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住院医师主导实施标准化交接班系统以促进术后神经外科患者向重症监护病房的转运

Resident-led Implementation of a Standardized Handoff System to Facilitate Transfer of Postoperative Neurosurgical Patients to the ICU.

作者信息

Birk Harjus S, Han Seunggu J, Rolston John D, Rowland Nathan C, Lau Catherine, Theodosopoulos Philip V, McDermott Michael W

机构信息

Department of Neurological Surgery, University of California, San Francisco ; Research Fellow, Howard Hughes Medical Institute.

Department of Neurological Surgery, University of California, San Francisco.

出版信息

Cureus. 2016 Jan 18;8(1):e461. doi: 10.7759/cureus.461.

Abstract

Transitions in care are pivotal moments for patient safety. Although many strategies have been suggested for handoff improvement in the healthcare realm, little focus has been placed on patient safety during the transition from the operative to the postoperative setting. Many surgical trainees have received limited instruction, if any, on how to conduct comprehensive handoffs that ensure the safe transition of care and optimize continuity of care. Therefore, structured transfers of patient care can be invaluable. Here, we describe the implementation of a standardized handoff system developed by residents in an academic neurosurgery department to communicate key perioperative data via both electronic documentation and in-person discussion as a means of reinforcement. Our results are part of a comprehensive effort to strengthen the culture of safety surrounding the care and treatment of neurosurgical patients at our institution.

摘要

护理转接是关乎患者安全的关键时刻。尽管在医疗领域已提出许多改善交接的策略,但在从手术阶段到术后阶段的过渡过程中,对患者安全的关注却很少。许多外科实习生即便接受过相关指导,也是关于如何进行全面交接的有限指导,这些指导旨在确保护理的安全过渡并优化护理的连续性。因此,结构化的患者护理转接可能非常宝贵。在此,我们描述了一个由学术性神经外科科室的住院医师开发的标准化交接系统的实施情况,该系统通过电子文档和面对面讨论来传达关键围手术期数据,以此作为一种强化手段。我们的结果是加强我们机构神经外科患者护理和治疗安全文化的全面努力的一部分。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/98c8/4762767/c9ca2e3ee53a/cureus-0008-000000000461-i01.jpg

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An observational study of postoperative handoff standardization failures.一项关于术后交接标准化失败的观察性研究。
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本文引用的文献

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Recent advances in the patient safety and quality initiatives movement: implications for neurosurgery.
Neurosurg Clin N Am. 2015 Apr;26(2):301-15, xi. doi: 10.1016/j.nec.2014.11.017. Epub 2015 Jan 31.
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Changes in medical errors with a handoff program.交接程序实施后医疗差错的变化
N Engl J Med. 2015 Jan 29;372(5):490-1. doi: 10.1056/NEJMc1414788.

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