Current situation and demand analysis of emergency and critical care training for medical staff in different levels of hospitals in plateau areas_West China Medical Journal

Authors：

HE Yarong ^1,2 , LUO Dan ^1,2 , TANG Songling ^1,2 , YAO Peng ^1,2 , MA Wen ^1,2 , ZHOU Tingyuan ^1,2 , ZENG Lihui ³ , YU Haifang ^1,2 ,  CAO Yu ^1,2

1. Department of Emergency Medicine and Laboratory of Emergency Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Disaster Medical Center, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
3. Department of Outpatient, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

CAO Yu, Email: yuyuer@126.com

Keywords：

Plateau areas; critical emergency; training; demand

DOI：

10.7507/1002-0179.202211069

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Objective To analyze the current situation and demand of emergency and critical care training for medical staff in plateau areas, and to provide a reference for further emergency and critical care training for medical staff in plateau areas. Methods From July 1, 2018 to July 30, 2020, medical staff (including physicians, nursing staff, and other medical staff) from hospitals in various regions of Tibet were surveyed anonymously, to investigate the content and demand of medical staff in plateau areas receiving emergency and critical care training. The content and demand of medical staff from different levels of hospitals receiving emergency and critical care training were further compared. Results A total of 45 questionnaires were distributed in this study, and a total of 43 valid questionnaires were collected, with an effective response rate of 95.6%. The average age of medical staff was (35.67±9.17) years old, with a male to female ratio of 1∶1.5. The proportion of tertiary, secondary, and lower level hospitals to which medical staff belong were 23.3%, 27.9%, and 48.8%, respectively. The number and proportion of medical staff receiving training on chest pain, heart failure, stroke, gastrointestinal bleeding, respiratory failure, metabolic crisis, and sepsis diseases were 25 (58.1%), 25 (58.1%), 24 (55.8%), 23 (53.5%), 20 (46.5%), 14 (32.6%), and 12 (27.9%), respectively. The number and proportion of medical staff who believed that training in the heart failure, respiratory failure, metabolic diseases, stroke, gastrointestinal bleeding, chest pain, and sepsis needed to be strengthened were 38 (88.4%), 36 (83.7%), 35 (81.4%), 34 (79.1%), 34 (79.1%), 33 (76.7%), and 29 (67.4%), respectively. Thirteen medical staff (30.2%) hoped to acquire knowledge and skills through teaching. There were no statistically significant differences in gender, age, job type, professional title, and department type among medical staff from tertiary, secondary, and lower level hospitals participating in the survey (P>0.05). The proportion of medical staff in hospitals below secondary receiving training on chest pain was lower than that in second level hospitals (38.1% vs. 91.7%). The proportion of medical staff in hospitals below secondary receiving training on heart failure was lower than that in secondary and tertiary hospitals (38.1% vs. 75.0% vs. 80.0%). The proportion of medical staff in hospitals below secondary receiving training on respiratory failure was lower than that in tertiary hospitals (28.6% vs. 80.0%). The demand for sepsis training among medical staff in hospitals below secondary was higher than that in tertiary hospitals (85.7% vs. 30.0%). There was no statistically significant difference in the other training contents and demands (P>0.05). Conclusion The content of critical care training for medical staff in plateau areas cannot meet their demands, especially for medical staff in hospitals below secondary. In the future, it is necessary to strengthen training support, allocate advantageous resources to different levels of hospitals, expand the scope of training coverage, and enrich training methods to better improve the ability of medical personnel in plateau areas to diagnose and treat related diseases.

