Department of Health and Care Sciences, Faculty of Health Sciences, University of Tromsø, The Arctic University of Norway, Tromsø, Norway.
Faculty of Health, Care and Nursing, Norwegian University of Science and Technology, Gjövik, Norway.
J Clin Nurs. 2018 Jan;27(1-2):e186-e194. doi: 10.1111/jocn.13911. Epub 2017 Jul 10.
The aim of the study was to describe nurses' experiences of patients' transition from ICUs to general wards and their suggestions for improvements.
In the ICU, the most seriously ill patients with life-threatening conditions and multiple organ dysfunction syndromes are cared for and carefully monitored by specially trained professionals using advanced techniques for the prevention of failure of vital functions. The transfer of ICU patients to general wards means a change from a high to a lower level, including the loss of one-to-one nursing and a reduction of visible monitoring equipment and general close attention.
A qualitative descriptive design.
Eight nurses from three different inpatient units in Norway, five from a university hospital and three from a local hospital were selected through a convenience sample. Interviews with open questions were conducted, and qualitative content analysis was used to explore the data.
Nurses' experiences were described in one main category: ICU patients' transition-a great responsibility and a huge challenge, and two generic categories: (i) a challenging transition for nurses, patients and relatives and (ii) dialogue and competencies as tools for improvement, with six subcategories.
A number of factors affected patient care, such as poor cooperation, communication, reporting, expertise and clinical gaze. It was clear that the general wards had major challenges, and a number of improvements were suggested.
This study shows that there is still a gap between the ICU and general wards and that nurses continue to struggle with this. It is therefore important that the managers responsible for the quality of care together with the professionals take seriously the criticism in the present and previous studies and work towards a safe transition for patients.
本研究旨在描述护士在患者从 ICU 转入普通病房过程中的体验，以及他们对改进的建议。
在 ICU 中，由经过专门培训的专业人员使用先进的技术来预防生命功能衰竭，对生命受到威胁且存在多器官功能障碍综合征的最危重患者进行护理和密切监测。将 ICU 患者转入普通病房意味着从高到低的级别变化，包括失去一对一护理以及减少可视监测设备和普遍的密切关注。
定性描述性设计。
通过便利抽样，从挪威的三个住院病房中选择了 8 名护士，其中 5 名来自大学医院，3 名来自当地医院。采用开放式问题进行访谈，并使用定性内容分析方法对数据进行了探索。
护士的体验被描述为一个主要类别：ICU 患者的过渡——重大责任和巨大挑战，以及两个通用类别：（i）对护士、患者和家属来说是一个具有挑战性的过渡，以及（ii）对话和能力是改进的工具，包含六个子类别。
许多因素影响了患者的护理，例如协作、沟通、报告、专业知识和临床关注不足。很明显，普通病房面临着重大挑战，并提出了一些改进措施。
本研究表明，ICU 和普通病房之间仍存在差距，护士仍在为此而努力。因此，负责护理质量的管理人员以及专业人员必须认真对待本研究及以往研究中的批评意见，并努力实现患者的安全过渡。
