Pediatrik Yanık Yoğun Bakım Ünitesi Klinik Vizitleri Sırasında Çocuk Cerrahisi Asistanlarının Vizit Yönetim Becerileri

Yıl 2022, Cilt: 21 Sayı: 63, 54 - 68, 30.04.2022

Nazmiye Celik , Sevgi Turan

https://doi.org/10.25282/ted.969954

Öz

Amaç: Klinik vizitler, hastane ortamında bütün sağlık profesyonellerinin günlük gerçekleştirmesi beklenen merkezi bir faaliyetttir. Bu çalışmada, Çocuk Yanık Yoğun Bakım Ünitesi klinik vizitleri sırasında çocuk cerrahisi asistanlarının vizit yönetim becerilerinin değerlendirlmesi amaçlanmıştır.
Yöntem: Kesitsel olarak tasarlanan bu araştırmada gözlem yöntemi kullanılmıştır. Araştırmanın çalışma grubunu, araştırmanın yürütüldüğü merkezin çocuk cerrahisi bölümünde görev yapan 8 çocuk cerrahisi asistanı oluşturmuştur. Araştırmaya katılan her çocuk cerrahisi asistanı için iki yatak başı klinik gözlemi yapılmıştır. Çocuk cerrahisi asistanlarının vizit yönetim becerilerini değerlendirmek için 43 klinik vizitte, 114 yatak başı hasta vizitine ilişkin gözlem yapılmıştır. Verilerin değerlendirilmesinde sayı, yüzdelik, ortalama ve Mann Whitney U testi kullanılmıştır.
Bulgular: Her iki gözlemde asistanların teknik olmayan vizit yönetim becerileri ortalamaları teknik vizit becerileri ortalamalarından düşük olduğu tespit edilmiştir. Birinci gözlem sonunda asistanların doktor ve çocuk cerrahı deneyim sürelerine göre fark olmamakla birlikte ikinci gözlem sonucunda asistanların teknik olmayan vizit yönetim becerilerinin puan ortalamasında fark (p=0,044) görülmüştür.
Sonuç: Çocuk cerrahisi asistanlarının teknik vizit yönetim becerilerilerinin teknik olmayan vizit yönetim becerilerinden yüksek olduğunu görülmüştür. İkinci gözlem sonuçlarına göre çocuk cerrahisi asistanların deneyim ve düzeylerine göre teknik olmayan vizit yönetim becerilerinin farklılık gösterdiği bulunmuştur.

Anahtar Kelimeler

Klinik Vizit, Klinik Vizit Becerileri, Teknik Olmayan Beceriler, Çocuk Yanık

Teşekkür

Araştırmanın gerçekleşmesine katkı sağlayan çocuk cerrahisi asistanlarına teşekkür ederiz. Araştırmanın yürütülmesinde destek veren Prof. Dr. Emrah Şenel’e teşekkür ederiz. Veri toplama araçlarının hazırlanmasında ve araştırmanın istatistiksel analizlerinin yapılmasında katkı sağlayan olan Dr. Öğr. Üyesi Gülşen Taşdelen Teker’e teşekkür ederiz.

Ward Round Management Skills of Pediatric Surgery Residents During Pediatric Burn Intensive Care Unit Rounds

Öz

Aim: Ward rounds are a central activity that all healthcare professionals are expected to perform daily in the hospital. In this study, it was aimed to evaluate the ward round management skills of pediatric surgery residents during their Pediatric Burn Intensive Care Unit ward rounds.
Methods: In this cross-sectional study, the observation method was used. The study group of the research consisted of 8 pediatric surgery residents working in the pediatric surgery department of the center where the research was conducted. Two bedside clinical observations were made for each pediatric surgery resident participating in the study. In order to assess the ward round management skills of pediatric surgery residents, observations of 114 bedside patient rounds were made in 43 rounds. Number, percentage, mean and Mann Whitney U test were used to evaluate the data.
Results: In both observations, it was determined that the averages of non-technical ward round management skills of the residents were lower than the averages of technical ward round skills. At the end of the first observation, there was no difference in terms of the experience period of the physicians and pediatric surgeons of the residents, but at the end of the second observation, there was a difference (p=0.044) in the mean score of the non-technical ward round management skills of the residents.
Conclusions: It was observed that the technical ward round management skills of pediatric surgery residents were higher than the non-technical ward round management skills. According to the results of the second observation, non-technical ward round management were found to differ according to the experience and level of pediatric surgery residents.

