中华医学教育杂志

中华医学教育杂志 ›› 2024, Vol. 44 ›› Issue (12): 943-947.DOI: 10.3760/cma.j.cn115259-20230822-00153

• 继续医学教育 • 上一篇    下一篇

复苏质量改善培训提高并保持急诊科医护人员心肺复苏术技能的研究

姜辉, 宋晓, 宗良, 朱华栋, 刘继海, 史迪   

  1. 中国医学科学院北京协和医学院,北京协和医院急诊科,疑难重症及罕见病全国重点实验室,北京 100730
  • 收稿日期:2023-08-22 出版日期:2024-12-01 发布日期:2024-12-03
  • 通讯作者: 史迪, Email: shidi@pumch.cn

Resuscitation quality improvement program to improve the acquisition and retention of cardiopulmonary resuscitation skills for healthcare professionals in emergency department

Jiang Hui, Song Xiao, Zong Liang, Zhu Huadong, Liu Jihai, Shi Di   

  1. Emergency Department, The State Key Laboratory for Complex, Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing 100730, China
  • Received:2023-08-22 Online:2024-12-01 Published:2024-12-03
  • Contact: Shi Di, Email: shidi@pumch.cn

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摘要： 目的 评估复苏质量改善(resuscitation quality improvement,RQI)培训在提高急诊科医护人员心肺复苏术(cardiopulmonary resuscitation,CPR)技能习得和保持的效果。方法 2021年4月至2022年4月,选择北京协和医院急诊科工作的149名医护人员(以下简称学员)采用RQI进行CPR培训。通过学员培训前后的CPR 测试成绩和4个季度复训期间(Q1、Q2、Q3、Q4)的按压和通气总成绩,以及问卷调查结果来评价培训效果。采用非参数Wilcoxon秩和检验对数据进行分析。结果 学员培训前后CPR 测试成绩比较,成人按压[64.5(59.0)比 96.0(15.0)]、成人通气[42.5(86.0)比97.5(14.0)]、婴儿按压[24.0(73.0)比94.0(19.0)]和婴儿通气[28.5(57.0)比74.5(46.0)]方面的差异均具有统计学意义(均P＜0.05)。Q1、Q2、Q3、Q4成人按压成绩分别是97.0(3.0)、98.0(4.0)、97.0(5.0)、98.0(4.0),婴儿按压成绩分别是98.0(6.0)、98.0(5.0)、99.0(8.0)、98.0(5.0),成人通气成绩分别是99.0(3.0)、99.0(3.0)、99.0(7.0)、99.0(3.0),婴儿通气成绩分别是98.0(7.0)、98.0(8.0)、99.0(5.0)、99.0(5.0),4个季度各项成绩的差异均无统计学意义(均P>0.05)。参与度Q1为99.3%(148/149),Q2为96.6%(144/149),Q3为94.6%(141/149),Q4为91.9%(137/149)。学员总体满意度为89.1%(122/137)。结论 急诊科采用RQI进行心肺复苏术培训,学员可以习得核心技能并实现技能保持,同时具有较高的课程参与度和满意度,能够作为急诊医护CPR培训的一种方法。

关键词: 心肺复苏术, 急诊科, 基础生命支持, 复苏质量改善

Abstract: Objective This study aims to evaluate the effectiveness of the resuscitation quality improvement (RQI) program in cardiopulmonary resuscitation (CPR) training for emergency department personnel. Methods From April 2021 to April 2022, a cohort of 149 healthcare professionals from the Emergency Department of Peking Union Medical College Hospital were enrolled in CPR training using the RQI program. Test scores of pre-training, post-training and four quarterly refresher training periods (Q1, Q2, Q3, Q4) were collected, questionnaires were also used to assess the training effects. Non-parametric Wilcoxon rank-sum tests were used for data analysis. Results There were statistical improvements in CPR test scores from pre- to post-training for adult compressions [64.5 (59.0) vs. 96.0 (15.0)], adult ventilation [42.5 (86.0) vs. 97.5 (14.0)], infant compressions [24.0 (73.0) vs. 94.0 (19.0)], and infant ventilation [28.5 (57.0) vs. 74.5 (46.0)](all P < 0.05). The adult compression scores for Q1, Q2, Q3, and Q4 were 97.0 (3.0), 98.0 (4.0), 97.0 (5.0), and 98.0 (4.0), respectively, and the infant compression scores were 98.0 (6.0), 98.0 (5.0), 99.0 (8.0), and 98.0 (5.0), respectively. The adult ventilation scores were 99.0 (3.0), 99.0 (3.0), 99.0 (7.0), and 99.0 (3.0), and the infant ventilation scores were 98.0 (7.0), 98.0 (8.0), 99.0 (5.0), and 99.0 (5.0), all with no statistical differences across the four quarters (all P>0.05). The participation rate was 99.3%(148/149) for Q1, 96.6%(144/149) for Q2, 94.6%(141/149) for Q3, and 91.9%(137/149) for Q4. The overall satisfaction rate was 89.1%(122/137). Conclusions The RQI program for CPR training in the emergency department was effective in enabling participants to acquire and maintain core skills, with high levels of course compliance and satisfaction. RQI could be an alternative approach for CPR training among emergency clinicians and nurses.

Key words: Cardiopulmonary resuscitation, Emergency department, Basic life support, Resuscitation quality improvement

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