多学科干预对医生与护士之间沟通与协作的影响。

Effect of a multidisciplinary intervention on communication and collaboration among physicians and nurses.

作者信息

Vazirani Sondra, Hays Ron D, Shapiro Martin F, Cowan Marie

机构信息

School of Medicine, University of California-Los Angeles, Los Angeles, CA, USA.

出版信息

Am J Crit Care. 2005 Jan;14(1):71-7.

PMID:15608112

Abstract

BACKGROUND

Improving communication and collaboration among doctors and nurses can improve satisfaction among participants and improve patients' satisfaction and quality of care.

OBJECTIVE

To determine the impact of a multidisciplinary intervention on communication and collaboration among doctors and nurses on an acute inpatient medical unit.

METHODS

During a 2-year period, an intervention unit was created that differed from the control unit by the addition of a nurse practitioner to each inpatient medical team, the appointment of a hospitalist medical director, and the institution of daily multidisciplinary rounds. Surveys about communication and collaboration were administered to personnel in both units. Physicians were surveyed at the completion of each rotation on the unit; nurses, biannually.

RESULTS

Response rates for house staff (n = 111), attending physicians (n = 45), and nurses (n = 123) were 58%, 69%, and 91%, respectively. Physicians in the intervention group reported greater collaboration with nurses than did physicians in the control group (P < .001); the largest effect was among the residents. Physicians in the intervention group reported better collaboration with the nurse practitioners than with the staff nurses (P < .001). Physicians in the intervention group also reported better communication with fellow physicians than did physicians in the control group (P = .006). Nurses in both groups reported similar levels of communication (P = .59) and collaboration (P = .47) with physicians. Nurses in the intervention group reported better communication with nurse practitioners than with physicians (P < .001).

CONCLUSIONS

The multidisciplinary intervention resulted in better communication and collaboration among the participants.

摘要

背景

改善医生与护士之间的沟通与协作能够提高参与者的满意度，并提升患者满意度及护理质量。

目的

确定多学科干预对急性内科住院病房中医生与护士之间沟通与协作的影响。

方法

在两年期间，设立了一个干预病房，它与对照病房的不同之处在于每个内科住院团队增加了一名执业护士、任命了一名住院医师主任，并制定了每日多学科查房制度。对两个病房的人员进行了关于沟通与协作的调查。在每个轮转结束时对医生进行调查；对护士每半年调查一次。

结果

住院医生（n = 111）、主治医生（n = 45）和护士（n = 123）的回复率分别为58%、69%和91%。干预组的医生报告与护士的协作比对照组的医生更多（P < .001）；最大的影响出现在住院医师中。干预组的医生报告与执业护士的协作比与 staff nurses（此处staff nurses表述有误，可能是指普通护士，原文可能为staff nurses）更好（P < .001）。干预组的医生还报告与同行医生的沟通比对照组的医生更好（P = .006）。两组护士报告与医生的沟通水平（P = .59）和协作水平（P = .47）相似。干预组的护士报告与执业护士的沟通比与医生更好（P < .001）。