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.	陳麗娜, 劉寶寶. 高原地區慢性阻塞性肺疾病患者肺動脈高壓的相關危險因素. 公共衛生與預防醫學, 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.	莊麗玲, 林玉燕, 莊陸香, 等. MEWS 評分在早期識別潛在危重癥患者中的價值. 中國衛生標準管理, 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, 韓存巧, 何亞榮, 等. 四川省基層醫院急診醫務人員培訓現狀調查與需求分析. 中華醫學教育探索雜志, 2019, 18(1): 101-106.
7.	公保才旦. 高原災難醫療救援的思考//中華醫學會急診醫學分會. 中華醫學會急診醫學分會第十六次全國急診醫學學術年會論文集. 成都: 中華醫學會急診醫學分會, 2013: 39-39.
8.	蔣琳. 華山醫院急診內科就診者疾病譜和就醫行為研究. 上海: 復旦大學, 2009.
9.	旺加. 西藏拉薩地區 410 例兩大節日期間急診內科病人病種回顧性統計分析. 西藏科技, 2010(12): 44-45.
10.	歐珠羅布, 央宗, 次仁, 等. 2014-2018 年西藏某三級醫院內科住院患者疾病譜分析. 現代預防醫學, 2020, 47(8): 1519-1523.
11.	左國平, 李紅霞, 馮碧剛, 等. 九寨溝景區急診病例疾病譜調查. 中國醫藥導報, 2015, 12(4): 133-136.
12.	楊生岳, 馮恩志, 祁玉曙, 等. 高原慢性肺源性心臟病血清酶活性與病情及預后的關系. 西北國防醫學雜志, 2000, 21(3): 170-172.
13.	楊生岳, 馮恩志, 閆自強, 等. 高原地區慢性阻塞性肺疾病合并阻塞性睡眠呼吸暫停低通氣綜合征患者的隨訪結果分析. 中華肺部疾病雜志(電子版), 2012, 5(1): 4-10.
14.	楊生岳, 馮恩志, 祁玉曙, 等. 呼吸指數判斷高原慢性肺源性心臟病急性加重期呼吸衰竭程度及預后的意義. 西北國防醫學雜志, 2001, 22(1): 21-23.
15.	劉海平, 鄒家華. 成立急診胸痛中心對急性 ST 段抬高型心肌梗死患者搶救效果的影響. 醫療裝備, 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, 鄭慧凌, 張娜娜, 等. 醫院級別對衛技人力資源配置均衡程度影響研究. 現代醫院管理, 2019, 17(4): 1-5.
19.	劉莉, 劉名鑫, 牛世慧, 等. 膿毒癥并發急性腎損傷患者腎功能衰竭的影響因素. 中華醫院感染學雜志, 2021, 31(20): 3078-3081.
20.	李康, 陳淼, 梅鴻, 等. T 細胞和 Treg 細胞表面 PD-1 水平與膿毒癥患者感染程度及近期預后的關系. 中華醫院感染學雜志, 2021, 31(20): 3046-3050.
21.	張燕茹. 三級綜合性醫院急診科護士膿毒癥指南認知調查與干預研究. 福州: 福建醫科大學, 2023.
22.	石煥玲. 縣級醫院 ICU 護士對“拯救膿毒癥戰役早期復蘇指南”認知現狀的調查研究. 青島: 青島大學, 2015.
23.	陳靜, 劉毅. 院前急救人員培訓現狀調查及優化培訓方式的研究. 西南國防醫藥, 2019, 29(12): 1203-1205.
24.	周其全, 羅榮, 羅勇軍, 等. 高原醫學通用人才培養模式與培養方法的改革與實踐. 西北醫學教育, 2014(2): 227-229, 247.
25.	劉志偉, 莊明, 仇胥斌, 等. 講授法組合討論法在骨科實習生教學中的應用. 臨床醫藥文獻電子雜志, 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.	于飛飛, 陳林靜. 多種教學方法在手術室臨床護理帶教中的聯合應用. 齊魯護理雜志, 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.	曾姍姍, 占瑋, 顏文貞. 大學生院前急救培訓方式的研究進展. 護理學報, 2018, 25(10): 32-35.
30.	李春河, 紀曉棟, 方俊鋒, 等. 桌面推演式教學在急診臨床教學中的應用. 中國中醫藥現代遠程教育, 2019, 17(24): 14-16.

