Tatum James M, White Terris, Kang Christopher, Ley Eric J, Melo Nicolas, Bloom Matthew, Alban Rodrigo F
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, California.
J Surg Educ. 2017 Sep-Oct;74(5):851-856. doi: 10.1016/j.jsurg.2017.03.003. Epub 2017 Mar 24.
The objective of the study was to characterize house staff time to response and intervention when notified of a patient care issue by pager vs. smartphone. We hypothesized that smartphones would reduce house staff time to response and intervention.
Prospective study of all electronic communications was conducted between nurses and house staff between September 2015 and October 2015. The 4-week study period was randomly divided into two 2-week study periods where all electronic communications between intensive care unit nurses and intensive care unit house staff were exclusively by smartphone or by pager, respectively. Time of communication initiation, time of house staff response, and time from response to clinical intervention for each communication were recorded. Outcomes are time from nurse contact to house staff response and intervention.
Single-center surgical intensive care unit of Cedars-Sinai Medical Center in Los Angeles, California, an academic tertiary care and level I trauma center.
All electronic communications occurring between nurses and house staff in the study unit during the study period were considered. During the study period, 205 nurse-house staff electronic communications occurred, 100 in the phone group and 105 in the pager group.
House staff response to communication time was significantly shorter in the phone group (0.5 [interquartile range = 1.7] vs. 2 [3]min, p < 0.001). Time to house staff intervention after response was also significantly more rapid in the phone group (0.8 [1.7] vs. 1 [2]min, p = 0.003).
Dedicated clinical smartphones significantly decrease time to house staff response after electronic nursing communications compared with pagers.
本研究的目的是描述住院医师在通过传呼机与智能手机接到患者护理问题通知后的响应时间和干预时间。我们假设智能手机将减少住院医师的响应时间和干预时间。
2015年9月至2015年10月期间，对护士与住院医师之间的所有电子通信进行了前瞻性研究。为期4周的研究期被随机分为两个2周的研究期，在此期间，重症监护病房护士与重症监护病房住院医师之间的所有电子通信分别仅通过智能手机或传呼机进行。记录每次通信的开始时间、住院医师的响应时间以及从响应到临床干预的时间。结果指标为从护士联系到住院医师响应和干预的时间。
加利福尼亚州洛杉矶雪松西奈医疗中心的单中心外科重症监护病房，这是一家学术性三级护理和一级创伤中心。
研究期间研究单元内护士与住院医师之间发生的所有电子通信均被纳入考虑。研究期间，共发生了205次护士与住院医师之间的电子通信，其中电话组100次，传呼机组105次。
电话组住院医师对通信的响应时间明显更短（0.5[四分位间距=1.7]分钟对2[3]分钟，p<0.001）。电话组住院医师响应后的干预时间也明显更快（0.8[1.7]分钟对1[2]分钟，p=0.003）。
与传呼机相比，专用临床智能手机显著缩短了电子护理通信后住院医师的响应时间。
