Randmaa Maria, Swenne Christine L, Mårtensson Gunilla, Högberg Hans, Engström Maria
From the Faculty of Health and Occupational Studies, University of Gävle (MR, GM, HH, ME), Centre for Research and Development, Uppsala University/County Council of Gävleborg, Gävle (MR), and Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden (MR, CLS, GM, ME).
Eur J Anaesthesiol. 2016 Mar;33(3):172-8. doi: 10.1097/EJA.0000000000000335.
Communication errors cause clinical incidents and adverse events in relation to surgery. To ensure proper postoperative patient care, it is essential that personnel remember and recall information given during the handover from the operating theatre to the postanaesthesia care unit. Formalizing the handover may improve communication and aid memory, but research in this area is lacking.
The objective of this study was to evaluate whether implementing the communication tool Situation-Background-Assessment-Recommendation (SBAR) affects receivers' information retention after postoperative handover.
A prospective intervention study with an intervention group and comparison nonintervention group, with assessments before and after the intervention.
The postanaesthesia care units of two hospitals in Sweden during 2011 and 2012.
Staff involved in the handover between the operating theatre and the postanaesthesia care units within each hospital.
Implementation of the communication tool SBAR in one hospital.
The main outcome was the percentage of recalled information sequences among receivers after the handover. Data were collected using both audio-recordings and observations recorded on a study-specific protocol form.
Preintervention, 73 handovers were observed (intervention group, n = 40; comparison group, n = 33) involving 72 personnel (intervention group, n = 40; comparison group, n = 32). Postintervention, 91 handovers were observed (intervention group, n = 44; comparison group, n = 47) involving 57 personnel (intervention group, n = 31; comparison group, n = 26). In the intervention group, the percentage of recalled information sequences by the receivers increased from 43.4% preintervention to 52.6% postintervention (P = 0.004) and the SBAR structure improved significantly (P = 0.028). In the comparison group, the corresponding figures were 51.3 and 52.6% (P = 0.725) with no difference in SBAR structure. When a linear regression generalised estimating equation model was used to account for confounding influences, we were unable to show a significant difference in the information recalled between the intervention group and the nonintervention group over time.
Compared with the comparison group with no intervention, when SBAR was implemented in an anaesthetic clinic, we were unable to show any improvement in recalled information among receivers following postoperative handover.
Current controlled trials http://www.controlled-trials.com Identifier: ISRCTN37251313.
沟通失误会引发与手术相关的临床事件和不良事件。为确保术后对患者的妥善护理，工作人员记住并回忆起从手术室到麻醉后护理单元交接过程中所提供的信息至关重要。将交接流程规范化可能会改善沟通并有助于记忆，但该领域的研究尚显不足。
本研究的目的是评估实施情境 - 背景 - 评估 - 建议（SBAR）沟通工具是否会影响术后交接后接收者的信息保留情况。
一项前瞻性干预研究，设有干预组和非干预对照组，并在干预前后进行评估。
2011年和2012年瑞典两家医院的麻醉后护理单元。
每家医院中参与手术室与麻醉后护理单元之间交接工作的人员。
在一家医院实施SBAR沟通工具。
主要观察指标是交接后接收者回忆起的信息序列的百分比。使用针对本研究的特定方案表格记录的音频和观察结果来收集数据。
干预前，观察到73次交接（干预组，n = 40；对照组，n = 33），涉及72名人员（干预组，n = 40；对照组，n = 32）。干预后，观察到91次交接（干预组，n = 44；对照组，n = 47），涉及57名人员（干预组，n = 31；对照组，n = 26）。在干预组中，接收者回忆起的信息序列百分比从干预前的43.4%增加到干预后的52.6%（P = 0.004），并且SBAR结构有显著改善（P = 0.028）。在对照组中，相应数字分别为51.3%和52.6%（P = 0.725），SBAR结构无差异。当使用线性回归广义估计方程模型来考虑混杂因素的影响时，我们无法显示随着时间推移干预组和非干预组之间在回忆信息方面存在显著差异。
与未进行干预的对照组相比，在麻醉诊所实施SBAR时，我们无法显示术后交接后接收者在回忆信息方面有任何改善。
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