Simpson Kathleen Rice, James Dotti C, Knox G Eric
St. John's Mercy Medical Center, Doisy College of Health Sciences School of Nursing, Saint Louis University, MO 63141, USA.
J Obstet Gynecol Neonatal Nurs. 2006 Jul-Aug;35(4):547-56. doi: 10.1111/j.1552-6909.2006.00075.x.
To describe communication between nurses and physicians during labor within the context of the nurse-managed labor model in community hospitals and its relationship to teamwork and patient safety.
Multicenter qualitative study involving focus groups and in-depth interviews.
Labor and birth units in 4 Midwestern community hospitals.
54 labor nurses and 38 obstetricians.
Focus groups and in-depth interviews were conducted using open-ended questions. Data were analyzed using inductive coding methods to gain understanding from the perspective of those directly involved.
Description of interdisciplinary interactions during labor.
Nurses and physicians shared the common goal of a healthy mother and baby but did not always agree on methods to achieve that goal. Two clinical situations critical to patient safety (fetal assessment and oxytocin administration) were frequent areas of disagreement and sources of mutual frustration, often leading to less than optimal teamwork. Minimal communication occurred when the mother and fetus are doing well, and this seemed to be purposeful and considered normal. Physicians and nurses had distinct opinions concerning desirable traits of members of the other discipline.
Interdisciplinary communication and teamwork could be improved to promote a safer care environment during labor and birth.
描述社区医院护士主导分娩模式下护士与医生在分娩期间的沟通情况，及其与团队协作和患者安全的关系。
涉及焦点小组和深入访谈的多中心定性研究。
中西部4家社区医院的分娩单元。
54名分娩护士和38名产科医生。
使用开放式问题进行焦点小组和深入访谈。采用归纳编码方法分析数据，以从直接参与者的角度进行理解。
分娩期间跨学科互动的描述。
护士和医生都有母婴健康的共同目标，但在实现该目标的方法上并不总是一致。对患者安全至关重要的两种临床情况（胎儿评估和缩宫素给药）是经常出现分歧的领域和相互沮丧的根源，往往导致团队协作不尽如人意。当母婴情况良好时，沟通极少，这似乎是有意为之且被视为正常。医生和护士对对方学科成员的理想特质有不同看法。
可以改善跨学科沟通和团队协作，以在分娩期间营造更安全的护理环境。
