Suppr超能文献

急诊科的交接班:不足与不良影响。

Handover in the emergency department: deficiencies and adverse effects.

作者信息

Ye Ken, McD Taylor David, Knott Jonathan C, Dent Andrew, MacBean Catherine E

机构信息

Emergency Department, Royal Melbourne Hospital, Melbourne, Victoria, Australia.

出版信息

Emerg Med Australas. 2007 Oct;19(5):433-41. doi: 10.1111/j.1742-6723.2007.00984.x.

Abstract

OBJECTIVE

To determine problems resulting from ED handover, deficiencies in current procedures and whether patient care or ED processes are adversely affected.

METHODS

A prospective observational study at three large metropolitan ED comprising three components: observation of handover sessions, 2 h post-handover surveys of the receiving doctors and a general survey of ED doctors.

RESULTS

The handovers of 914 patients were observed during 60 handover sessions in a 3-month period. Medical information, including presenting complaints, was handed over better than communication and disposition information. Seven hundred and seven (77.4%) of 914 potential post-handover interviews were undertaken. Most (88.3%) doctors thought the handover was 'adequate/good'. However, information was perceived as lacking in 109 (15.4%) handovers, especially details of management (35, 5.0%), investigations (33, 4.7%) and disposition (33, 4.7%). There was a significant difference in the perceived quality of handovers (1-5 scale where 5 = excellent) when all required information was handed over and when it was not (median scores 4.0 vs 3.0, respectively, P < 0.001). As a result of perceived inadequate handovers, the doctor/ED and patient were affected adversely in 62 (8.8%) and 33 (4.7%) cases, respectively, for example, repetition of assessment, delays in disposition and care. Fifty doctors completed the general survey. Most believed communications made to inpatient units, inaccurate/incomplete information and disorganization were problematic.

CONCLUSION

Deficiencies in handover processes exist, especially in communication and disposition information. These affect doctors, the ED and patients adversely. Recommendations for improvement include guideline development to standardize handover processes, the greater use of information technology facilities, ongoing feedback to staff, and quality assurance and education activities.

摘要

目的

确定急诊交接产生的问题、当前流程中的不足,以及患者护理或急诊流程是否受到不利影响。

方法

在三家大型都市急诊部进行一项前瞻性观察研究,该研究包括三个部分:交接环节的观察、交接后2小时对接收医生的调查以及对急诊医生的全面调查。

结果

在3个月的时间里,共观察了60次交接环节中的914例患者的交接情况。包括主诉在内的医疗信息交接情况优于沟通和处置信息。对914例可能进行交接后访谈的患者中的707例(77.4%)进行了访谈。大多数(88.3%)医生认为交接“充分/良好”。然而,在109次(15.4%)交接中,信息被认为有所缺失,尤其是管理细节(35次,5.0%)、检查情况(33次,4.7%)和处置情况(33次,4.7%)。当所有所需信息都交接时与未交接时,交接质量的感知评分(1 - 5分制,5分为优秀)存在显著差异(中位数分别为4.0和3.0,P < 0.001)。由于认为交接不充分,医生/急诊部和患者分别在62例(8.8%)和33例(4.7%)病例中受到了不利影响,例如评估重复、处置和护理延迟。50名医生完成了全面调查。大多数人认为与住院科室的沟通、信息不准确/不完整以及混乱无序是问题所在。

结论

交接流程存在不足,尤其是在沟通和处置信息方面。这些不足对医生、急诊部和患者都产生了不利影响。改进建议包括制定指南以规范交接流程、更多地使用信息技术设施、持续向工作人员提供反馈,以及开展质量保证和教育活动。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验