Application of multidisciplinary in situ simulation training in the treatment of acute ischemic stroke: a quality improvement project  

作　　者：Ganying Huang Huijie Yang Huan Yao Xinxin Fan Wenqin Xia Yuansheng Xu Xiaoling Shen Xue Zhao 

机构地区：[1]Fourth School of Clinical Medicine,Zhejiang Chinese Medical University,Hangzhou 310053,China [2]Emergency Medicine Departent,Hangzhou First People's Hospital,Hangzhou 310006,China

出　　处：《World Journal of Emergency Medicine》2024年第1期41-46,共6页世界急诊医学杂志（英文）

基　　金：supported by Hangzhou Construction Fund of Key Medical Disciplines(OO20200265);Zhejiang Medical and Health Science and Technology Plan Project(2020KY687);Hangzhou Science and Technology Development Project(20200401B04);Hangzhou Biomedical and Health Industry Development Supporting Technology Projects(2021WJCY256).

摘　　要：BACKGROUND:Ischemic stroke refers to a disorder in the blood supply to a local area of brain tissue for various reasons and is characterized by high morbidity,mortality,and disability.Early reperfusion of brain tissue at risk of injury is crucial for the treatment of acute ischemic stroke.The purpose of this study was to evaluate comfort levels in managing acute stroke patients with hypoxemia who required endotracheal intubation after multidisciplinary in situ simulation training and to shorten the door-to-image time.METHODS:This quality improvement project utilized a comprehensive multidisciplinary in situ simulation exercise.A total of 53 participants completed the two-day in situ simulation training.The main outcome was the self-reported comfort levels of participants in managing acute stroke patients with hypoxemia requiring endotracheal intubation before and after simulation training.A 5-point Likert scale was used to measure participant comfort.A paired-sample t-test was used to compare the mean self-reported comfort scores of participants,as well as the endotracheal intubation time and door-to-image time on the fi rst and second days of in situ simulation training.The door-to-image time before and after the training was also recorded.RESULTS:The findings indicated that in situ simulation training could enhance participant comfort when managing acute stroke patients with hypoxemia who required endotracheal intubation and shorten door-to-image time.For the emergency management of hypoxemia or tracheal intubation,the mean post-training self-reported comfort score was signifi cantly higher than the mean pre-training comfort score(hypoxemia:4.53±0.64 vs.3.62±0.69,t=-11.046,P<0.001;tracheal intubation:3.98±0.72 vs.3.43±0.72,t=-6.940,P<0.001).We also observed a decrease in the tracheal intubation and door-to-image time and a decreasing trend in the door-to-image time,which continued after the training.CONCLUSION:Our study demonstrates that the implementation of in situ simulation training in a clinical enviro

关 键 词：Ischemic stroke Endotracheal intubation Door-to-image time In situ simulation Multidisciplinary approach 

分 类 号：R743.3[医药卫生—神经病学与精神病学]