Holden Lela M, Watts D D, Walker P H
Center for Quality and Safety, Massachusetts General Hospital, Boston, Massachusetts 02114, USA.
Qual Saf Health Care. 2010 Jun;19(3):169-72. doi: 10.1136/qshc.2008.026435. Epub 2010 Feb 1.
Collaboration and communication as dimensions of patient safety climate have been measured in acute care hospital units, and discrepant viewpoints have been documented between different professional groups, particularly between physicians and nurses. In the ambulatory care setting, these groups often work more closely together throughout the day than in acute care settings, thereby enhancing effective collaboration and communication. This study sought to determine if the communication differences that are known to impact patient safety, which are found in acute care, also exist in ambulatory care.
The Safety Attitudes Questionnaire, a 77-item survey of collaboration, communication and safety attitudes, was administered to the primary care staff at four Midwestern military ambulatory care clinics.
There were 107 participants consisting of nurses (n=46), nurse practitioners (n=12), pharmacists (n=10) and physicians (n=39), yielding an overall response rate of 65%. All groups rated their peer group higher than other professional groups. The ratings of nurses and physicians were very similar: 85.0% of nurses rated physicians, and 85.7% of physicians rated nurses as high or very high in communication and collaboration. Pharmacists were rated the lowest by each of the other professional groups. Only 60% of pharmacists rated physicians as high or very high.
Collaboration and communication ratings among physicians and nurses appear to be higher in the ambulatory care setting than in the acute care. However, interactions with pharmacists are more problematic, perceived as adversarial. Teamwork training that focuses on specific interactions among professional groups should target these concerns.
作为患者安全氛围维度的协作与沟通已在急症护理医院科室中得到衡量，并且不同专业群体之间，尤其是医生和护士之间存在观点差异已被记录在案。在门诊护理环境中，这些群体通常比在急症护理环境中全天工作时配合得更紧密，从而加强了有效的协作与沟通。本研究旨在确定在急症护理中发现的、已知会影响患者安全的沟通差异在门诊护理中是否也存在。
对中西部地区四家军事门诊护理诊所的初级护理人员进行了《安全态度问卷》调查，这是一项包含77个项目的关于协作、沟通和安全态度的调查。
共有107名参与者，包括护士（n = 46）、执业护士（n = 12）、药剂师（n = 10）和医生（n = 39），总体回复率为65%。所有群体对自己同行群体的评价高于其他专业群体。护士和医生的评价非常相似：85.0%的护士对医生的沟通与协作评价为高或非常高，85.7%的医生对护士的评价为高或非常高。药剂师在其他每个专业群体中的评价最低。只有60%的药剂师对医生的评价为高或非常高。
在门诊护理环境中，医生和护士之间的协作与沟通评分似乎高于急症护理环境。然而，与药剂师的互动问题更多，被视为具有对抗性。专注于专业群体之间特定互动的团队合作培训应针对这些问题。
