新入职医师心肺复苏质量的现状及影响因素分析  

Analysis of current situation and influencing factors of cardiopulmonary resuscitation quality in newly recruited physicians

作　　者：吴清玉 吴智鑫[1,2,3] 陈务民[4] 张琳[5] 马明远[2] 范文定 胡惠娟[2] 何明丰[6] 凌皓 蒋超群 吴曦 张娇娇 赵丹丹 WU Qingyu;WU Zhixin;CHEN Wumin;ZHANG Lin;MA Mingyuan;FAN Wending;HU Huijuan;HE Mingfeng;LING Hao;JIANG Chaoqun;WU Xi;ZHANG Jiaojiao;ZHAO Dandan(The Eighth Clinical Medical College of Guangzhou University of Chinese Medicine,Foshan Guangdong 528000,China)

机构地区：[1]广州中医药大学第八临床医学院,广东佛山528000 [2]佛山市中医院重症医学科,广东佛山528000 [3]佛山市中医院神经重症监护病房,广东佛山528000 [4]佛山市中医院医务科,广东佛山528000 [5]上海交通大学公共卫生学院,上海200025 [6]佛山市中医院院长办公室,广东佛山528000

出　　处：《中国急救复苏与灾害医学杂志》2023年第5期687-690,700,共5页China Journal of Emergency Resuscitation and Disaster Medicine

基　　金：国家自然科学基金资助项目(编号:72074144);佛山市科学技术局科技创新项目资助项目(编号:2015AG10001,2017AG100061);佛山市科技局医学攻关计划项目资助项目(编号:1920001001102);广东省医学科学技术研究基金项目资助项目(编号:A2023198)。

摘　　要：目的 探讨新入职医师心肺复苏(CPR)质量的现状及其影响因素。方法 2021年3月,在佛山市中医院国家医师资格考试中医类别实践技能考试基地使用Resusci Anne QCPR~?模拟人,参考2020年美国心脏协会心肺复苏及心血管急救指南标准对佛山市中医院105名新入职医师进行CPR质量考核,并使用Wireless Skill Reporter~?软件收集数据。结果(1)参与考核的新入职医师共105名,CPR考核合格率仅为61.9%。(2)不同性别、专业方向、学位、毕业院校、工作经验、住院医师规范化培训证书类型、接受CPR的培训类型在新入职医师之间的CPR合格率差异无统计学差异(P>0.05)。(3)多因素Logistic回归分析结果显示:是否参加过CPR培训和完成住院医师规范化培训是影响CPR质量的独立因素。参加过CPR培训的新入职医师,其CPR考核的合格率是未参加过培训的59.192倍(OR=59.192, 95%CI:10.854~322.107);完成住院医师规范化培训的新入职医师,其CPR考核的合格率是未完成住院医师规范化培训医师的23.224倍(OR=23.224, 95%CI:4.455~121.07),差异有统计学意义(P<0.001)。不同年龄、性别、工作经验的新入职医师之间CPR质量差异无统计学意义(P>0.05)。结论 综上所述,新入职医师的CPR考核合格率低(61.9%),主要存在按压深度不够,按压频率太快,胸廓回弹不够充分,按压中断时间过长,有效通气量不足等问题,CPR质量需要进一步提高。新入职医师无论性别、年龄、资历、专业方向、学位、毕业院校、住院医师规范化培训证书类型、接受的CPR培训类型,均需要加强CPR培训。医院需加强新入职医师的CPR培训,定期复训,提高其CPR质量。Objective To explore the current situation and influencing factors of cardiopulmonary resuscitation quality in new physicians.Methods In March 2021,a total of 105 newly-employed physicians participated the CPR skills test according to the 2020 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations in Foshan Hospital of Traditional Chinese Medicine National Medical Licensing Examination(Chinese Medicine)Clinical Skills Testing Base.The Resusci Anne QCPR®Simulator was used to assess the CPR quality while the Wireless Skill Reporter®software was implemented to collect data.Results①A total of 105 newly hired physicians participated in the assessment,with a CPR assessment pass rate of only 61.9%.②There was no statistical difference in the qualified rate of CPR among new physicians in terms of gender,professional direction,degree,graduate college,work experience,the type of standardized training certificate for physicians and the type of CPR training(P>0.05).③The results of multivariate logistic regression analysis showed that the CPR training and the standardized residency training were independent factors associated with the quality of CPR.The qualification rate of CPR assessment for new physicians who have participated in CPR training is 59.192 times that of those who have not participated in the training(OR=59.192,95%CI:10.854~322.107);The qualification rate of CPR assessment for new physicians who completed the standardized training for physicians was 23.224 times that of new physicians who did not complete the standardized training for physicians(OR=23.224,95%CI:4.455~121.07),with a statistically significant difference(P<0.001).There was no statistical difference in CPR quality among new physicians with different age,sex and work experience.Conclusion The qualified rate of CPR assessment of new physicians is low(61.9%),and the quality of CPR needs to be further improved.The mainly problems are as follows:insufficient compression de

关 键 词：新入职医师 心肺复苏质量 心肺复苏 CPR考核 

分 类 号：R459.7[医药卫生—急诊医学]