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首页> 外文期刊>Pediatric critical care medicine: a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies >Evaluation of Pediatric Cardiac ICU Advanced Practice Provider Education and Practice Variation*
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Evaluation of Pediatric Cardiac ICU Advanced Practice Provider Education and Practice Variation*

机译：评估儿科心脏ICU高级实践提供者教育和实践变异*

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Objectives: The education, training, and scope of practice of cardiac ICU advanced practice providers is highly variable. A survey was administered to cardiac ICU advanced practice providers to examine specific variations in orientation format, competency assessment during and at the end of orientation, and scope of clinical practice to determine gaps in resources and need for standardization. Design: This study was a cross-sectional descriptive study utilizing survey responses. Setting: Pediatric cardiac ICUs in the United States. Subjects: The survey was delivered to a convenience sample of advanced practice providers currently practicing in pediatric cardiac ICUs. Interventions: A list of pediatric cardiothoracic surgery programs was generated from the Society of Thoracic Surgery database. A self-administered, electronic survey was delivered via email to advanced practice providers at those institutions. Descriptive data were compared using a chi-square test or Fisher exact test depending on the normalcy of data. Continuous data were compared using a Student t test or Mann-Whitney U test. Measurements and Main Results: Eighty-three of 157 advanced practice providers responded (53% response rate, representing 36 institutions [35% of institutions]). Sixty-five percent of respondents started as new graduates. Ninety-three to one-hundred percent obtain a history and physical, order/interpret laboratory, develop management plans, order/titrate medications, and respiratory support. Ability to perform invasive procedures was highly variable but more likely for those in a dedicated cardiac ICU. Seventy-seven percent were oriented by another advanced practice provider, with a duration of orientation less than 4 months (66%). Fifty percent of advanced practice providers had no guidelines in place to guide learning/competency during orientation. Sixty-seven percent were not evaluated in any way on their knowledge or skills during or at the end of orientation. Orientation was rated as poor/fair by the majority of respondents for electrophysiology (58%) and echocardiography (69%). Seventy-one percent rated orientation as moderately effective or less. Respondents stated they would benefit from more structured didactic education with clear objectives, standardized management guidelines, and more simulation/procedural practice. Eighty-five percent were very/extremely supportive of a standardized cardiac ICU advanced practice provider curriculum. Conclusions: Orientation for cardiac ICU advanced practice providers is highly variable, content depends on the institution/preceptor, and competency is not objectively defined or measured. A cardiac ICU advanced practice provider curriculum is needed to standardize education and promote the highest level of advanced practice provider practice.
机译：目标：心脏ICU高级实践提供者的教育，培训和实践范围是高度变化的。向心脏ICU高级实践提供商提供了一项调查，以检查方向格式，能力评估期间和在方向结束时的具体变化，以及临床实践范围，以确定资源中的差距和标准化。设计：本研究是利用调查响应的横截面描述性研究。环境：美国小儿心脏病icus。主题：该调查被交付给了当前在儿科心脏病icus练习的高级实践提供商的便利样本。干预措施：从胸外科数据库社会产生小儿心肺手术计划。通过电子邮件向在这些机构提供先进的实践提供商来提供自我管理的电子调查。使用Chi-Square测试或Fisher精确测试比较描述性数据，具体取决于数据的正常情况。使用学生T测试或Mann-Whitney U测试进行比较连续数据。测量和主要结果：157个高级实践提供者中有八十三个（响应率53％，代表36个机构[35％的机构]）。六十五名受访者始于新毕业生。百分之九十三到百分之百获得历史和物理，订单/解释实验室，制定管理计划，订单/滴定药物和呼吸支持。执行侵入手术的能力是高度变化，但对于专用心脏ICU中的人更有可能。七十七百以另一种高级实践提供者为导向，持续时间不到4个月（66％）。 50％的高级练习提供商在取向期间没有指导学习/能力的指导。在入学期间或在方向结束时，六十七分之一没有以任何方式进行评估。大多数受访者对电生理学（58％）和超声心动图（69％）的大多数受访者，方向被评为差/公平。百分之七十一额定取向，如适度有效或更少。受访者表示，他们将从更明确的目标，标准化的管理指南和更多模拟/程序实践中受益于更具结构化的教学教育。百分之八十五个人非常/极其支持，标准化的心脏ICU高级实践提供商课程非常支持。结论：心脏病ICU先进实践提供商的方向是高度变化的，内容取决于机构/备忘录，并且没有客观地确定或衡量能力。需要心脏ICU先进的实践提供商课程，以规范教育，促进高级高级实践提供者实践。

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