk.

劳拉·坎帕南，临床副总裁RN，Bakersfield Heart Hospital *

Cross-functional Team Training

Often when healthcare professionals are provided with training, it is conducted in silos and sorted by discipline. But,cross-functional team training can positively impact a team's interactions during a high-stress, time-sensitive emergency case like severe sepsis.

模拟可以帮助来自不同角色的不同护理团队的成员，培养有效的沟通技巧。通过更好的沟通和预防性团队行为到位，患者更有可能接受安全保健。

Arthur Childs博士区域医疗中心的博士学分为医院的败血症或严重败血症患者数量的仿真。6.Prior to his team’s training with a simulator, 72% of the hospital's sepsis patients led to major complications or comorbidities.After simulation training, that percentage lowered to 63% - a result suggesting that patients with sepsis are now identified earlier.7.

When doctors were interviewed [after the simulation experience], they admitted they hadn’t known everything and that it was stimulating to train as part of a multidisciplinary team.

Arthur Childs，M.D.，Cape Regural Medical Center Cape Caper Care董事**

败血症Treatment Protocols

使用模拟的培训可以加强已知最成功的方案在治疗败血症患者方面是最成功的。研究表明learners correctly diagnose sepsis and administer antibiotics correctly when they participate in a simulation.8.

而且，学习者的性能分数继续通过仿真练习多种机会来改善。9.

In addition to supporting a learner’s training on protocols, simulation training offers exposure to how quickly a patient’s condition can deteriorate. Septicpatient mortality increases an estimated 9% per hour when antibiotics are delayed after hypotension.10.

提供低风险的环境观看和治疗时间敏感的患者，可以教导学习者在败血症患者案例中所需的紧迫性。然后，这种理解可以直接转化为床头，改善响应时间以及患者结果。

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References
  1. 世界卫生组织。（2018）。败血症. Retrieved from https://www.who.int/news-room/fact-sheets/detail/sepsis
  2. 疾病预防与控制中心。（2019）。什么是败血症？从https://www.cdc.gov/sepsis/what-is-sepsis.html中检索
  3. 世界卫生组织。（2018）。请参见参考＃1。
  4. 马林，K。（2014）。作为早期识别败血症的仿真。急诊护理杂志，39（5），p。427. DOI：https://doi.org/10.1016/j.jen.2013.03.021
  5. Dix, A. (2017). 3 scenarios to train for diagnosis, treatment of sepsis. EMS1.com. Retrieved from https://www.ems1.com/ems-products/capnography/articles/3-scenarios-to-train-for-diagnosis-treatment-of-sepsis-pYAoKGarKW6P3C09/
  6. Maguire，P。（2014）。实践学习改善了败血症结果。今天的医院。从https://www.todayshospitalist.com/hands-on-learning-improves-sepsis-outcomes/
  7. 同上。
  8. Dugan, M.C., McCracken, C.E., & Hebbar, K.B. (2016). Does simulation improve recognition and management of pediatric septic shock, and if one simulation is good, is more simulation better? Pediatric Critical Care Medicine, 17(7), p. 605-614. DOI: 10.1097/PCC.0000000000000766
  9. 同上。
  10. Dix, A. (2017). See reference #5.

* Zimmerman，B。（2016）。关于SEPSIS仿真培训的3件事Becker的临床领导和感染控制。从https://www.beckershospitalreview.com/quality/3-things-to-know-about-sepsis-simulation-training.html.

** Maguire, P. (2014). See reference #6.

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