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多学科交接可改善沟通认知。

Multidisciplinary handoffs improve perceptions of communication.

作者信息

Solan Lauren G, Yau Connie, Sucharew Heidi, O'Toole Jennifer K

机构信息

Divisions of Hospital Medicine and.

Biostatistics and Epidemiology, and.

出版信息

Hosp Pediatr. 2014 Sep;4(5):311-5. doi: 10.1542/hpeds.2014-0005.

Abstract

BACKGROUND

Communication errors during handoffs are a leading cause of sentinel events. The Accreditation Council for Graduate Medical Education 2011 duty hour standards (DHS) increase the frequency of handoffs.

OBJECTIVE

The goal of this study was to determine if a multidisciplinary group handoff bundle improves communication while working within the 2011 DHS.

METHODS

During 1-month pilot programs of the 2011 DHS, 2 groups were observed. Group A adopted a multidisciplinary group handoff bundle, including presence of residents and charge nurses, a standardized mnemonic in verbal and written form, and resident training. Group B received only a mnemonic pocket card. Residents completed preintervention and postintervention Likert scale surveys to assess handoff perceptions. Within-group preintervention to postintervention changes were analyzed by using the signed rank test. Measuring communication errors, an institutional tool was used to track unanticipated patient occurrences (UPOs) postintervention for both groups.

RESULTS

Significant improvements for the preintervention to postintervention surveys regarding the perceptions of quality of handoffs received, effective and efficient delivery of handoffs, comfort in giving handoffs, and handoff practices focusing on safety (all, P ≤ .05) were observed in group A. There were no significant changes in group B. Overall, 17% of collected group A UPO forms and 11% of group B UPO forms had at least 1 UPO recorded. The most common reason for a UPO was unaddressed nursing concerns.

CONCLUSIONS

A multidisciplinary group of residents and charge nurses and a handoff bundle was associated with improved resident perceptions of handoffs and communication within the 2011 DHS.

摘要

背景

交接班期间的沟通失误是警讯事件的主要原因。毕业后医学教育认证委员会2011年工作时间标准(DHS)增加了交接班的频率。

目的

本研究的目的是确定多学科团队交接班综合措施在遵循2011年DHS的情况下是否能改善沟通。

方法

在2011年DHS的1个月试点项目期间,观察了2个组。A组采用了多学科团队交接班综合措施,包括住院医师和责任护士在场、口头和书面形式的标准化记忆法以及住院医师培训。B组仅收到一张记忆卡。住院医师完成干预前和干预后的李克特量表调查,以评估对交接班的看法。采用符号秩检验分析组内干预前至干预后的变化。为衡量沟通失误,使用一种机构工具跟踪两组干预后的意外患者事件(UPO)。

结果

A组在干预前至干预后的调查中,在对所接收交接班质量的看法、交接班的有效和高效传递、进行交接班时的舒适度以及注重安全的交接班实践方面均有显著改善(均P≤0.05)。B组无显著变化。总体而言,收集的A组UPO表格中有17%、B组UPO表格中有11%记录了至少1次UPO。UPO最常见的原因是护理问题未得到解决。

结论

在2011年DHS范围内,由住院医师和责任护士组成的多学科团队以及交接班综合措施与住院医师对交接班和沟通的看法改善相关。

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