沉浸式情景模拟教学在医务人员感控能力提升中的效果观察

Observation on effect of immersive scenario simulation training on improving the competency of infection prevention for health-care workers

目的 分析沉浸式情景模拟教学在培训医务人员感控能力提升中的作用和效果。 方法 以浙江大学医学院附属邵逸夫医院沉浸式情景模拟教学培训的实施时间(2020年8月)为界限,将实施前(2019年8月入职)的352名新员工纳为对照组,采用理论培训+普通实践操作培训的岗前培训形式;将实施后(2020年8月入职)的298名新员工纳为观察组,采用理论培训+沉浸式情景模拟操作的岗前培训形式。比较两组新员工理论培训后及不同形式的实践培训后的医院感染相关知识掌握情况、感控措施执行情况[手卫生依从率、手卫生正确率、个人防护用品(personal protective equipment,PPE)正确选择率、PPE穿脱实践操作100%合格率、医疗废弃物处置合格率];比较两组新员工的培训效果(最终考核成绩)及培训满意度[明尼苏达满意度短式量表(Minnesota satisfaction questionnaire,MSQ)]。运用SPSS 22.0进行 t 检验和卡方检验。 结果 两组新员工经过理论+实践操作培训后,理论考核成绩较仅理论培训后提高,且观察组高于对照组( P <0.05);观察组新员工经沉浸式情景模拟教学培训后的感控措施执行情况较对照组改善,且观察组PPE选择正确率、PPE穿脱100%合格率高于对照组( P <0.05),而两组间手卫生正确率及医疗废弃物处置合格率比较差异无统计学意义( P >0.05);培训结束时,观察组新员工的最终考核成绩及满意度MSQ评分高于对照组( P <0.05)。 结论 沉浸式情景模拟教学培训干预有利于提高新员工医院感染知识的掌握度,规范其手卫生、PPE选择及使用等临床感控行为,获得了良好培训效果,有利于其感控能力的提升。

Objective To analyze the effect of immersive scenario simulation training on improving the competency of infection prevention for health-care workers(HCWs).Methods Taking the implementation time of immersive scenario simulation teaching training in Sir Run Run Shaw Hospital,Zhejiang University School of Medicine(August 2020)as the boundary,352 new HCWs entered the hospital before the training(August 2019)were included as control group taking traditional teaching method,and 298 new HCWs entered the hospital after the training(August 2020)were included as observation group taking immersive scenario simulation combined with theoretical training.The mastery status of nosocomial infection-related knowledge and the implementation status of infection control measures(hand hygiene compliance,hand hygiene accuracy,correct personal protective equipment(PPE)selection,100%of pass rate of PPE on and off,and qualified disposal of medical waste)were compared between the two groups of HCWs after theoretical teaching and different forms of practical training.The training effect(final assessment results)and training satisfaction(Minnesota satisfaction questionnaire,MSQ)of the two groups of HCWs were compared.SPSS 22.0 was used for t test and chi-square test.Results The assessment results of the two groups of new HCWs trained by theoretical lecturing and immersive scenario simulation training were significantly improved compared with those just received theoretical lecturing,and the results of observation group were significantly higher than those of control group(P<0.05).The implementation status of infection control measures after practical training were obviously improved in the two groups of HCWs compared to after theoretical lecturing,and the correct rates of PPE selection and all the procedure of donning and doffing PPE of observation group were significantly higher than those of control group(P<0.05),but there were no significant differences in the hand hygiene accuracy and qualified disposal of medical waste between the two groups(P>0.05).At the end of training,the final assessment results and satisfaction MSQ score of HCWs in observation group were significantly higher than those in control group(P<0.05).Conclusion Immersive scenario simulation teaching and training intervention is beneficial to improve the mastery of nosocomial infection knowledge of new HCWs,standardize their clinical infection control behaviors such as hand hygiene and aseptic operation,and finally obtain good training effect of infection prevention competency.