贵州省急危重症医生心肺复苏指南掌握情况及培训现状调查

Investigation on mastery and training status of cardiopulmonary resuscitation guidelines for emergency and intensive care doctors in Guizhou province

目的:对贵州省二、三级公立综合医院急危重症医生心肺复苏指南掌握及培训情况进行调查分析,为心肺复苏培训方式与考核办法提供改进建议,同时为贵州省心肺复苏临床大数据平台建设提供基础研究数据。方法:采用“问卷星”自行设计制作网上调查问卷及发放纸质问卷形式,对贵州省二、三级公立综合医院急诊、危重症科室进行调查,时间为2018-09-08—2018-11-04。结果:有效回收调查问卷429份,贵州省6个地级市、3个自治州均参与此次问卷调查,二、三级公立综合医院共计88家,其中二级医院有67家(76.1%),三级医院21家(23.9%)。二、三级医院被调查者对美国心脏病学会(AHA)2015版CPR指南中基础生命支持(BLS)培训率较高,分别为97.5%及98.6%,指南掌握情况相似,两级医院间差异无统计学意义(P>0.05)。对指南中高级生命支持(ALS)熟悉情况调查结果显示,二级医院被调查者对ALS掌握情况低于三级医院,两者间差异有统计学意义(P<0.01)。两级医院CPR培训多采取学术讲座、技能培训方式,且大多数被调查者参加了2种及2种以上方式的培训。结论:贵州省二、三级公立综合医院急危重症医生对AHA2015版CPR指南掌握情况不佳,尤其是对ALS的熟悉程度较差。建议医院在推行CPR培训及考核中,借鉴国内外先进培训方式,利用网络平台改革培训制度及考核办法,注重临床场景反应及处置能力培养,从而提高省内全体医护人员CPR实施及团队协作能力。

Objective:To investigate and analyze the grasp and training situation of cardiopulmonary resuscitation guidelines for emergency department and intensive care unit doctors in second and third level public general hospitals in Guizhou province,and to provide suggestions for improving training methods and assessment methods of cardiopulmonary resuscitation,as well as basic research data for the construction of clinical big data platform of cardiopulmonary resuscitation in Guizhou province.Method:By using the online questionnaire made by"questionnaire star"and paper questionnaire,the emergency department and intensive care unit doctors of the second and third level public general hospitals in Guizhou province were investigated from September 08,2018 to November 04,2018.Result:A total of 429 questionnaires were effectively recovered.Six prefecture-level cities and three autonomous prefectures in Guizhou province all participated in the questionnaire survey.There were 88 public general hospitals at the second and third level,among which 67(76.1%)were secondary level hospitals,21(23.9%)third level hospitals.The training rate of basic life support(BLS)in the American heart association(AHA)2015 CPR guidelines was higher in the second and third level hospitals,97.5%and 98.6%,respectively,with similar grasp situation,there was no significant difference between the two hospitals(P>0.05).The survey results of familiarity with advanced life support(ALS)in the guidelines showed that the knowledge of ALS in secondary level hospitals was lower than that in third level hospitals,and there was a significant difference between the two hospitals(P<0.01).The CPR training in two-level hospitals mostly adopted academic lectures and skill training methods,and most of the respondents participated in two or more methods of training.Conclusion:The emergency department and intensive care unit doctors in the second and third level public general hospitals in Guizhou province have poor mastery of the AHA 2015 CPR guidelines,especially the knowledge of ALS.It is suggested that in carrying out CPR training and assessment,hospitals should learn from advanced training at domestic and foreign approaches,reform the training system and assessment methods by using the network platform,pay attention to the training of clinical scene response and disposal ability,so as to improve the CPR implementation and team cooperation ability of all medical staff.