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跨学科会诊与结构化沟通可减少再入院率并改善部分患者结局。

Interdisciplinary Rounds and Structured Communication Reduce Re-Admissions and Improve Some Patient Outcomes.

作者信息

Townsend-Gervis Mary, Cornell Paul, Vardaman James M

机构信息

Baptist Healthcare, Desoto, MS, USA.

Healthcare Practice Transformation, Grapevine, TX, USA

出版信息

West J Nurs Res. 2014 Aug;36(7):917-28. doi: 10.1177/0193945914527521. Epub 2014 Mar 20.

Abstract

Hospital communication is more than access to information. Among staff, it is about achieving situation awareness-an understanding of a patient's current condition and likely trajectory. In the multidisciplinary context of providing care, structure, consistency, and repeatability of communication will enable a shared understanding of the patient and plan, leading to improved patient satisfaction and outcomes. This was tested using the Situation-Background-Assessment-Recommendation (SBAR) protocol, a re-admissions risk assessment and daily interdisciplinary rounds (IDR) in the medical/surgical units of a hospital. The impact of these interventions on patient satisfaction, Foley catheter removal compliance, and patient re-admission rates was assessed. Over the 3 year period, Foley compliance improved from 78% to 94%, and re-admissions decreased from 14.5% to 2.1%, both significant. Patient satisfaction trended positively, but was not significant. These results support the value of SBAR and IDR, and are advocated to improve situation awareness and maintain focus on key patient data.

摘要

医院沟通不仅仅是获取信息。在医护人员之间,它关乎达成态势感知——即了解患者当前的病情及可能的发展轨迹。在提供护理的多学科背景下,沟通的结构、一致性和可重复性将促成对患者情况和治疗计划的共同理解,从而提高患者满意度并改善治疗效果。这通过情景-背景-评估-建议(SBAR)协议、再入院风险评估以及一家医院内科/外科病房的每日多学科查房(IDR)进行了测试。评估了这些干预措施对患者满意度、导尿管拔除依从性和患者再入院率的影响。在三年期间,导尿管依从性从78%提高到94%,再入院率从14.5%降至2.1%,两者均有显著变化。患者满意度呈上升趋势,但不显著。这些结果证明了SBAR和IDR的价值,提倡它们用于提高态势感知并持续关注关键患者数据。

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