de Lange Santel, van Eeden Ilze, Heyns Tanya
Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Department of Nursing Science, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
Int Emerg Nurs. 2018 Jan;36:46-50. doi: 10.1016/j.ienj.2017.09.009. Epub 2017 Oct 16.
We explored the existing patient handover practices between emergency care practitioners and healthcare professionals in the emergency department. In the emergency department, patient handover between emergency care practitioner's and healthcare professionals is a complex process involving multiple functions, such as the transfer of information, responsibility and accountability from one person to another. We used a qualitative study design. Emergency care practitioners and healthcare professionals were identified using purposive and convenience sampling data. Data were collected through unstructured participant observation. We conducted 20 observation sessions, varying between 15 and 20min. The data were analysed using a creative hermeneutic approach. The 'how' or manner of patient handover observed between emergency care practitioners and health professionals was perceived as important. A diagnosis of disrespectful behaviour was made which could negatively influence patient handover and ultimately patient outcome. Disrespectful behaviour stemmed from the two signs that supported the diagnosis: task-orientated behaviour and the use of indigenous language. Involving the emergency care practitioners and healthcare professionals in observing and analysing the existing patient handover practices in the ED raised their awareness of the current workplace culture. Transforming behaviour from disrespectful to respectful should include greeting one another, listening attentively to the patient handover and include emergency care practitioners, patients and their significant other in the handover process that should be conducted in a commonly understood language. Emergency care practitioners and healthcare professionals should recognise that during patient handover 'how' is as important as 'what'.
我们探讨了急诊科急救从业人员与医护人员之间现有的患者交接流程。在急诊科，急救从业人员与医护人员之间的患者交接是一个复杂的过程，涉及多种功能，如信息、责任和问责从一人向另一人的转移。我们采用了定性研究设计。通过立意抽样和便利抽样数据确定急救从业人员和医护人员。数据通过非结构化参与观察收集。我们进行了20次观察，每次观察时长在15至20分钟之间。数据采用创造性诠释学方法进行分析。急救从业人员与医护人员之间观察到的患者交接“方式”或方法被认为很重要。诊断出存在不尊重行为，这可能会对患者交接产生负面影响，并最终影响患者的治疗结果。不尊重行为源于支持该诊断的两个迹象：任务导向行为和使用本土语言。让急救从业人员和医护人员参与观察和分析急诊科现有的患者交接流程，提高了他们对当前工作场所文化的认识。将行为从不尊重转变为尊重，应包括相互问候、认真倾听患者交接内容，并让急救从业人员、患者及其重要他人参与到应以通用语言进行的交接过程中。急救从业人员和医护人员应认识到，在患者交接过程中，“方式”与“内容”同样重要。
