A Study On The Training And Evaluation Of Health Management In Chronic Heart Failure For Community Medical Personnel Based On The Medical Alliance And Kirkpatrick Evaluating Model

Objectives1.Investigate the health management knowledge,health management,training status and training needs of chronic heart failure health management of community medical personnel of Zhongda Hospital of Southeast University,so as to provide a basis for training.2.Establish training programs,develop a remote training platform,and carry out remote training on chronic heart failure health management for community medical personnel.3.Take Kirkpatrick evaluating model as the theoretical basis for the training effect evaluation,and formulate and adopt the corresponding evaluation methods to evaluate the training effect.In order to provide a reference for the development of the relevant training,the development and use of the remote training platform,and the evaluation of the training effect.Methods1.Baseline survey:take convenient sampling method,select southeast university affiliated hospital medical union meet the standard of community medical personnel,select 21 community health service center of 398 community medical personnel,using their own design and discussed by the relevant experts of the community medical personnel chronic heart failure health management knowledge,management status and training needs survey for cross-sectional survey.Analyze the knowledge of chronic heart failure health management,the current status of health management and training,and the training needs.2.Training implementation:According to the baseline survey,develop training programs,and conduct training for community medical personnel.The study process is divided into three stages.The first stage is to research and develop a remote training platform.The second stage:develop the training plan,make the remote training courseware and materials.The third stage:Implement the training on chronic heart failure health management in the medical consortium of the Affiliated Zhongda Hospital of Southeast University.A total of 333 community medical personnel were trained in 21 community health service centers.3.Evaluation of training effect:Taking Kirkpatrick evaluating model as the theoretical guidance,the training effect of the community medical personnel participating in the training was investigated from four levels.The response level is evaluated by the training program satisfaction questionnaire,the learning level adopts the knowledge and skills paper,the behavior level uses the behavior attitude change questionnaire on chronic HF health management,and the outcome level uses the chronic HF health management interview.All the questionnaires used in this study were designed by researchers after consulting relevant literature and consulting relevant experts.Study data were entered and analyzed using SPSS 22.0,count data were expressed as frequency and percentage(%),measurement data were expressed as mean±standard deviation(~—x±s),and compared by t-test and ANOVA,with P<0.05.Results1.Baseline survey:The chronic heart failure health management knowledge of community medical personnel was 18.49±5.60,the title accuracy was 0.75%-95.23%,and the average accuracy of each topic was 46.29%.By univariate analysis,gender(P=0.0.011),occupation(P<0.001),Professional title(P=0.002),educational level(P=0.001),medical/nursing age(P=0.014),and years of HF health management(P=0.025)were statistically significant(P<0.05).The results of the current situation of chronic heart failure health management suggest that there are obvious deficiencies and difficulties in organizing patient activities,patient follow-up,patient medication management,medical communication and health management information system.At the same time,community health personnel have a serious lack of chronic heart failure health management training,training needs mainly include:guideline interpretation(91.21%),theoretical knowledge(87.44%),skill operation(84.42%),interpersonal skills(65.58%);online training(74.12%),training frequency(38.94%);training duration short-term training(44.72%).2.Training implementation:A remote training platform for chronic heart failure health management was developed,a training program was formulated,and remote training for community medical personnel.A total of 333 medical personnel in 21 community health service centers in the Affiliated Hospital of Southeast University were finally trained.3.Training effect evaluation:Reaction layer evaluation:through the"community personnel chronic health failure health management training satisfaction questionnaire",get the training object feedback,from five aspects statistical training object of training satisfaction,respectively is:training content arrangement 97.90%,training form design 97.90%,training schedule 97.00%,training teachers arrangement 99.10%,training organization management 98.50%.Learning layer evaluation:the knowledge and skills of health management was 6-37,and the average score was(23.31±5.67).The correct rate of the question was 7.81%-98.50%,and the average correct rate of each question was 58.15%.The highest accuracy was found for the biological laboratory indicators(98.50%)to determine the progression,severity and prognosis of heart failure.The differences in knowledge and skills scores before and after the training were statistically significant(P<0.05).Behavioral layer evaluation:In the community work,the activity organization,patient follow-up and medical communication for chronic heart failure health management were all improved.The establishment of peer groups and the increase of family visits can confirm that the training has changed the behavior of community medical workers in practical work.Through the training,the self-recognition of community health workers is generally at a high level.Among them,the highest self-recognition is the improvement of their own business level(64.57%),followed by the basic theory mastery(60.36%),the"guide"mastery(59.76%),and the improvement of health education ability(59.16%).Compared with the first 67.09%of the training participants said that they had not received the"guide"related training,and the training participants’mastery of the“guide”was greatly improved.After training,76.58%of the training participants believed that chronic heart failure health management training was very important,which was statistically significant compared with(70.85%)before training(P<0.05).Some training object,training behavior impact on their work,it is mainly reflected in the training object directly engaged in chronic heart failure health management related work is less(less than 25.63%of the total training),not directly engaged in chronic heart failure health management training object think not through practice to consolidate,master the knowledge and skills.Results layer evaluation:This training has improved the workflow of community chronic heart failure health management,improved the satisfaction of community chronic heart failure patients to the community,and confirmed to a certain extent that this training program is meaningful at the organizational performance level.Conclusions1.Community health personnel have insufficient knowledge of chronic heart failure health management,the current situation of health management is not optimistic,there is a serious lack of training,and the training demand is strong.Therefore,it is urgent to carry out chronic heart failure health management training for community medical personnel to improve their health management level.2.According to the characteristics of the community,a convenient and intelligent remote training platform for chronic heart failure health management based on medical alliance was built,a systematic training plan was formulated,and a 2-month training was carried out.Intelligent management improved the training effect.This training program is highly evaluated,which can improve the knowledge and skills of chronic heart failure health management,promote the change of knowledge,attitude and behavior,and improve the job competence.3.The Kirkpatrick evaluating model was taken as the theoretical basis,the evaluation method of the training project was established according to the characteristics of the discipline,and the training effect was systematically evaluated from four levels of reaction,learning,behavior and result layer,which promoted the continuous optimization of the training project.