Citation： HE Yarong, LUO Dan, TANG Songling, YAO Peng, MA Wen, ZHOU Tingyuan, ZENG Lihui, YU Haifang, CAO Yu. Current situation and demand analysis of emergency and critical care training for medical staff in different levels of hospitals in plateau areas. West China Medical Journal, 2023, 38(12): 1902-1907. doi: 10.7507/1002-0179.202211069 Copy

1.	陈丽娜, 刘宝宝. 高原地区慢性阻塞性肺疾病患者肺动脉高压的相关危险因素. 公共卫生与预防医学, 2021, 32(5): 134-137.
2.	Garrido E, Botella de Maglia J, et al. Acute, subacute and chronic mountain sickness. Rev Clin Esp (Barc), 2021, 221(8): 481-490.
3.	Zhu W, Wei X, Zhang L, et al. The effect and prediction of diurnal temperature range in high altitude area on outpatient and emergency room admissions for cardiovascular diseases. Int Arch Occup Environ Health, 2021, 94(8): 1783-1795.
4.	庄丽玲, 林玉燕, 庄陆香, 等. MEWS 评分在早期识别潜在危重症患者中的价值. 中国卫生标准管理, 2021, 12(3): 164-166.
5.	Zhou Q, Yang S, Fan Y. The relationship between different time mean pulmonary artery pressure and cell factor leels about highland aseismatic officers and men who returned lowland areas//International Heart Forum. Abstracts of International Heart Forum. Beijing: International Heart Forum, 2011, 120: 38-39.
6.	江朋, 韩存巧, 何亚荣, 等. 四川省基层医院急诊医务人员培训现状调查与需求分析. 中华医学教育探索杂志, 2019, 18(1): 101-106.
7.	公保才旦. 高原灾难医疗救援的思考//中华医学会急诊医学分会. 中华医学会急诊医学分会第十六次全国急诊医学学术年会论文集. 成都: 中华医学会急诊医学分会, 2013: 39-39.
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9.	旺加. 西藏拉萨地区 410 例两大节日期间急诊内科病人病种回顾性统计分析. 西藏科技, 2010(12): 44-45.
10.	欧珠罗布, 央宗, 次仁, 等. 2014-2018 年西藏某三级医院内科住院患者疾病谱分析. 现代预防医学, 2020, 47(8): 1519-1523.
11.	左国平, 李红霞, 冯碧刚, 等. 九寨沟景区急诊病例疾病谱调查. 中国医药导报, 2015, 12(4): 133-136.
12.	杨生岳, 冯恩志, 祁玉曙, 等. 高原慢性肺源性心脏病血清酶活性与病情及预后的关系. 西北国防医学杂志, 2000, 21(3): 170-172.
13.	杨生岳, 冯恩志, 闫自强, 等. 高原地区慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征患者的随访结果分析. 中华肺部疾病杂志(电子版), 2012, 5(1): 4-10.
