Kassean Hemant K, Jagoo Zaheda B
Department of Health and Medical Sciences and Management, University of Mauritius, Reduit, Mauritius.
Department of Health and Medical Sciences, University of Mauritius, Reduit, Mauritius.
BMC Nurs. 2005 Jan 28;4:1. doi: 10.1186/1472-6955-4-1. eCollection 2005.
The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system.
A force field analysis in terms of the driving forces had shown that there was dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work. A 3 - step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making.
An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general.
This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system.
交接班是妇科病房护士工作日内进行两次的沟通流程的重要组成部分。本文探讨了实施新的床边交接班系统这一话题,该系统将患者置于整个护理管理过程的核心位置,同时也解决了传统交接班系统的一些不足之处。
从驱动力方面进行的力场分析表明,人们对传统交接班方法存在不满,这导致严重事件的数量增加,患者、家属和医生的投诉也增多。确定的制约因素包括对问责制的恐惧、缺乏信心以及认为这种改变会带来更多工作。采用由解冻、移动和再冻结组成的三步计划变革模型来指导我们完成变革过程。通过营造开放沟通的氛围来应对变革阻力,在这种氛围中,利益相关者可以表达意见、分享担忧、见解和想法,从而积极参与决策。
一项评估表明,该流程已成功实施,患者和全体工作人员总体上感到满意。
这一成功的变革应鼓励其他护士在确定变革管理领域时更加积极主动,以改善我们的医疗保健系统。