Department of Plastic Surgery and Burn Centre, BG University Hospital Bergmannsheil, Ruhr University Bochum, Bochum, Germany.
Burns. 2009 Jun;35(4):509-12. doi: 10.1016/j.burns.2008.11.008. Epub 2009 Mar 17.
Effective handover of clinical information between working shifts is essential for patient safety. The aim of this study was to identify current practice and trainees' assessment of handover in the burns units of the British Isles.
A telephone questionnaire was conducted to trainee burns surgeons (at junior and senior grades) currently working at all 30 burns surgery units in the British Isles. Information regarding timing, location, duration, participation and quality of handover was collated anonymously. Trainees commented on satisfaction with current practice and its perceived safety.
A 100% response from all 30 units was obtained. 23/30 units (76.7%) had junior to junior trainee handovers. 17/30 (56.7%) had senior to senior trainee handovers. 19/30 units (63.3%) reported that handover took place with more than one grade of doctor present (range 1-4 grades). 3/30 (10%) reported that handover was bleep-free. 3/30 (10%) had received formal training on good burns handover. 5/30 (16.7%) were working in a unit that operated a "burns surgeon of the week" pattern of emergency cover. Mean satisfaction level was 3.8 out of 5. Those working in "surgeon of the week" teams had significantly higher scores, 4.4 versus 3.68 (p=0.037). Other healthcare professionals were present at only 4/30 (13.3%) handovers. Overall 26/30 (86.7%) of trainees judged their current handover practice "safe" (100% in "surgeon of week" group and 84% in the remaining group, p=0.289).
Effective handover remains a keystone in safe and effective communication between doctors. The study highlights areas for improvement in handover practice, including greater involvement of an integrated multidisciplinary team. Those working under the "surgeon of the week" pattern are more satisfied.
在轮班之间有效交接临床信息对于患者安全至关重要。本研究旨在确定不列颠群岛烧伤病房当前的交接实践和受训者对交接的评估。
对不列颠群岛所有 30 个烧伤病房工作的初级和高级烧伤外科住院医师进行了电话问卷调查。匿名收集有关交接时间、地点、持续时间、参与度和交接质量的信息。住院医师对当前实践的满意度及其安全性进行了评价。
所有 30 个单位均获得了 100%的回复。23/30 个（76.7%）单位有初级住院医师对初级住院医师的交接。17/30 个（56.7%）单位有高级住院医师对高级住院医师的交接。19/30 个单位（63.3%）报告说，有不止一级医生（1-4 级）参与交接，范围为 1-4 级。3/30 个（10%）单位报告说交接时没有传呼。3/30 个（10%）单位接受过关于良好烧伤交接的正式培训。5/30 个（16.7%）单位在运作“一周烧伤外科医生”紧急覆盖模式。满意度平均得分为 3.8 分。在“一周外科医生”团队中工作的人员得分明显更高，为 4.4 分，而其余团队为 3.68 分（p=0.037）。其他医护人员仅出现在 4/30 次交接中（13.3%）。总体而言，26/30 名（86.7%）住院医师认为其当前交接实践“安全”（“一周外科医生”组的 100%和其余组的 84%认为安全，p=0.289）。
有效的交接仍然是医生之间安全有效沟通的关键。该研究强调了交接实践中需要改进的领域，包括更广泛地纳入一个综合的多学科团队。在“一周外科医生”模式下工作的人员满意度更高。
