Hay James M, Barnette William, Shaw Sandra Egeto
James M. Hay, EdD, MSN, RN, CRRN, is Nurse Educator, VA-National Center for Patient Safety, Ann Arbor, Michigan. William Barnette, MSN, RN, NE-BC, is Associate Chief Nurse of Surgery, Huntington VA Medical Center, Huntington, West Virginia. Sandra Egeto Shaw, MSN, RN, is Clinical Research Nurse Coordinator, Huntington VA Medical Center, Huntington, West Virginia.
Gastroenterol Nurs. 2016 May-Jun;39(3):181-5. doi: 10.1097/SGA.0000000000000190.
Failure in communication during the process of delivering healthcare can have dangerous repercussions. Specifically, failure in interdisciplinary team communication contributes to lapses in patient care. Distractions in procedural areas disrupt team communication. Application of a structured communication algorithm creates agreed-upon cues that promote team communication and facilitate clinical decision making. Frequent disruptions before, during, and after gastro-intestinal endoscopy procedures place veterans at risk for an error. A hierarchical culture promotes intimidation and reduces the likelihood that staff will speak up for patient safety. An endoscopy procedure area implemented a "sterile cockpit" methodology to reduce the number of distractions during procedures. Data collected from a self-reported safety awareness were measured by two different questionnaires and collected through observation of actual practice. Improved awareness of distraction and the impact on patient safety was reported, with a reduction from 24 observed interruptions to zero in 9 months. After reducing distractions in the procedural area, there is a perception of improved nursing quality of care. Additional support is required to consistently remove electronic distractions during a procedure.
在提供医疗保健过程中沟通失败可能会产生危险的后果。具体而言，跨学科团队沟通失败会导致患者护理失误。操作区域的干扰会扰乱团队沟通。应用结构化沟通算法可创建大家认可的提示，促进团队沟通并有助于临床决策。胃肠内窥镜检查程序之前、期间和之后频繁的干扰使退伍军人面临出错风险。等级森严的文化会助长恐吓行为，并降低工作人员为患者安全发声的可能性。一个内窥镜检查操作区域实施了“无菌驾驶舱”方法，以减少操作过程中的干扰次数。通过两份不同的问卷对自我报告的安全意识收集的数据进行测量，并通过实际操作观察进行收集。报告显示，对干扰及其对患者安全的影响的认识有所提高，在9个月内观察到的干扰次数从24次降至零。在减少操作区域的干扰后，人们感觉护理质量有所改善。需要额外的支持以在操作过程中持续消除电子干扰。
