Walsh Heather A, Jolly Inouye Adriane A, Goldman Ellen F
Children's National Medical Center, Washington, District of Columbia; and
Children's National Medical Center, Washington, District of Columbia; and.
Hosp Pediatr. 2017 Nov;7(11):660-667. doi: 10.1542/hpeds.2017-0001. Epub 2017 Oct 3.
Previously, reduced resident hours, multiple ways to communicate (text paging, calling), and fewer opportunities for face-to-face communication had led to increased frustration from residents and nurses in our institution about communicating and prioritizing patient care needs. It was thought that a shared understanding and improved teamwork and communication between residents and nurses might be achieved if the residents could watch the nurses' workflow and observe their care priorities.
To understand the experience of residents and nurses who had participated in a novel 4-hour nurse shadowing experience conducted during the first year of pediatric medical residency in a children's hospital.
We undertook a basic interpretive qualitative study by using semistructured interviews to formally evaluate the shadowing program by examining the experiences of both the first-year residents and the nurses being shadowed. Residents and nurses who had participated in the past 3 years were eligible for inclusion in the study.
Seven themes emerged that supported the overarching theme of improving communication between residents and nurses. Shadowing led to improved resident understanding and appreciation of nurses' work. Both residents and nurses experienced enhanced relationships as they discussed opportunities to improve care delivery. Residents reported practice changes after shadowing a nurse. Peer relationships formed among the dyads that extended beyond the shadowing experience.
Shadowing a nurse proved to be a valuable experience that had an impact on participants and potentially a positive impact on patient care.
此前，住院医师工作时长减少、沟通方式多样（短信传呼、打电话）以及面对面交流机会减少，导致我院住院医师和护士在沟通及确定患者护理需求优先级方面的挫败感增加。人们认为，如果住院医师能够观察护士的工作流程并了解其护理重点，或许可以实现住院医师与护士之间达成共同理解并改善团队合作及沟通。
了解参与了一家儿童医院儿科医学住院医师第一年期间开展的为期4小时的新型护士跟班体验活动的住院医师和护士的经历。
我们采用半结构化访谈进行了一项基本的解释性定性研究，通过考察第一年住院医师和被跟班护士的经历来正式评估跟班项目。过去3年参与过的住院医师和护士符合纳入本研究的条件。
出现了七个主题，支持了改善住院医师与护士之间沟通这一总体主题。跟班体验使住院医师对护士工作的理解和认识得到提高。住院医师和护士在讨论改善护理服务的机会时，双方关系都得到了加强。住院医师报告称在跟班护士后实践发生了变化。在二元组中形成的同伴关系超出了跟班体验的范围。
事实证明，跟班护士是一次宝贵的经历，对参与者产生了影响，并可能对患者护理产生积极影响。
