University of Texas Southwestern Medical Center, Division of General Pediatrics, Department of Pediatrics, Dallas, TX 75390-9063, USA.
Pediatrics. 2010 Jul;126(1):37-43. doi: 10.1542/peds.2009-2364. Epub 2010 Jun 29.
The goal was to examine pediatric hospitalist rounding practices and characteristics associated with programs conducting family-centered rounds (FCRs).
The Pediatric Hospitalist Triennial Survey, sent to a subset of pediatric hospitalists on the Pediatric Research in Inpatient Settings listserv from the United States and Canada, consisted of 63 questions on sociodemographic characteristics, training, practice characteristics, and rounding practices.
Among 265 respondents (response rate: 70%), 78% practiced in academic hospitals and 22% in nonacademic hospitals. The prevalences of specific rounding categories were as follows: FCRs, 44%; sit-down, 24%; hallway, 21%; others, 11%. FCRs occurred significantly more often in academic (48%) than nonacademic (31%) hospitals (P = .04). FCRs can include pediatric residents, bedside nurses, charge nurses, case managers, pharmacists, and social workers. Academic settings and higher average daily patient censuses, but not FCRs, were significantly associated with prolonged rounding duration. The most commonly perceived FCR benefits included increased family involvement and understanding, trainee role modeling, and effective team communication. Physical constraints, trainees' apprehensions, and time were the main perceived FCR barriers. Greater perceived benefit/barrier ratios, FCR benefits, and family involvement in care were associated with a greater likelihood of conducting FCRs, whereas a greater number of perceived FCR barriers was associated with not conducting FCRs.
FCRs were the most-common rounding category among respondents. FCRs were not associated with a self-reported increase in rounding duration. Successful FCR implementation may require educating staff members and trainees about FCR benefits and addressing FCR barriers.
本研究旨在探讨儿科住院医师巡房实践以及与开展以家庭为中心的巡房(FCR)相关的特征。
该研究采用横断面调查方法,通过向美国和加拿大的儿科住院医师在住院患者研究列表服务(Pediatric Research in Inpatient Settings listserv)上的一个子集发送儿科住院医师三年期调查(Pediatric Hospitalist Triennial Survey),该调查共包含 63 个问题,内容涉及社会人口学特征、培训、实践特征和巡房实践等。
在 265 名受访者(应答率:70%)中,78%在学术医院工作,22%在非学术医院工作。特定巡房类别的流行率如下:以家庭为中心的巡房(FCRs)占 44%,坐式巡房占 24%,走廊巡房占 21%,其他形式占 11%。FCRs 在学术医院(48%)比非学术医院(31%)更常见(P =.04)。FCRs 可以包括儿科住院医师、床边护士、值班护士、个案管理员、药剂师和社会工作者。学术环境和更高的平均每日患者人数,而不是 FCRs,与巡房时间延长显著相关。最常被认为的 FCR 益处包括增加家庭参与和理解、培训生角色模范和有效的团队沟通。物理限制、培训生的担忧和时间是主要的 FCR 障碍。更大的感知 FCR 收益/障碍比、FCR 收益和家庭参与护理与更有可能开展 FCR 相关,而更多的感知 FCR 障碍与不开展 FCR 相关。
FCRs 是受访者中最常见的巡房类别。FCRs 与报告的巡房时间延长无关。成功实施 FCR 可能需要教育工作人员和培训生 FCR 的益处,并解决 FCR 障碍。