Mehmood Sajid, Ahmed Jamil, Razzaq Muhammad Haroon, Khan Shakeeb, Perry Eugene Phillip
Department of Transplant Surgery, Freeman Hospital, UK.
J Coll Physicians Surg Pak. 2012 Jun;22(6):385-8.
To examine the current practice of handover and to record trainees' assessment of handover process.
An audit study.
Department of General Surgery, Scarborough General Hospital, Scarborough, United Kingdom, from January to April 2010.
A paper-based questionnaire containing instruments pertaining to handover guidelines was disseminated to trainees on surgical on-call rota at the hospital. Trainees' responses regarding handover process including information transferred, designated location, duration, structure, senior supervision, awareness of guidelines, formal training, and rating of current handover practice were analysed.
A total of 42 questionnaires were returned (response rate = 100%). The trainees included were; registrars 21% (n=9), core surgical trainees 38 % (n=16), and foundation trainees 41% (n=17). Satisfactory compliance (> 80% handover sessions) to RCS guidelines was observed for only five out of nine components. Ninety-five percent of hand over sessions took place at a designated place and two-third lasted less than 20-minutes. Computer generated handover sheet 57% (n=24) was the most commonly practised method of handover. Specialist registrar 69 % (n=29) remained the supervising person in majority of handover sessions. None of the respondents received formal teaching or training in handover, whereas only half of them 48% (n=20) were aware of handover guidelines. Twenty-one percent of the trainees expressed dissatisfaction with the current practice of handover.
Current practice of surgical handover lacks structure despite a fair degree of compliance to RCS handover guidelines. A computerised-sheet based structured handover process, subjected to regular audit, would ensure patient safety and continuity of care.
研究目前的交接班情况，并记录实习医生对交接班过程的评估。
一项审计研究。
英国斯卡伯勒市斯卡伯勒综合医院普通外科，2010年1月至4月。
向医院外科值班轮值表上的实习医生发放一份纸质问卷，问卷包含与交接班指南相关的内容。分析实习医生关于交接班过程的回答，包括传递的信息、指定地点、时长、结构、上级监督、对指南的认知、正规培训以及对当前交接班情况的评分。
共收回42份问卷（回复率 = 100%）。参与的实习医生包括：住院医生21%（n = 9）、核心外科实习医生38%（n = 16）、基础实习医生41%（n = 17）。在九个组成部分中，只有五个部分对皇家外科学院指南的满意度达到了80%以上。95%的交接班在指定地点进行，三分之二的交接班时长不到20分钟。57%（n = 24）的人最常采用电脑生成的交接班表进行交接班。在大多数交接班中，专科住院医生69%（n = 29）仍是监督人员。没有受访者接受过关于交接班的正规教学或培训，而只有一半人48%（n = 20）了解交接班指南。21%的实习医生对当前的交接班情况表示不满。
尽管在一定程度上符合皇家外科学院的交接班指南，但目前外科交接班实践缺乏系统性。基于电脑表格的结构化交接班流程，并定期进行审计，将确保患者安全和护理的连续性。
