血液透析中の不具合判断に関する新人技士への訓練項目明確化:―ベテラン臨床工学技士の判断箇所可視化に基づいた検討―  [in Japanese] Clarification of Training Items for Novice Staff Related to Their Judgments during Hemodialysis Treatment:— Based on Visualizing Expert Medical Staff Judgments —  [in Japanese]

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Abstract

血液透析では,体外循環に伴う出血などの事故の防止や,患者の容態に応じた透析条件設定・調整を確実に行うため,装置の透析条件設定は適切か等の判断を適切・迅速に行うことが医療安全上重要となる.一方,同じ透析状態でも,それが不具合に相当するか否かの判断基準は様々な要因により異なり,臨床工学技士の経験度により判断が異なる場合も多い.また,判断基準の多くは各技士が経験により獲得した内在化された知識から構成されているため,新人教育上の課題も多い.本稿では透析中の判断に関して,新人技士が難度を高く感じる判断箇所に着目し,技士が困難さを感じている理由を抽出することで,新人技士の訓練項目を明確化した.

Medical safety is one of the most important and basic concerns of medical services. For instance, in clinical hemodialysis, medical staff are expected to notice problems or abnormalities when the patient is undergoing medical treatment, such as falling blood pressure, and to deal with any abnormality appropriately. Experienced medical staff are able to promptly notice an abnormality and take appropriate countermeasures quickly, and they can provide safe service. Such actions are, however, based on specific knowledge obtained through their long-time experiences, and such knowledge seems sometimes like being held in a black-box as know-how. This becomes one of the educational problems of novice staff during hemodialysis treatment.  Therefore, for the sake of educating novice staff, this study focused on the process of taking judgments which are difficult for novices and clarifying the points for which novices should be trained. By clarifying the reason why these judgments are difficult for novices, this study also revealed the training items for novice staff as related to their judgments during hemodialysis treatment. These training items show the insufficient skills of novices. Experts of hemodialysis treatment, who work in a certain university hospital, evaluated these items to be useful for education. This approach diminishes the skill gap between experts and novices. Therefore, we believe it is applicable in a variety of service sites with educational problems similar to those in the case of hemodialysis treatment.

Journal

  • Journal of Japan Industrial Management Association

    Journal of Japan Industrial Management Association 65(4), 302-310, 2015

    Japan Industrial Management Association

Codes

  • NII Article ID (NAID)
    130005002556
  • NII NACSIS-CAT ID (NCID)
    AN10561806
  • Text Lang
    JPN
  • ISSN
    1342-2618
  • NDL Article ID
    026034775
  • NDL Call No.
    Z4-298
  • Data Source
    NDL  J-STAGE 
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