136: The Other End: Evaluation of Blood Bank Technologists and Hematologists During a Massive Hemorrhage Simulation Project
Notice bibliographique
Résumé
Massive hemorrhages (MH) are life-threatening complications of trauma and obstetrical cases. Expertise and effective communication is key among all team members involved. Collaboration with blood bank technologists (BBT) and hematologists assisting teams with prompt preparation and delivery of blood products further contributes to optimizing care. To evaluate communication and expertise when preparing and delivering blood products during MH cases using in situ simulation. Prospective observational study held at a blood bank (BB) and simlab of a tertiary care facility. Participants were BBTs and hematologists and pediatric emergency/critical care and obstetrical/anesthesia teams submitted to high fidelity (HF) simulated pediatric trauma and post-partum MH scenarios, respectively. BBT were videotaped at the BB and conversations with teams at the simlab were recorded. If hematologists were consulted, the chief BBT questioned them on issues relevant to MH.BBT were evaluated by a blinded trained independent rater using a checklist rating expertise and key communication skills necessary when preparing and delivering blood products to teams involved in MH. Hematologists were rated using a questionnaire exploring their ability to assist and communicate with BBTs and clinicians dealing with choosing blood products or compatibility issues. Means and SDs of scores on checklists and questionnaires were calculated. Participants were eight BBT, eight hematologists and 62 healthcare professionals involved in eight interdisciplinary teams (four obstetrics/anaesthesia and four pediatric emergency/critical care). BBT scored on average 78% (61% to 92%) and 76%(62% to 100%) in expertise and communication checklists (trauma and post-partum simulations, respectively). Hematologists rightly refused blood specimens to determine blood type in 57% (four of seven) (discrepant ABO/Rh blood group with previous ABO group results).Their ability to choose or substitute blood products was observed in 71% (five of seven).When challenged by the fact that an incompatible blood product was delivered to the patient, 37.5% (three of eight) asked for phenotype analysis of products already transfused and those being prepared and no one advised teams or of the possibility of a hemolytic transfusion reaction. BBT were considered relatively ready and possess necessary expertise and communication skills to prepare and deliver blood products to teams dealing with MH. For hematologists, knowledge gaps were identified and additional training is mandatory to ensure proficiency when assisting teams with such emergencies. Using in situ simulation at the BB and hematologists in addition to HF interdisciplinary team simulations at a simlab can further add to improving performances of all professionals actively involved in MH crisis situations.
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Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,008 | 0,030 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,001 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,001 | 0,002 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».