Ingram Treva C, Kamat Pradip, Coopersmith Craig M, Vats Atul
Department of Pediatrics, Emory University School of Medicine, Atlanta, GA; Critical Care Medicine, Children's Healthcare of Atlanta at Egleston, Atlanta, GA.
Emory Center for Critical Care and Department of Surgery, Emory University School of Medicine, Atlanta, GA.
J Crit Care. 2014 Dec;29(6):915-8. doi: 10.1016/j.jcrc.2014.07.015. Epub 2014 Jul 22.
Our goal was to examine intensivists' perception of comfort, staff satisfaction, teaching, and efficiency with family-centered rounds (FCR).
Surveys were sent to intensivists at Emory University. Responses of physicians that participate in FCR were compared with those who do not. Survey questions were developed using a 5-point Likert scale with 1 representing a negative response and 5 being positive.
Of 46 surveys sent, there were 31 responses (response rate, 67%). Seventeen responses were from adult intensivists and 14 from pediatric. Sixteen respondees (52%) participate in FCR, whereas 15 respondents (48%) do not. There is a significant difference in physician comfort with the practice with an average score of 4.4+1.0 for those who participate and 2.7+1.7 for those who do not (P=.002). There is also a significant difference in the perception of the impact of FCR on staff. Those who participate feel that it has a significantly greater positive impact on staff's involvement during rounds with an average score of 3.6+1.2 vs an average score of 2.3+1.2 for those who do not practice FCR (P=.003). Those who participate in FCR have significantly more positive perception on its impact on patient outcomes with an average score of 3.8+1.1 compared with an average score of 2.9+1.3 for those who do not participate in FCR (P=.05). There are no significant differences in perceptions on teaching and efficiency among participants and nonparticipants in FCR.
Participation in FCR is associated with an increase in perceived physician comfort, positive impact on staff involvement, and positive impact on patient outcome. Concerns over teaching and efficiency remain.
我们的目标是研究重症监护医师对以家庭为中心的查房（FCR）在舒适度、员工满意度、教学及效率方面的看法。
向埃默里大学的重症监护医师发放调查问卷。将参与FCR的医师的回复与未参与的医师的回复进行比较。调查问卷问题采用5分制李克特量表，1代表负面回答，5代表正面回答。
共发放46份调查问卷，收到31份回复（回复率67%）。17份回复来自成人重症监护医师，14份来自儿科重症监护医师。16名回复者（52%）参与FCR，而15名回复者（48%）未参与。参与FCR的医师在实践中的舒适度得分显著更高，参与的医师平均得分为4.4±1.0，未参与的医师平均得分为2.7±1.7（P = 0.002）。对于FCR对员工的影响的看法也存在显著差异。参与FCR的医师认为其对查房期间员工参与度有显著更大的积极影响，平均得分为3.6±1.2，而未进行FCR的医师平均得分为2.3±1.2（P = 0.003）。参与FCR的医师对其对患者结局的影响有显著更积极的看法，平均得分为3.8±1.1，而未参与FCR的医师平均得分为2.9±1.3（P = 0.05）。FCR参与者和非参与者在教学和效率看法上无显著差异。
参与FCR与医师感知舒适度的提高、对员工参与度的积极影响以及对患者结局的积极影响相关。对教学和效率的担忧依然存在。
