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产前住院环境中标准化查房的评估

Evaluation of a standardized ward round in a prenatal inpatient setting.

作者信息

Christensen Katie, Janssens Sarah, Beckmann Michael

机构信息

Department of Obstetrics and Gynaecology, Mather Mothers' Hospital, Mater Health, Brisbane, QLD, Australia.

University of Queensland, Brisbane, QLD, Australia.

出版信息

Int J Gynaecol Obstet. 2017 Mar;136(3):357-361. doi: 10.1002/ijgo.12080. Epub 2017 Jan 14.

Abstract

OBJECTIVE

To evaluate the impact of incorporating a standardized ward round (SWR) tool including checklists for communication, safety, and efficiency into ward rounds.

METHODS

A prospective non-randomized, before-and-after observational study was conducted at a tertiary maternity hospital in Brisbane, Australia, between October 1, 2014, and October 1, 2015. Obstetric team members performing prenatal ward rounds used role-specific lanyards prompting the structure of each consultation. Rounds were audited before and after the introduction of the SWR for safety checks, hand hygiene, the duration of patient encounters, and plan congruity. Patients completed a paper-based satisfaction survey. Results from before and after the introduction of the SWR were compared.

RESULTS

There were 71 conventional ward rounds and 79 SWRs audited, and no difference was found in the mean duration of patient encounters (P=0.566). SWRs were associated with increased rates of each of the five safety checks being performed and of hand hygiene being observed correctly (all P<0.001). SWR was also associated with a greater proportion of patients indicating that they understood their plan of care.

CONCLUSION

The use of a structured tool for ward rounds improved communication with patients, increased the frequency of safety checks being performed, and improved hand hygiene without prolonging ward rounds.

摘要

目的

评估将包含沟通、安全和效率清单的标准化查房(SWR)工具纳入查房的影响。

方法

2014年10月1日至2015年10月1日期间,在澳大利亚布里斯班的一家三级妇产医院进行了一项前瞻性非随机前后观察研究。进行产前查房的产科团队成员使用特定角色的挂绳来提示每次会诊的结构。在引入SWR之前和之后,对查房进行安全检查、手卫生、患者会诊时间和计划一致性方面的审核。患者完成纸质满意度调查。比较引入SWR前后的结果。

结果

共审核了71次传统查房和79次SWR,患者会诊的平均时长没有差异(P = 0.566)。SWR与五项安全检查中每项检查的执行率增加以及正确观察手卫生的比率增加相关(所有P < 0.001)。SWR还与更大比例的患者表示理解其护理计划相关。

结论

使用结构化查房工具改善了与患者的沟通,增加了安全检查的执行频率,改善了手卫生,且未延长查房时间。

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