Radtke Kimberly
MSICU/MSIMC, Aspirus Wausau Hospital, Tomahawk, Wisconsin, USA.
Clin Nurse Spec. 2013 Jan-Feb;27(1):19-25. doi: 10.1097/NUR.0b013e3182777011.
The objective of this study was to determine if standardizing shift report improves patient satisfaction with nursing communication.
Patient surveys taken after discharge from the hospital show that patients perceive nursing communication during their stay could be improved. Standardizing bedside reporting is one step toward improving communication between nurses, patients, and their families.
A pilot bedside shift report process was developed on a medical/surgical intermediate care unit to improve patient satisfaction scores in the area of "nurse communicated well," with the goal of reaching 90% satisfaction rates, which increased from 76% and 78%. Peplau's interpersonal relations theory was used in the adoption of this practice. This theory is based on the idea that the nurse-patient relationship is therapeutic and that it is crucial for nurses to assess, plan, and put context behind the care delivered to their patients. Lewin's Change Theory and the tenets of unfreezing, moving, and refreezing were crucial to the implementation of this practice change.
Monitoring of patient satisfaction was continued for 3 months. There was a rise in patient satisfaction in nursing communication to 87.6%, an increase from 75% in the previous 6 months. This score did not meet the goal of 90%, but did show that this practice change did impact this particular area of patient satisfaction.
This process was instituted organization-wide. Reaching the goal of 90% satisfaction in the area of patient perceptions of nursing communication is the overall goal of this program.
本研究的目的是确定标准化交接班报告是否能提高患者对护理沟通的满意度。
患者出院后进行的调查显示,患者认为住院期间的护理沟通有待改善。标准化床边报告是改善护士、患者及其家属之间沟通的重要一步。
在一个内科/外科中级护理单元开发了一个试点床边交接班报告流程,以提高“护士沟通良好”领域的患者满意度评分,目标是达到90%的满意度,此前该评分分别为76%和78%。在采用这种做法时运用了佩普劳的人际关系理论。该理论基于这样一种观点,即护患关系具有治疗作用,护士对所提供给患者的护理进行评估、规划并说明背景情况至关重要。勒温的变革理论以及解冻、移动和再冻结的原则对实施这一实践变革至关重要。
对患者满意度的监测持续了3个月。护理沟通方面的患者满意度升至87.6%,较前6个月的75%有所提高。该评分未达到90%的目标,但确实表明这一实践变革对患者满意度的这一特定领域产生了影响。
这一流程已在全组织范围内推行。在患者对护理沟通的认知方面达到90%的满意度目标是该项目的总体目标。