评估麻醉护士在手术室中的非技术技能

摘要(中文译文)

手术室中的事件报告和实地调查显示，麻醉中出现的部分错误与非技术技能的运用不足有关。为了提供一种用于护士麻醉师非技术技能培训和反馈的工具，本研究旨在将麻醉师非技术技能（ANTS）改编为一种行为标记系统，用于手术室中护士麻醉师非技术技能的形成性评估。采用焦点小组访谈的定性方法，以识别手术室中护士麻醉师的非技术技能。访谈资料被逐字转录。采用定向内容分析，将资料演绎编码并归类至ANTS的类别中：任务管理、团队合作、情境意识和决策制定。将名为护士麻醉师非技术技能（N-ANTS）的原型呈现给一组主题专家进行讨论，以确保表面效度。N-ANTS系统包含与ANTS相同的四个类别和15个底层要素。每个要素确定了三至五个良好和不良行为标记。各类别和要素的标题及定义经过调整，以涵盖N-ANTS中的行为标记。所出现的差异主要反映在关于角色确立、胜任能力和任务委派的陈述中。一种针对护士麻醉师的行为标记系统N-ANTS，改编自针对麻醉医师的行为标记系统ANTS。

Abstract

Incident reporting and fieldwork in operating rooms have shown that some of the errors that arise in anaesthesia relate to inadequate use of non-technical skills. To provide a tool for training and feedback on nurse anaesthetists' non-technical skills, this study aimed to adapt the Anaesthetists' Non-Technical Skills (ANTS) as a behavioural marker system for the formative assessment of nurse anaesthetists' non-technical skills in the operating room. A qualitative approach with focus group interviews was used to identify the non-technical skills of nurse anaesthetists in the operating room. The interview data were transcribed verbatim. Directed content analysis was used to code and sort data deductively into the ANTS categories: task management, team working, situation awareness and decision making. The prototype named Nurse Anaesthetists' Non-Technical Skills (N-ANTS) was presented and discussed in a group of subject matter experts to ensure face validity. The N-ANTS system consists of the same four categories as ANTS and 15 underlying elements. Three to five good and poor behavioural markers for each element were identified. The headings and definitions of the categories and elements were adjusted to encompass the behavioural markers in N-ANTS. The differences that emerged mainly reflected statements regarding the establishment of role, competence, and task delegation. A behavioural marker system, N-ANTS, for nurse anaesthetists was adapted from a behavioural marker system, ANTS, for anaesthesiologists.

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