14.	杨生岳, 冯恩志, 祁玉曙, 等. 呼吸指数判断高原慢性肺源性心脏病急性加重期呼吸衰竭程度及预后的意义. 西北国防医学杂志, 2001, 22(1): 21-23.
15.	刘海平, 邹家华. 成立急诊胸痛中心对急性 ST 段抬高型心肌梗死患者抢救效果的影响. 医疗装备, 2019, 32(24): 81-82.
16.	Fan F, Li Y, Zhang Y, et al. Chest pain center accreditation is associated with improved in-hospital outcomes of acute myocardial infarction patients in china: findings from the CCC-ACS project. J Am Heart Assoc, 2019, 8(21): e013384.
17.	Chao BH, Yan F, Hua Y, et al. Stroke prevention and control system in China: CSPPC-stroke program. Int J Stroke, 2021, 16(3): 265-272.
18.	高山, 郑慧凌, 张娜娜, 等. 医院级别对卫技人力资源配置均衡程度影响研究. 现代医院管理, 2019, 17(4): 1-5.
19.	刘莉, 刘名鑫, 牛世慧, 等. 脓毒症并发急性肾损伤患者肾功能衰竭的影响因素. 中华医院感染学杂志, 2021, 31(20): 3078-3081.
20.	李康, 陈淼, 梅鸿, 等. T 细胞和 Treg 细胞表面 PD-1 水平与脓毒症患者感染程度及近期预后的关系. 中华医院感染学杂志, 2021, 31(20): 3046-3050.
21.	张燕茹. 三级综合性医院急诊科护士脓毒症指南认知调查与干预研究. 福州: 福建医科大学, 2023.
22.	石焕玲. 县级医院 ICU 护士对“拯救脓毒症战役早期复苏指南”认知现状的调查研究. 青岛: 青岛大学, 2015.
23.	陈静, 刘毅. 院前急救人员培训现状调查及优化培训方式的研究. 西南国防医药, 2019, 29(12): 1203-1205.
24.	周其全, 罗荣, 罗勇军, 等. 高原医学通用人才培养模式与培养方法的改革与实践. 西北医学教育, 2014(2): 227-229, 247.
25.	刘志伟, 庄明, 仇胥斌, 等. 讲授法组合讨论法在骨科实习生教学中的应用. 临床医药文献电子杂志, 2019, 6(1): 179-180.
26.	Devi B, Khandelwal B, Das M. Comparison of the effectiveness of video-assisted teaching program and traditional demonstration on nursing students learning skills of performing obstetrical palpation. Iran J Nurs Midwifery Res, 2019, 24(2): 118-123.
27.	于飞飞, 陈林静. 多种教学方法在手术室临床护理带教中的联合应用. 齐鲁护理杂志, 2012, 18(6): 105-106.
28.	Bai Y, Huang F, Wang Q, et al. Development of practical teaching model based on intelligent comprehensive nursing practice platform. Stud Health Technol Inform, 2018, 250: 240.
29.	曾姗姗, 占玮, 颜文贞. 大学生院前急救培训方式的研究进展. 护理学报, 2018, 25(10): 32-35.
30.	李春河, 纪晓栋, 方俊锋, 等. 桌面推演式教学在急诊临床教学中的应用. 中国中医药现代远程教育, 2019, 17(24): 14-16.