Anahtar Kelimeler

Ward Round, Ward Round Skills, Non-Technical Skills, Pediatric Burn

Kaynakça

• Referans1 Krautter M, Koehl-Hackert N, Nagelmann L, Jünger J, Norcini J, Tekian AÜ, Nikendei C. Improving ward round skills. Medical teacher.2014. 36(9); 783–788.
• Referans2 Nikendei C, Huhn D, Pittius G, Trost Y, Bugaj TJ, Koechel A, Schultz, JH. Students' Perceptions on an Interprofessional Ward Round Training–A Qualitative Pilot Study. GMS journal for medical Education. 2016, 33(2).
• Referans3 O'Hare JA. Anatomy of the ward round. European journal of internal medicine. 2008; 19(5):309–313.
• Referans4 Pucher PH, Aggarwal R, Singh P, Srisatkunam T, Twaij A, Darzi, A. Ward simulation to improve surgical ward round performance: a randomized controlled trial of a simulation-based curriculum. Annals of surgery. 2014, 260(2);236–243.
• Referans5 Murray K, McKenzie K, Kelleher M. The evaluation of a framework for measuring the non-technical ward round skills of final year nursing students: An observational study. Nurse education today. 2016,45; 87–90.
• Referans6 PH, Aggarwal R, Singh P, Srisatkunam T, Twaij, A, Darzi, A. Ward simulation to improve surgical ward round performance: a randomized controlled trial of a simulation-based curriculum. Annals of surgery. 2014,260(2);236–243.
• Referans7 M, Klein E, Hapfelmeier A, Wuensch A, Berberat PO, Gartmeier M. Improving physicians' surgical ward round competence through simulation-based training. Patient education and counseling. 2020, 103(5),971–977.
• Referans8 Behrens C, Dolmans DH, Leppink J, Gormley GJ, Driessen, EW. Ward round simulation in final year medical students: Does it promote students learning? Medical teacher. 2018, 40(2); 199–204.
• Referans9 C, Kraus B, Lauber H, Schrauth M, Weyrich P, Zipfel S, Junger J, Briem S. An innovative model for teaching complex clinical procedures: Integration of standardised patients into ward round training for final year students. Med. Teach. 2007, 29: 246–252
• Referans10 Nikendei C, Huhn D, Pittius G, Trost Y, Bugaj TJ, Koechel A, Schultz JH. Students' Perceptions on an Interprofessional Ward Round Training–A Qualitative Pilot Study. GMS journal for medical Education. 2016, 33(2).
• Referans11 G, McNab D. Developing a ward round checklist to improve patient safety. BMJ Open Quality.2015, 4(1); u204775–w2440.
• Referans12 Pitcher M, Lin JT, Thompson G, Tayaran A, Chan, S. Implementation and evaluation of a checklist to improve patient care on surgical ward rounds. ANZ journal of surgery. 2016,86(5);356–360.
• Referans13 Royal College of Physicians and Royal College of Nursing. Ward Rounds in Medicine: Principles for best practice. London; 2012. https://www.colleaga.org/sites/default/files/attachments/ward_rounds_in_medicine.pdf.
• Referans14 Lakshminarayana I, Wall D, Bindal T, Goodyear HM. A multisource feedback tool to assess ward round leadership skills of senior paediatric trainees:(1) development of tool. Postgraduate medical journal. 2015; 91(1075):262 –267.
• Referans15 Norgaard K, Ringsted C, Dolmans D. Validation of a checklist to assess ward round performance in internal medicine. Med Educ. 2004;38(7):700–7.
• Referans16 R, Desai T, Caldwell G. Quality and safety at the point of care: how long should a ward round take. Clinical medicine (London, England). 2011;11(1):20–2.
• Referans17 Somasundram K, Spence H, Colquhoun AJ, Mcilhenny C, Biyani CS, Jain S. Simulation in urology to train non‐technical skills in ward rounds.BJU international. 2018; 122(4): 705–712.
• Referans18 TW, Flin R, Mearns K, Cuthbertson BH. Team situation awareness and the anticipation of patient progress during ICU rounds. BMJ quality & safety. 2011 20(12); 1035–1042.
