McCann Lloyd, McHardy Karina, Child Stephen
Auckland District Health Board, Auckland.
N Z Med J. 2007 Oct 26;120(1264):U2778.
To survey house officers and nurses regarding timing, structure and content of clinical handover and compare these results. Secondary aims included the development of an 'on-call' sheet and the development of guidelines for handovers from the results collated.
60 house officers (post graduate years 1-3) and 60 nurses working at Auckland City Hospital were asked to complete a survey covering various aspects of clinical handover in their current department.
This study showed that nurses have more handovers than house officers in a 24-hour period. Nurses had an average of 3.2 handovers compared with the 1.2 handovers reported by house officers. Nurses rated their handovers as 'good', with a mean score of 7.8/10, while house officers rated the standard of their handovers as only 'average', with a mean score of 5.1/10. This was noted to be a statistically significant difference with a p-value of 0.01. Our study found that 60.9% of house officers reported that they had encountered a problem at least seven times in their most recent clinical rotation that they could directly attribute to a poor handover. However, nurses reported a much lower incidence of problems relating to poor handover standards, with 37.5% of this group indicating that they had experienced a clinical problem with a patient related to a nursing handover.
In this study, we identified that health professionals perceive that clinical problems can be attributed to poor clinical handover. The majority of respondents in the study felt that an effective handover system should include a set location for handover, a standardised 'on-call' sheet and training related to handovers.
就临床交接班的时间、结构和内容对住院医生和护士进行调查，并比较这些结果。次要目的包括制定一份“值班”表，并根据整理的结果制定交接班指南。
要求奥克兰市医院的60名住院医生（研究生1至3年级）和60名护士完成一项涵盖其所在科室临床交接班各个方面的调查。
本研究表明，护士在24小时内的交接班次数比住院医生多。护士平均有3.2次交接班，而住院医生报告的交接班次数为1.2次。护士将他们的交接班评为“良好”，平均得分为7.8/10，而住院医生将他们的交接班标准评为“一般”，平均得分为5.1/10。这被认为是一个具有统计学意义的差异，p值为0.01。我们的研究发现，60.9%的住院医生报告说，在他们最近的临床轮转中，他们至少七次遇到可以直接归因于交接班不佳的问题。然而，护士报告的与交接班标准不佳相关的问题发生率要低得多，该组中有37.5%的人表示他们在护理交接班方面遇到过与患者相关的临床问题。
在本研究中，我们发现卫生专业人员认为临床问题可归因于临床交接班不佳。研究中的大多数受访者认为，有效的交接班系统应包括一个固定的交接班地点、一份标准化的“值班”表以及与交接班相关的培训。
