Bost Nerolie, Crilly Julia, Wallis Marianne, Patterson Elizabeth, Chaboyer Wendy
Gold Coast Hospital & Griffith University, Emergency Department, Southport 4215 QLD, Australia.
Int Emerg Nurs. 2010 Oct;18(4):210-20. doi: 10.1016/j.ienj.2009.11.006. Epub 2010 Feb 6.
To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals.
Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes.
From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED.
Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies.
对有关医院急救服务与急诊科之间临床交接的研究进行批判性综述。
使用关键词“救护车”“交接”“移交”“急诊科”“急诊室”“ER”“沟通”和“临床交接”进行数据库检索和手工检索。提取、总结并批判性评估数据,以提供当前临床交接流程的证据。
从252篇文献中,有8项研究符合临床交接及救护车到急诊科患者转运的纳入标准。综述中确定了三个主题:(1)临床交接过程中可能会遗漏重要信息;(2)包括书面和口头部分的结构化交接可能会改善信息交流;(3)关于临床交接过程的多学科教育可能会促进团队合作、形成共同语言以及建立从急救服务机构向医院急诊科传递最低限度患者信息的框架。
在交接信息、交接不佳的后果、责任转移、工作人员对交接的认知、工作人员培训以及对改善临床交接的推荐策略的评估方面存在知识空白。需要有实施策略的证据以及进一步的研究来检验实施这些策略的持续效果。