Objective To construct a simulation course of opioid-induced clinical crisis management for pain nurse in ward and evaluate its effects. Methods Following the best practice standards of International Nursing Association for Clinical Simulation and Learning,according to the five basic dimensions of scenario development,facilitator preparation,equipment preparation,environmental preparation and pre-course student preparation,a opioid-induced clinical crisis management simulation course was constructed. From November to December 2019,a group of 61 pain nurses in wards from a tertiary general hospital in Zhejiang Province were selected for training in the simulation teaching center of the Anesthesia-Operation Department of the hospital. The teaching evaluation was carried out by using the questionnaire of Critical Thinking Disposition Inventory and clinical decision-making self-confidence assessment of excessive sedation and respiratory depression caused by opioids. Results After training,the total score of critical thinking was （264.57± 2.77）. There were statistical differences before and after the training（P< 0.05）. After training,the clinical decision-making self-confidence of the trainees in the excessive sedation and respiratory depression caused by opioids was（3.89± 0.82） and（3.89± 0.80） respectively,which were statistically different compared with those before the training（P< 0.001）. Pain nurses in wards were highly satisfied with the simulation teaching course. Conclusion The simulation course can effectively improve the clinical crisis management ability and clinical decision-making confidence of pain nurses in wards,and can provide reference for the training of comprehensive emergency response ability of pain nurses.
RUAN Xiaofen
,
FENG Yan
,
YAN Min
,
HAN Xiaoxu
,
CHEN Jie
,
LÜ Bifang
,
YU Xiaoling
. Construction and application of simulation course of opioid-induced clinical crisis management for pain nurse in ward[J]. Chinese Journal of Emergency and Critical Care Nursing, 2022
, 3(5)
: 414
-419
.
DOI: 10.3761/j.issn.2096-7446.2022.05.005
[1] 张文斌,王敏,沈啸华,等. 临床危机管理虚拟仿真教学平台的构建与实践[J]. 中国高等医学教育,2018(8):41-42.
Zhang WB,Wang M,Shen XH,et al.Construction and practice of clinical crisis management virtual simulation teaching platform[J]. China High Med Educ,2018(8):41-42.
[2] Baker DW.History of the joint commission's pain standards:lessons for today's sprescription opioid epidemic[J]. JAMA,2017, 317(11):1117-1118.
[3] Hayes K,Gordon DB. Delivering quality pain management:the challenge for nurses[J]. AORN J,2015,101(3):328-334;quiz335-337.
[4] Kent ML,Hurley RW,Oderda GM,et al.American society for enhanced recovery and perioperative quality initiative-4 joint consensus statement on persistent postoperative opioid use:definition,incidence,risk factors,and health care system initiatives[J]. Anesth Analg,2019,129(2):543-552.
[5] Soffin EM,Lee BH,Kumar KK,et al.The prescription opioid crisis:role of the anaesthesiologist in reducing opioid use and misuse[J]. Br J Anaesth,2019,122(6):e198-e208.
[6] Ladak SS,McPhee C,Muscat M,et al. The journey of the pain resource nurse in improving pain management practices:understanding role implementation[J]. Pain Manag Nurs,2013,14(2):68-73.
[7] Gupta S,Mohta A,Gottumukkala V.Opioid-free anesthesia-caution for a one-size-fits-all approach[J]. Perioper Med (Lond),2020,9:16.
[8] Hsu LL,Chang WH,Hsieh SI.The effects of scenario-based simulation course training on nurses' communication competence and self-efficacy:a randomized controlled trial[J]. J Prof Nurs,2015,31(1):37-49.
[9] 方良玉,唐碧云,陈洁,等. 以病区疼痛护士为主体的疼痛管理实践[J]. 护理与康复,2018,17(1):79-83.
Fang LY,Tang BY,Chen J,et al.Pain management practice based on ward pain nurses[J]. Nurs Rehabil,2018,17(1):79-83.
[10] 方雅璇,李婷,杨冰香,等. 《国际护理临床模拟教学协会最佳实践标准:学员评价》解读[J]. 中华护理教育,2020,17(1):12-17.
Fang YX,Li T,Yang BX,et al.Interpretation of the INACSL standards of best practice:simulationSM participant evaluation[J]. Chin J Nurs Educ,2020,17(1):12-17.
[11] 康晓凤,郭爱敏,梁涛,等. 情景模拟教学课程资源核查表的构建[J]. 中华医学教育杂志,2018,38(1):40-45.
Kang XF,Guo AM,Liang T,et al.Development of resource checklist for nursing simulation-based training[J]. Chin J Med Educ,2018,38(1):40-45.
[12] 童莺歌,田素明. 疼痛护理学[M]. 杭州:浙江大学出版社,2017.
Tong YG,Tian SM.Pain management nursing[M]. Hangzhou:Zhejiang University Press,2017.
[13] 杨冰香,黄润,徐爱京,等. 模拟教学引导性反馈的标准和策略[J]. 中华护理教育,2020,17(1):18-23.
Yang BX,Huang R,Xu AJ,et al.Standards and strategies of debriefing in simulation[J]. Chin J Nurs Educ,2020,17(1):18-23.
[14] INACSL Standard Committee.INACSL standards of best prac-tice:SimulationSM debriefing[J]. Clin Simul Nurs,2016,12:S21-S25.
[15] 彭美慈,汪国成,陈基乐,等. 批判性思维能力测量表的信效度测试研究[J]. 中华护理杂志,2004,39(9):644-647.
Peng MC,Wang GC,Chen JL,et al.Validity and reliability of the Chinese critical thinking disposition inventory[J]. Chin J Nurs,2004,39(9):644-647.
[16] Crowe S,Ewart L,Derman S.The impact of simulation based education on nursing confidence,knowledge and patient outcomes on general medicine units[J]. Nurse Educ Pract,2018,29:70-75.
[17] 王明弘,权峰松,王利群. 评判性思维倾向对护理教学影响的研究[J]. 中国卫生事业管理,2016,33(4):300-302,319.
Wang MH,Quan FS,Wang LQ.Study of the influence of the critical thinking dispositions of the undergraduates on nursing teaching[J]. Chin Heal Serv Manag,2016,33(4):300-302,319.
[18] 凌陶,金瑞华,王金玄. 情境模拟教学法在护理本科生综合实训中的应用研究[J]. 中华护理教育,2018,15(9):655-660.
Ling T,Jin RH,Wang JX.Application of situational simulation in comprehensive training for nursing undergraduates[J]. Chin J Nurs Educ,2018,15(9):655-660.
[19] Weatherspoon DL,Phillips K,Wyatt TH.Effect of electronic interactive simulation on senior bachelor of science in nursing students' critical thinking and clinical judgment skills[J]. Clin Simul Nurs,2015,11(2):126-133.
[20] Akalin A,Sahin S.The impact of high-fidelity simulation on knowledge,critical thinking,and clinical decision-making for the management of pre-eclampsia[J]. Int J Gynaecol Obstet,2020,150(3):354-360.