1. 陳麗娜, 劉寶寶. 高原地區慢性阻塞性肺疾病患者肺動脈高壓的相關危險因素. 公共衛生與預防醫學, 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. 莊麗玲, 林玉燕, 莊陸香, 等. MEWS 評分在早期識別潛在危重癥患者中的價值. 中國衛生標準管理, 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, 韓存巧, 何亞榮, 等. 四川省基層醫院急診醫務人員培訓現狀調查與需求分析. 中華醫學教育探索雜志, 2019, 18(1): 101-106.
7. 公保才旦. 高原災難醫療救援的思考//中華醫學會急診醫學分會. 中華醫學會急診醫學分會第十六次全國急診醫學學術年會論文集. 成都: 中華醫學會急診醫學分會, 2013: 39-39.
8. 蔣琳. 華山醫院急診內科就診者疾病譜和就醫行為研究. 上海: 復旦大學, 2009.
9. 旺加. 西藏拉薩地區 410 例兩大節日期間急診內科病人病種回顧性統計分析. 西藏科技, 2010(12): 44-45.
10. 歐珠羅布, 央宗, 次仁, 等. 2014-2018 年西藏某三級醫院內科住院患者疾病譜分析. 現代預防醫學, 2020, 47(8): 1519-1523.
11. 左國平, 李紅霞, 馮碧剛, 等. 九寨溝景區急診病例疾病譜調查. 中國醫藥導報, 2015, 12(4): 133-136.
12. 楊生岳, 馮恩志, 祁玉曙, 等. 高原慢性肺源性心臟病血清酶活性與病情及預后的關系. 西北國防醫學雜志, 2000, 21(3): 170-172.
13. 楊生岳, 馮恩志, 閆自強, 等. 高原地區慢性阻塞性肺疾病合并阻塞性睡眠呼吸暫停低通氣綜合征患者的隨訪結果分析. 中華肺部疾病雜志(電子版), 2012, 5(1): 4-10.
14. 楊生岳, 馮恩志, 祁玉曙, 等. 呼吸指數判斷高原慢性肺源性心臟病急性加重期呼吸衰竭程度及預后的意義. 西北國防醫學雜志, 2001, 22(1): 21-23.
15. 劉海平, 鄒家華. 成立急診胸痛中心對急性 ST 段抬高型心肌梗死患者搶救效果的影響. 醫療裝備, 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, 鄭慧凌, 張娜娜, 等. 醫院級別對衛技人力資源配置均衡程度影響研究. 現代醫院管理, 2019, 17(4): 1-5.
19. 劉莉, 劉名鑫, 牛世慧, 等. 膿毒癥并發急性腎損傷患者腎功能衰竭的影響因素. 中華醫院感染學雜志, 2021, 31(20): 3078-3081.
20. 李康, 陳淼, 梅鴻, 等. T 細胞和 Treg 細胞表面 PD-1 水平與膿毒癥患者感染程度及近期預后的關系. 中華醫院感染學雜志, 2021, 31(20): 3046-3050.
21. 張燕茹. 三級綜合性醫院急診科護士膿毒癥指南認知調查與干預研究. 福州: 福建醫科大學, 2023.
22. 石煥玲. 縣級醫院 ICU 護士對“拯救膿毒癥戰役早期復蘇指南”認知現狀的調查研究. 青島: 青島大學, 2015.
23. 陳靜, 劉毅. 院前急救人員培訓現狀調查及優化培訓方式的研究. 西南國防醫藥, 2019, 29(12): 1203-1205.
24. 周其全, 羅榮, 羅勇軍, 等. 高原醫學通用人才培養模式與培養方法的改革與實踐. 西北醫學教育, 2014(2): 227-229, 247.
25. 劉志偉, 莊明, 仇胥斌, 等. 講授法組合討論法在骨科實習生教學中的應用. 臨床醫藥文獻電子雜志, 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. 于飛飛, 陳林靜. 多種教學方法在手術室臨床護理帶教中的聯合應用. 齊魯護理雜志, 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. 曾姍姍, 占瑋, 顏文貞. 大學生院前急救培訓方式的研究進展. 護理學報, 2018, 25(10): 32-35.
30. 李春河, 紀曉棟, 方俊鋒, 等. 桌面推演式教學在急診臨床教學中的應用. 中國中醫藥現代遠程教育, 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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