O'Rourke Kathleen, Teel Joseph, Nicholls Erika, Lee Daniel D, Colwill Alyssa Covelli, Srinivas Sindhu K
J Obstet Gynecol Neonatal Nurs. 2018 Mar;47(2):264-272. doi: 10.1016/j.jogn.2017.11.008. Epub 2017 Dec 27.
To improve staff perception of the quality of the patient admission process from obstetric triage to the labor and delivery unit through standardization.
Preassessment and postassessment online surveys.
A 13-bed labor and delivery unit in a quaternary care, Magnet Recognition Program, academic medical center in Pennsylvania.
Preintervention (n = 100), postintervention (n = 52), and 6-month follow-up survey respondents (n = 75) represented secretaries, registered nurses, surgical technicians, certified nurse-midwives, nurse practitioners, maternal-fetal medicine fellows, anesthesiologists, and obstetric and family medicine attending and resident physicians from triage and labor and delivery units.
We educated staff and implemented interventions, an admission huddle and safety time-out whiteboard, to standardize the admission process. Participants were evaluated with the use of preintervention, postintervention, and 6-month follow-up surveys about their perceptions regarding the admission process. Data tracked through the electronic medical record were used to determine compliance with the admission huddle and whiteboards.
A 77% reduction (decrease of 49%) occurred in the perception of incomplete patient admission processes from baseline to 6-month follow-up after the intervention. Postintervention and 6-month follow-up survey results indicated that 100% of respondents responded strongly agree/agree/neutral that the new admission process improved communication surrounding care for patients. Data in the electronic medical record indicated that compliance with use of admission huddles and whiteboards increased from 50% to 80% by 6 months.
The new patient admission process, including a huddle and safety time-out board, improved staff perception of the quality of admission from obstetric triage to the labor and delivery unit.
通过标准化提高工作人员对从产科分诊到分娩单元的患者入院流程质量的认知。
预评估和后评估在线调查。
宾夕法尼亚州一家拥有四级护理、获磁体认证计划的学术医疗中心的13张床位的分娩单元。
干预前（n = 100）、干预后（n = 52）以及6个月随访调查的受访者（n = 75），包括秘书、注册护士、外科技术员、认证护士助产士、执业护士、母胎医学研究员、麻醉师以及分诊和分娩单元的产科和家庭医学主治医生及住院医生。
我们对工作人员进行培训并实施干预措施，即入院碰头会和安全暂停白板，以规范入院流程。通过干预前、干预后以及6个月随访调查来评估参与者对入院流程的看法。利用电子病历跟踪的数据来确定对入院碰头会和白板的遵守情况。
干预后，从基线到6个月随访期间，对患者入院流程不完整的认知下降了77%（减少了49%）。干预后和6个月随访调查结果显示，100%的受访者强烈同意/同意/中立地认为新的入院流程改善了围绕患者护理的沟通。电子病历中的数据表明，到6个月时，对入院碰头会和白板的使用遵守率从50%提高到了80%。
新的患者入院流程，包括碰头会和安全暂停板，提高了工作人员对从产科分诊到分娩单元的入院质量的认知。
