TEAM STEPPS在危重病危机管理教学中的应用

Application of Team STEPPS in Critical Disease Crisis Management Teaching

海军军事特色麻醉学科在海军官兵战伤救治、挽救伤员生命等方面做出大量贡献,是恢复和保存官兵战斗力的医疗重要组成部分。海军军事特色危重病患者由于伤情复杂,发生心搏骤停、急性器官衰竭的几率大,因此对抢救复苏、生命支持和综合管理水平要求更高,需要更强大的团队支持和有效协作。综合危机管理是当前危重病伤员突发紧急情况的抢救治疗核心,是提升麻醉医学生综合处置能力、临床应变能力和分析判断能力所必须具备的临床素质。基于美国医疗研究与质量局( The Agency for Healthcare Research and Quality,AHRQ)提出的“加强临床表现和医疗安全的团队策略与工具( TeamStrategies & Tools to Enhance Performance & Patient Safety,Team STEPPS)”,结合海军军事特色麻醉学学历教育的基本内容和教学大纲,初步探索了危重病伤员临床情景,以“基础生命支持”、“高级生命支持”和“复苏后治疗”三大板块对海军麻醉医学生团队进行实景模拟教学,培养不同阶段的有效团队合作、团队反应和团队处置等能力。

The Navy military characteristic anesthesia discipline has made a great contribution to rescuing the war wounds and saving lives of wounded officers and soldiers and thus is an important part of medical treatment to restore and preserve the combat effectiveness of officers and soldiers. Because of the complexity of the wounds and the high probability of cardiac arrest and acute organ failure,the military characteristic critically ill patients of the Navy require a higher level of rescue and resuscitation,life support and comprehensive management,and need stronger team support and more effective collaboration. As the core of rescue and treatment for critical patients in emergencies,comprehensive crisis management is the necessary clinical quality of anesthesiologists to improve the comprehensive disposal ability,clinical response ability and analytical judgment ability. Based on the Team Strate- gies & Tools to Enhance Performance & Patient Safety ( Team STEPPS) proposed by the Agency for Health Care Research and Quality ( AHRQ),according to the basic contents and syllabus of the education of naval military an- esthesiology,this paper preliminarily explored the clinical situation of the critically ill and wounded patients. Simu- lated in-situ teaching was carried out among naval anesthesiology student teams through three major modules, namely“basic life support”,“advanced life support”and“post-resuscitation therapy”,in order to foster their ca- pabilities of effective team cooperation,team reaction and team disposal in different stages.