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住院医师研讨会规范了患者交接流程,提高了质量、信心和知识水平。

Resident Workshop Standardizes Patient Handoff and Improves Quality, Confidence, and Knowledge.

作者信息

Murphy Heidi J, Karpinski Aryn C, Messer Amanda, Gallois Julie, Mims Michelle, Farge Ashley, Hernandez Lauren, Steinhardt Michelle, Sandlin Chelsey

机构信息

From the Department of Pediatrics, Louisiana State University Health Science Center, New Orleans.

出版信息

South Med J. 2017 Sep;110(9):571-577. doi: 10.14423/SMJ.0000000000000698.

Abstract

OBJECTIVES

Residency programs are required to instruct residents in handoff; however, a handoff curriculum endorsed by the Accreditation Council for Graduate Medical Education does not exist. Although curricula are available, we preferred to use a curriculum that could be taught quickly, was easy to implement, and used a mnemonic that resembled current practices at our institution. We designed and implemented a novel handoff educational workshop intended to improve resident confidence and performance.

METHODS

In this observational study, pediatric residents across postgraduate training years during winter 2014-spring 2015 participated in two study segments: a handoff workshop with questionnaires and handoff observations. Co-investigators developed and led an interactive workshop for residents that emphasized a standardized approach using the SIGNOUT mnemonic (see text for definition). The effect of workshop participation on handoff abilities was evaluated using a validated, handoff evaluation tool administered before and after the workshop. Qualitative feedback was obtained from residents using pre- and postworkshop surveys.

RESULTS

Forty-three residents participated in the workshop; 41 residents completed handoff observations. Improvements were noted in clinical judgment ( = 0.02) and organization/communication ( = 0.005). Pre- and postworkshop surveys demonstrated self-perceived increases in confidence, comfort, and knowledge ( < 0.001).

CONCLUSIONS

Improvements in handoffs, particularly in clinical judgment and organization/communication domains, suggest that a more standardized handoff approach is beneficial, especially for postgraduate year 1 residents. The novel, interactive workshop we developed can be taught quickly, is easy to implement, is appropriate for all resident training levels, and improves resident confidence and skill. This workshop can be implemented by training programs across all disciplines, possibly leading to improved patient safety.

摘要

目的

住院医师培训项目要求对住院医师进行交接班培训;然而,研究生医学教育认证委员会认可的交接班课程并不存在。尽管有相关课程可用,但我们更倾向于使用一种能够快速传授、易于实施且使用类似我们机构当前做法的记忆法的课程。我们设计并实施了一个新颖的交接班教育工作坊,旨在提高住院医师的信心和表现。

方法

在这项观察性研究中,2014年冬季至2015年春季各研究生培训阶段的儿科住院医师参与了两个研究环节:一个带有问卷调查和交接班观察的交接班工作坊。共同研究者为住院医师开发并主持了一个互动工作坊,该工作坊强调使用SIGNOUT记忆法(定义见正文)的标准化方法。使用工作坊前后管理的经过验证的交接班评估工具来评估参与工作坊对交接班能力的影响。通过工作坊前后的调查从住院医师那里获得定性反馈。

结果

43名住院医师参加了工作坊;41名住院医师完成了交接班观察。在临床判断(P = 0.02)和组织/沟通(P = 0.005)方面有改善。工作坊前后的调查显示,自我感知的信心、舒适度和知识有所增加(P < 0.001)。

结论

交接班的改善,特别是在临床判断和组织/沟通领域,表明更标准化的交接班方法是有益的,尤其是对于第一年住院医师。我们开发的新颖互动工作坊可以快速传授,易于实施,适用于所有住院医师培训水平,并提高住院医师的信心和技能。这个工作坊可以由所有学科的培训项目实施,可能会提高患者安全。

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