ABSTRACT
Objective:To look for the problems faced in the construction of the tele-critical care system, explore the framework of construction of the tele-critical care system, and verify the application effects of the established tele-critical care system.Methods:Through literature review and on-site investigation and demonstration, the causes affecting the construction of the tele-critical care system were explored. Through on-site investigation of the actual situation of the critical care department in relevant hospitals, arguing and choosing intended intensive care unit (ICU) and cooperative third-party communication and equipment companies, and through the Internet of Things and 5G communication technology, a tele-critical care system with the core hospital of the group as the center and the member institutes within the group as the nodes was built. Via the established tele-critical care system, activities such as tele-monitoring, visual remote ward rounds, remote consultation, remote teaching were carried out to verify the functions of the system.Results:The insufficient cognition of relevant personnel, tele-medicine practice certification requirements, information security issues and the barriers of equipment information integration were the main causes affecting the construction of tele-critical care system. There were five parts in the tele-critical care system architecture foundations, including bed unit equipment and audio and video information collection system, lossless and secure transmission of collected information, real-time display of information in the remote center, real-time staff interaction between the centre and the nodal hospitals, and information cloud storage. It has been verified that patients' diagnostic and treatment information can be transmitted safely, losslessly and in real-time by a special line through private 5G network. Through this system, real-time and stable upload of audio and video information of patients and application information of monitors, ventilators and infusion work stations can be achieved; combined with tele-conference connections to conduct two-way communication with local medical staff, real-time tele-monitoring, visual remote ward rounds, remote consultation, remote teaching and other functions can be achieved.Conclusion:The tele-critical care system we established is feasible to construct within the medical group and can safely and effectively realize the functions of real-time tele-monitoring, visual remote ward rounds, remote consultation, and remote teaching.
ABSTRACT
Objective:To observe the impact of application of ward rounds checklist on the post competency of residents in the standardized residency training of critical care medicine.Methods:From April 2016 to January 2017, different batches of residents who were admitted to the Department of Critical Care Medicine for standardized residency training were randomized into the experimental group and the control group. Both groups were taught by experienced ICU senior attending physicians one-to-one. The control group routinely conducted rounds and handovers. The experimental group implemented a ward rounds checklist system during rounds and handovers. The training time for each group was 2 months. According to the characteristics of ICU combined with the requirements of post competency, a questionnaire was formulated. SPSS 17.0 was used for t test and chi-square test. Results:The resident physicians in the experimental group gave more satisfactory evaluations in terms of the actual patient care ability, medical knowledge mastery, clinical work under the system, learning and improvement from work, professional literacy, and communication skills to reflect the post competency, and had relatively higher degree of satisfaction with the teaching training, all with statistical significance ( P<0.05). Conclusion:It's helpful to improve the post competency and teaching satisfaction of ICU residents by implementing the ward rounds checklist system during the rotation of resident physicians in the standardized residency training of critical care medicine.