Goyal Anupama A, Tur Komalpreet, Mann Jason, Townsend Whitney, Flanders Scott A, Chopra Vineet
Division of Hospital Medicine, Michigan Medicine, University of Michigan, Ann Arbor, Michigan, USA.
University of Michigan, Ann Arbor, Michigan, USA.
J Hosp Med. 2017 Nov;12(11):930-936. doi: 10.12788/jhm.2871.
Although common, the impact of low-cost bedside visual tools, such as whiteboards, on patient care is unclear.
To systematically review the literature and assess the influence of bedside visual tools on patient satisfaction.
Medline, Embase, SCOPUS, Web of Science, CINAHL, and CENTRAL.
Studies of adult or pediatric hospitalized patients reporting physician identification, understanding of provider roles, patient-provider communication, and satisfaction with care from the use of visual tools were included. Outcomes were categorized as positive, negative, or neutral based on survey responses for identification, communication, and satisfaction. Two reviewers screened studies, extracted data, and assessed the risk of study bias.
Sixteen studies met the inclusion criteria. Visual tools included whiteboards (n = 4), physician pictures (n = 7), whiteboard and picture (n = 1), electronic medical record-based patient portals (n = 3), and formatted notepads (n = 1). Tools improved patients' identification of providers (13/13 studies). The impact on understanding the providers' roles was largely positive (8/10 studies). Visual tools improved patient-provider communication (4/5 studies) and satisfaction (6/8 studies). In adults, satisfaction varied between positive with the use of whiteboards (2/5 studies) and neutral with pictures (1/5 studies). Satisfaction related to pictures in pediatric patients was either positive (1/3 studies) or neutral (1/3 studies). Differences in tool format (individual pictures vs handouts with pictures of all providers) and study design (randomized vs cohort) may explain variable outcomes.
The use of bedside visual tools appears to improve patient recognition of providers and patient-provider communication. Future studies that include better design and outcome assessment are necessary before widespread use can be recommended.
尽管低成本的床边视觉工具（如白板）很常见，但它们对患者护理的影响尚不清楚。
系统回顾文献并评估床边视觉工具对患者满意度的影响。
医学期刊数据库（Medline）、荷兰医学文摘数据库（Embase）、斯高帕斯数据库（SCOPUS）、科学引文索引数据库（Web of Science）、护理学与健康领域数据库（CINAHL）和考克兰系统评价数据库（CENTRAL）。
纳入关于成人或儿科住院患者的研究，这些研究报告了使用视觉工具后患者对医生的识别、对医护人员角色的理解、医患沟通以及对护理的满意度。根据关于识别、沟通和满意度的调查回复，将结果分为积极、消极或中性。两名评审员筛选研究、提取数据并评估研究偏倚风险。
16项研究符合纳入标准。视觉工具包括白板（4项研究）、医生照片（7项研究）、白板和照片（1项研究）、基于电子病历的患者门户（3项研究）以及格式化便签本（1项研究）。这些工具提高了患者对医护人员的识别能力（13/13项研究）。对理解医护人员角色的影响大多是积极的（8/10项研究）。视觉工具改善了医患沟通（4/5项研究）和患者满意度（6/8项研究）。在成人中，使用白板时满意度为积极（2/5项研究），使用照片时满意度为中性（1/5项研究）。儿科患者对照片的满意度要么是积极（1/3项研究）要么是中性（1/3项研究）。工具形式（个人照片与包含所有医护人员照片的资料）和研究设计（随机对照试验与队列研究）的差异可能解释了不同的结果。
使用床边视觉工具似乎能提高患者对医护人员的识别能力以及医患沟通。在建议广泛使用之前，有必要进行设计更好、结果评估更完善的未来研究。
