情景模拟实践演练对基层医院护士长心肺复苏能力的影响

陈彩凤　朱雪梅　陆茹茵

[摘要]目的 探讨情景模拟演练对基层医院护士长心肺复苏能力的影响。方法 选取2016年6～12月期间在我院培训的基层医院护士长共96名为研究对象，根据随机分配原则，与1名心内科医生共同组成立三人抢救小组（三人组），四人抢救小组（四人组），由心内科医生任组长，组员分别编号并分配不同的抢救职责。根据2015心肺复苏指南采用医护配合的方法，开展心肺复苏情景模拟演练，进行心肺复苏专业理论知识、胸外按压、人工呼吸、静脉通道建立等方面的培训，比较演练前后各观察指标的变化。结果 情景模拟演练前后基层医院护士长总心肺复苏时间，理论知识等的比较，差异均有统计学意义（P<0.05）；三人组以及四人组间比较，四人组成绩较三人组理想，但未见明显差异（P>0.05）。结论 规范化的情景模拟演练可有效提高基层医院护士长的心肺复苏综合能力和业务水平，有望提高基层抢救的成功率，可能值得在临床上推广。

[关键词]情景模拟演练；心跳呼吸骤停；心肺复苏

[中图分类号] R472.2 [文献标识码] A [文章编号] 1674-4721（2017）05（a）-0195-03

[Abstract]Objective To explore the efficacy of scene simulation exercises on the cardiopulmonary resuscitation in basic-hospital head nurses.Methods 96 basic-hospital head nurses were selected as the research objects who trained in our hospital from June 2016 to December 2016，the nurses were divided randomly into three-personsrescued group and four-personsrescued group，that groups also had a cardiologist，and the cardiologist in every group was the group leader；the nurses were the team menbers.The team menbers were numbered and distributed to different rescued responsibilities.Accordingto the 2015 cardiopulmonary resuscitation guidelines，The nurses were trained with theory knowledge of cardiopulmonary resuscitation、chest compressions、artificial respiration，establishing venous channel by scene simulation exercises，and analysized the changes of observation indexes before and after the train.Results After the scene simulation exercises train，there were significantly statistical difference （P<0.05） when comparing with the head nurse′s the total time of cardiopulmonary resuscitation，theoretical knowledge etc.when comparing between the three-personsrescuedgroup and four-personsrescued group，the four-personsrescued group′s scorewere well than the three-personsrescuedgroup′s score，but there were no significant difference between them（P>0.05）.Conclusion The standardized scene simulation exercises can effectively improve basic-level hospitals head nurse of cardiopulmonary resuscitation comprehensive ability andbusiness level，and it is expected to improve the success rate of the rescue in basic-hospital，it is worth for popularizing in clinic.

[Key words]Scene simulationexercises；Cardiopulmonary arrest；Cardiopulmonary resuscitation

心跳呼吸骤停是人类死亡的主要病因，由于其临床特点导致其成功率较低[1]。据统计，我国心跳呼吸骤停患者的抢救成功率总体约为3.0%[2]，现场及时的心肺复苏术对抢救患者的生命尤为重要，作为实施心肺复苏的医护人员具备良好的专业理论知识、灵活熟练的抢救技术、默契配合[3]等是心跳呼吸骤停抢救成功的关键因素。广大基层医院抢救心跳呼吸骤停的成功率低，而且护士整體的急救能力参差不齐，急救知识和技能掌握不全等均不利于目前医疗的发展以及严峻医患关系的改善。……