• Referans19 Spence H, Somasundram K, Biyani CS, Jain S. Training nontechnical skills in ward rounds to improve team performance. Journal of surgical Education. 2020, 77(4);921–930.
• Referans20 Laskaratos FM, Wallace D, Gkotsi D, Burns A, Epstein O. The educational value of ward rounds for junior trainees. Medical education online. 2015: 20(1); 27559.
• Referans21 Weber H, Stockli M, Nubling M, Langewitz WA. Communication during ward rounds in internal medicine. An analysis of patient-nurse-physicianinteractions using RIAS. Patient Educ Couns. 2007;67(3):343–8
• Referans22 Tariq M, Motiwala A, Ali SU, Riaz M, Awan S, Akhter J. The learners' perspective on internal medicine ward rounds: a cross-sectional study. BMC medical education. 2010; 10:53.
• Referans23 Gonzalo JD, Heist BS, Duffy BL, Dyrbye L, Fagan MJ, Ferenchick G and et al. Identifying and overcoming the barriers to bedside rounds: a multicenter qualitative study. Academic Medicine. 2014; 89(2): 326–334.
• Referans24 Ahmed K, Anderson O, Jawad M, Tierney T, Darzi A, Athanasiou T and et al. Design and validation of the surgical ward round assessment tool: a quantitative observational study. The American Journal of Surgery. 2015; 209(4): 682–688.
• Referans25 Bismilla Z, Wong B, Editörler. Handover Toolkit, A Resource to help teach, assess and implement a handover improvement program. The Royal College of Physicians and Surgeons of Canada; 2018.
• Referans26 Oztorun CI, Demir S, Azili MN, Senayli A, Livanelioglu Z,Senel E. (2016). The outcomes of becoming a pediatric burn center in Turkey. Turkish Journal of Trauma and Emergency Surgery. 2016; 22(1): 34–39.
• Referans27 Güler N, Teker GT. Açık uçlu maddelerde farklı yaklaşımlarla elde edilen puanlayıcılar arası güvenirliğin değerlendirilmesi. Eğitimde ve psikolojide ölçme ve değerlendirme dergisi. 2015; 6(1):12-24.
• Referans28 Downing SM. Reliability: on the reproducibility of assessment data. Medical education .2004;38(9):1006–1012.
• Referans29 Wainer H, Thissen D. How is reliability related to the quality of test scores? What is the effect of local dependence on reliability? Educational Measurement: Issues Pract. 1996;15 (1):22–29.
• Referans30 Fletcher G, Flin R, McGeorge P, Glavin R, Maran N, Patey R. Anaesthetists’ Non‐Technical Skills (ANTS): evaluation of a behavioural marker system. British journal of anaesthesia. 2003;90(5): 580–588 .
• Referans31 Yule S, Paterson-Brown S. Surgeons’ non-technical skills. Surgical Clinics. 2012; 92(1):37–50.
• Referans32 Coutris N, Gawaziuk JP, Cristall N, Logsetty S. Interrupted Nutrition Support in Patients With Burn Injuries: A Single-Centre Observational Study.Plastic Surgery. 2019: 27(4); 334–339.
• Referans33 Carson JS, Khosrozadeh H, Norbury WB, Herndon DN. Nutritional needs and support for the burned patient. In Total burn care. 2018:287 –300.
• Referans34 Meyer EC, Sellers DE Browning DM, McGuffie K, Solomon MZ, Truog RD. Difficult conversations: improving communication skills and relational abilities in health care. Pediatr Crit Care Med. 2009:10(3);352–359.
• Referans35 Brand SR, Fasciano K, Mack JW. Communication preferences of pediatric cancer patients: talking about prognosis and their future life. Supportive care in cancer. 2017: 25(3);769–774.
• Referans36 Perry V. CNE SERIES. A Daily Goals Tool to Facilitate Indirect Nurse-Physician Communication During Morning Rounds on a Medical-Surgical Unit. MedSurg Nursing. 2016;25(2).
• Referans37 Wright M, Endsley M. Building situation awareness in healthcare teams. Improving Healthcare Team Communication. Bodmin, UK: Ashgate, 2008:97–114.