1. 陈丽娜, 刘宝宝. 高原地区慢性阻塞性肺疾病患者肺动脉高压的相关危险因素. 公共卫生与预防医学, 2021, 32(5): 134-137.
2. Garrido E, Botella de Maglia J, et al. Acute, subacute and chronic mountain sickness. Rev Clin Esp (Barc), 2021, 221(8): 481-490.
3. Zhu W, Wei X, Zhang L, et al. The effect and prediction of diurnal temperature range in high altitude area on outpatient and emergency room admissions for cardiovascular diseases. Int Arch Occup Environ Health, 2021, 94(8): 1783-1795.
4. 庄丽玲, 林玉燕, 庄陆香, 等. MEWS 评分在早期识别潜在危重症患者中的价值. 中国卫生标准管理, 2021, 12(3): 164-166.
5. Zhou Q, Yang S, Fan Y. The relationship between different time mean pulmonary artery pressure and cell factor leels about highland aseismatic officers and men who returned lowland areas//International Heart Forum. Abstracts of International Heart Forum. Beijing: International Heart Forum, 2011, 120: 38-39.
6. 江朋, 韩存巧, 何亚荣, 等. 四川省基层医院急诊医务人员培训现状调查与需求分析. 中华医学教育探索杂志, 2019, 18(1): 101-106.
7. 公保才旦. 高原灾难医疗救援的思考//中华医学会急诊医学分会. 中华医学会急诊医学分会第十六次全国急诊医学学术年会论文集. 成都: 中华医学会急诊医学分会, 2013: 39-39.
8. 蒋琳. 华山医院急诊内科就诊者疾病谱和就医行为研究. 上海: 复旦大学, 2009.
9. 旺加. 西藏拉萨地区 410 例两大节日期间急诊内科病人病种回顾性统计分析. 西藏科技, 2010(12): 44-45.
10. 欧珠罗布, 央宗, 次仁, 等. 2014-2018 年西藏某三级医院内科住院患者疾病谱分析. 现代预防医学, 2020, 47(8): 1519-1523.
11. 左国平, 李红霞, 冯碧刚, 等. 九寨沟景区急诊病例疾病谱调查. 中国医药导报, 2015, 12(4): 133-136.
12. 杨生岳, 冯恩志, 祁玉曙, 等. 高原慢性肺源性心脏病血清酶活性与病情及预后的关系. 西北国防医学杂志, 2000, 21(3): 170-172.
13. 杨生岳, 冯恩志, 闫自强, 等. 高原地区慢性阻塞性肺疾病合并阻塞性睡眠呼吸暂停低通气综合征患者的随访结果分析. 中华肺部疾病杂志(电子版), 2012, 5(1): 4-10.
14. 杨生岳, 冯恩志, 祁玉曙, 等. 呼吸指数判断高原慢性肺源性心脏病急性加重期呼吸衰竭程度及预后的意义. 西北国防医学杂志, 2001, 22(1): 21-23.
15. 刘海平, 邹家华. 成立急诊胸痛中心对急性 ST 段抬高型心肌梗死患者抢救效果的影响. 医疗装备, 2019, 32(24): 81-82.
16. Fan F, Li Y, Zhang Y, et al. Chest pain center accreditation is associated with improved in-hospital outcomes of acute myocardial infarction patients in china: findings from the CCC-ACS project. J Am Heart Assoc, 2019, 8(21): e013384.
17. Chao BH, Yan F, Hua Y, et al. Stroke prevention and control system in China: CSPPC-stroke program. Int J Stroke, 2021, 16(3): 265-272.
18. 高山, 郑慧凌, 张娜娜, 等. 医院级别对卫技人力资源配置均衡程度影响研究. 现代医院管理, 2019, 17(4): 1-5.
19. 刘莉, 刘名鑫, 牛世慧, 等. 脓毒症并发急性肾损伤患者肾功能衰竭的影响因素. 中华医院感染学杂志, 2021, 31(20): 3078-3081.
20. 李康, 陈淼, 梅鸿, 等. T 细胞和 Treg 细胞表面 PD-1 水平与脓毒症患者感染程度及近期预后的关系. 中华医院感染学杂志, 2021, 31(20): 3046-3050.
21. 张燕茹. 三级综合性医院急诊科护士脓毒症指南认知调查与干预研究. 福州: 福建医科大学, 2023.
22. 石焕玲. 县级医院 ICU 护士对“拯救脓毒症战役早期复苏指南”认知现状的调查研究. 青岛: 青岛大学, 2015.
23. 陈静, 刘毅. 院前急救人员培训现状调查及优化培训方式的研究. 西南国防医药, 2019, 29(12): 1203-1205.
24. 周其全, 罗荣, 罗勇军, 等. 高原医学通用人才培养模式与培养方法的改革与实践. 西北医学教育, 2014(2): 227-229, 247.
25. 刘志伟, 庄明, 仇胥斌, 等. 讲授法组合讨论法在骨科实习生教学中的应用. 临床医药文献电子杂志, 2019, 6(1): 179-180.
26. Devi B, Khandelwal B, Das M. Comparison of the effectiveness of video-assisted teaching program and traditional demonstration on nursing students learning skills of performing obstetrical palpation. Iran J Nurs Midwifery Res, 2019, 24(2): 118-123.
27. 于飞飞, 陈林静. 多种教学方法在手术室临床护理带教中的联合应用. 齐鲁护理杂志, 2012, 18(6): 105-106.
28. Bai Y, Huang F, Wang Q, et al. Development of practical teaching model based on intelligent comprehensive nursing practice platform. Stud Health Technol Inform, 2018, 250: 240.
29. 曾姗姗, 占玮, 颜文贞. 大学生院前急救培训方式的研究进展. 护理学报, 2018, 25(10): 32-35.
30. 李春河, 纪晓栋, 方俊锋, 等. 桌面推演式教学在急诊临床教学中的应用. 中国中医药现代远程教育, 2019, 17(24): 14-16.

West China Medical Journal

Current situation and demand analysis of emergency and critical care training for medical staff in different levels of hospitals in plateau areas

Abstract Full text Figures/Tables Video References Cited by

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