改善患者安全
使用模拟建立高性能团队
许多组织已经开始实施计划以支持更好的患者安全。事实证明，通过使用模拟培训多学科团队可以降低患者的风险。
医院如何培训员工的灾难准备和降低风险
When disasters occur, healthcare providers play a critical role as part of the response team. Although hospitals have general emergency management plans in place,专家说，大多数设施没有为大规模的灾难做好准备。1
Laying significant groundwork is required to ensure that a hospital remains operational during and after natural and man-made disasters, pandemic outbreaks, and other大规模休闲事件。In this article, we explore how simulation training can prepare your organization to manage a crisis.And, in training for the worst, healthcare providers can feel confident that they will reduce risk in single patient emergencies as well.
风险=
威胁x脆弱性x结果*
在系统中找到漏洞
在大规模休闲事件（每次医院的床和平方英尺的空间）中，不是时候遇到潜在系统威胁了。作为较大风险计划的一部分，现场模拟（在真实的临床环境中进行）已被证明有效地最大程度地减少了这种风险。3
By practicing in the real-world care environment, team members are better able to spot process issues, flaws in room arrangement and storage, and other factors slowing a team’s response time.而且，这些问题可以在真正的患者进入房间之前解决。
除了确定脆弱的护理领域外，通过原位模拟培训还可以导致：4
- Increased confidence
- 更好的知识获取
- 在学习者中，床边的技能应用率更高。
提供高级团队培训
Chaos in the middle of an emergency can be off-set by command and coordination.Designated leaders, defined roles and responsibilities, and proper communication help teams stay focused and take meaningful action toward the same goal.
仿真为医疗保健提供者提供了共同发展这些技能的机会，而不是在自己的学科的孤岛中。汇集一个陌生的团队可以提供练习：
- Handing off patients
- 导航拥挤的房间或走廊
- 互相报告
- Requesting and administering medication
- Closed-loop communication skills
- 穿个人保护装备和衣服
多学科模拟培训可以有效地转移到床边，即使在添加新团队成员并开始超过医疗保健提供者的紧急情况下。5
It’s also worth considering the psychological impact that a disaster can have on the care team, patients, and their families. Stress, emotion, and shock can all affect the overall care given to a patient.作为预防措施，医院可以通过增强其实用性来减少患者护理的错误two-challenge ruleand CUS (concerned, uncomfortable, safety) warnings.
In high-stress situations, it is critical that healthcare providers feel empowered to assert their concerns with one another.
Prepare For Uncommon Patient Emergencies
Single patient emergencies can sometimes feel like small-scale disasters. Increased adrenaline levels, less familiar procedures and protocols, and a higher probability of making errors all contribute to this feeling. Fortunately, simulating massive incidents can provide a framework for safely treating patients every day.
事实证明，灾难中使用的有效沟通和快速的决策技巧已被证明可以减少常见的医疗错误。6具体而言，研究表明，针对医生，护士和药剂师的模拟实践导致：7
- Lower rates of drug administration and preparation errors
- 更好地遵守清单
- 改善了药物错误的检测
通过模拟学习是针对参与风险管理的医疗保健专业人员的教育计划的额外支持。8
通过加强应对大规模灾难所需的能力，医疗保健提供者可能会为低频，高激人的患者病例做好准备。
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References
- Muchmore，S。（2017）。为医院准备灾难是什么意思？医疗保健潜水。取自https://www.healthcaredive.com/news/what-does-it-mean-for-a-hospital-to-be-ready-for-disaster/505573/
- Toner，E。（2017）。医疗保健准备：挽救生命。卫生安全，15（1），8-11。doi：10.1089/hs.2016.0090
- 帕特森（M.D.原位模拟：在高风险急诊室检测安全威胁和团队合作培训。BMJ质量与安全，第22页。468-477。doi：10.1136/bmjqs-2012-000942
- McGaghie，W。C.，Issenberg，S。B.，Petrusa，E。R.和Scalese，R。J.（2010）。基于模拟的医学教育研究的批判性综述：2003- 2009年。医学教育，44（1），50-63。
- Teamwork and Communication Working Group. (2011). Improving patient safety with effective teamwork and communication: Literature review needs assessment, evaluation of training tools and expert consultations. Edmonton (AB): Canadian Patient Safety Institute.
- Loprieato, J.O. (2018). How does healthcare simulation affect patient care? Agency for Healthcare Research and Quality. Retrieved from https://psnet.ahrq.gov/perspectives/perspective/255/How-Does-Health-Care-Simulation-Affect-Patient-Care
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