团队合作对澳大利亚四家医院护理失误的影响。

Impact of teamwork on missed care in four Australian hospitals.

作者信息

Chapman Rose, Rahman Asheq, Courtney Mary, Chalmers Cheyne

机构信息

Emergency Nursing, Australian Catholic University and Monash Health, Melbourne, Vic., Australia.

Faculty of Health Sciences, School of Nursing, Midwifery and Paramedicine, Australian Catholic University, Brisbane, Qld, Australia.

出版信息

J Clin Nurs. 2017 Jan;26(1-2):170-181. doi: 10.1111/jocn.13433.

DOI:10.1111/jocn.13433

PMID:27322941

Abstract

AIMS AND OBJECTIVES

Investigate effects of teamwork on missed nursing care across a healthcare network in Australia.

BACKGROUND

Missed care is universally used as an indicator of quality nursing care, however, little is known about mitigating effects of teamwork on these events.

DESIGN

A descriptive exploratory study.

METHODS

Missed Care and Team Work surveys were completed by 334 nurses. Using Stata software, nursing staff demographic information and components of missed care and teamwork were compared across the healthcare network. Statistical tests were performed to identify predicting factors for missed care.

RESULTS

The most commonly reported components of missed care were as follows: ambulation three times per day (43·3%), turning patient every two hours (29%) and mouth care (27·7%). The commonest reasons mentioned for missed care were as follows: inadequate labour resources (range 69·8-52·7%), followed by material resources (range 59·3-33·3%) and communication (range 39·3-27·2%). There were significant differences in missed care scores across units. Using the mean scores in regression correlation matrix, the negative relationship of missed care and teamwork was supported (r = -0·34, p < 0·001). Controlling for occupation of the staff member and staff characteristics in multiple regression models, teamwork alone accounted for about 9% of missed nursing care.

CONCLUSION

Similar to previous international research findings, our results showed nursing teamwork significantly impacted on missed nursing care. Teamwork may be a mitigating factor to address missed care and future research is needed.

RELEVANCE TO CLINICAL PRACTICE

These results may provide administrators, educators and clinicians with information to develop practices and policies to improve patient care internationally.

摘要

目的

调查团队合作对澳大利亚一个医疗网络中护理缺失的影响。

背景

护理缺失普遍被用作优质护理的一个指标，然而，关于团队合作对这些事件的缓解作用却知之甚少。

设计

一项描述性探索性研究。

方法

334名护士完成了护理缺失和团队合作调查。使用Stata软件，对医疗网络中护理人员的人口统计学信息以及护理缺失和团队合作的组成部分进行了比较。进行了统计测试以确定护理缺失的预测因素。

结果

护理缺失最常报告的组成部分如下：每天三次下床活动（43.3%）、每两小时为患者翻身（29%）和口腔护理（27.7%）。提到的护理缺失最常见原因如下：劳动力资源不足（范围为69.8% - 52.7%），其次是物资资源（范围为59.3% - 33.3%）和沟通（范围为39.3% - 27.2%）。各科室的护理缺失得分存在显著差异。在回归相关矩阵中使用平均得分，护理缺失与团队合作的负相关关系得到支持（r = -0.34，p < 0.001）。在多元回归模型中控制工作人员的职业和工作人员特征后，团队合作单独约占护理缺失的9%。