Sepsis: a common, but under recognized condition
仿真培训可以使医疗保健提供者能够准确诊断和治疗败血症。使用仿真情景来学习鉴定标准和严重的败血症，以识别高危患者的败血症，区分败血症和其他疾病，并评估和治疗败血性休克是模拟训练的一些学习目标之一。
如何有效教授败血症的干预措施
Sepsis, the body’s extreme and life-threatening response to an infection, can lead to septic shock, multiple organ failure, and death if not recognized early and managed promptly.
Worldwide each year, sepsis affects more than 30 million people and causes as many as 6 million deaths.1Those with the highest risk include:2
- 年龄超过65岁的成年人
- 1岁以下的儿童
- People with weakened immune systems
- 患有慢性病患者，例如糖尿病，肺病，癌症和肾脏疾病
300万新生儿和120万儿童每年全球败血症。3
专家建议使用仿真培训来培训高峰患者情况，因为它可以增强学习者的专业知识，建立信心并提供创造性的学习环境来增强保留率。4Simulation can prove highly effective when training healthcare professionals to detect and treat patients suspected of having sepsis.
Specifically, simulation can aid educators in the following areas:
Early Detection and Diagnosis of Sepsis
In simulations designed to teach sepsis interventions, providers use simulators to repeatedly practice both diagnostic and treatment procedures that can optimize clinical outcomes.Learners can "rehearse" identifying early symptoms of sepsis in real-world scenarios – particularly those that may not reflect a clear-cut, simple sepsis diagnosis.
一些组织曹ose to follow a progression of three different sepsis cases:5
Standard sepsis
a non-complicated scenario that easily demonstrates the signs and symptoms of sepsis.
Differentiating Sepsis/pneumonia from the flu
教学者在限制假阳性的同时，保持对败血症患者的高灵敏度。
败血性冲击
provides the opportunity to aggressively treat and understand the nuances of septic shock.
通过模拟学习，医疗保健专业人员有机会使用模拟技术来完善自己的技能，而不会使患者处于危险之中。
Laura Cunanan, RN, Vice President of Clinical, Bakersfield Heart Hospital*
跨职能团队培训
通常，当提供医疗保健专业人员接受培训时，它是用筒仓进行的，并通过纪律进行分类。但，跨职能团队训练可以在高压力，时间敏感的紧急情况（如严重的败血症）中对团队的互动产生积极影响。
Simulation can help members from different care teams, who play different roles, develop effective communication skills. With better communication and precautionary team behaviors in place, patients are more likely to receive safe care.
Dr. Arthur Childs at Cape Regional Medical Center credits simulation for the hospital’s decrease in the number of patients with septicemia or severe sepsis.6在他的团队进行模拟器培训之前，医院的败血症患者中有72％导致了重大并发症或合并症。在模拟训练之后，该百分比降低到63％ - 这表明败血症患者现在已较早发现。7
当[在模拟经验之后]接受医生接受采访时，他们承认自己并不了解一切，并且正在刺激训练作为多学科团队的一部分。
Arthur Childs, M.D., Director of Critical Care, Cape Regional Medical Center **
败血症治疗方案
Training using simulation can reinforce the protocols that are known to be most successful in treating patients with sepsis. Research shows that学习者在参加模拟时正确诊断败血症并正确施用抗生素。8
And, performance scores for learners continue to improve with more than one chance to practice with simulation.9
除了支持学习者对协议的培训外，模拟培训还可以暴露于患者病情恶化的速度。化粪池当抗生素延迟低血压后，患者死亡率估计增加了9％。10
Providing a low-risk environment to watch and treat a time-sensitive patient can teach learners the urgency required in a sepsis patient case. This understanding can then translate directly to the bedside, improving response times as well as patient outcomes.
参考
- World Health Organization. (2018). Sepsis. Retrieved from https://www.who.int/news-room/fact-sheets/detail/sepsis
- Centers for Disease Control and Prevention. (2019). What is sepsis? Retrieved from https://www.cdc.gov/sepsis/what-is-sepsis.html
- World Health Organization. (2018). See reference #1.
- Marin, K. (2014). Simulation as a tool in early recognition of sepsis. Journal of Emergency Nursing, 39(5), p. 427. DOI: https://doi.org/10.1016/j.jen.2013.03.021
- Dix，A。（2017）。3个训练诊断，败血症治疗的方案。EMS1.com。取自https://www.ems1.com/ems-products/capn金宝搏官方app下载ography/articles/3-scenarios-to-train-frain-for-diareatment-wareatment-eatment-of-sepsis-pyaokgarkw6p3c09/
- Maguire, P. (2014). Hands-on learning improves sepsis outcomes. Today’s Hospitalist. Retrieved from https://www.todayshospitalist.com/hands-on-learning-improves-sepsis-outcomes/
- Ibid.
- Dugan，M.C.，McCracken，C.E。，＆Hebbar，K.B。（2016）。仿真是否可以改善对小儿败血性休克的识别和管理，如果一个模拟是好的，则模拟更好？小儿重症监护医学，第17（7）页，第1页。605-614。doi：10.1097/pcc.0000000000000766
- Ibid.
- Dix，A。（2017）。请参阅参考＃5。
* Zimmerman, B. (2016). 3 things to know about sepsis simulation training. Becker’s Clinical Leadership and Infection Control. Retrieved from https://www.beckershospitalreview.com/quality/3-things-to-know-about-sepsis-simulation-training.html
** Maguire，P。（2014年）。请参阅参考＃6。
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