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急性成人保健环境中的故意变圆:系统的混合方法综述。

Intentional rounding in acute adult healthcare settings: A systematic mixed-method review.

机构信息

Centre for Nursing, Midwifery & Health Services Research, School of Nursing & Midwifery, Edith Cowan University, Joondalup, Perth, WA, Australia.

Centre for Nursing Research, Sir Charles Gairdner Hospital, Nedlands, Perth, WA, Australia.

出版信息

J Clin Nurs. 2018 May;27(9-10):1759-1792. doi: 10.1111/jocn.14370.

Abstract

AIMS AND OBJECTIVES

To determine the impact of intentional rounding on patient and nursing outcomes and identify the barriers and facilitators surrounding implementation.

BACKGROUND

Intentional rounding is an organised approach whereby health professionals' regularly check on patients to ensure their fundamental care needs are met. Despite wide scale adoption of intentional rounding, there is limited evidence to inform practice.

METHODS

This systematic mixed-method review was conducted using the Joanna Briggs Institute methodology. Databases CINAHL, MEDLINE, EMBASE, COCHRANE, SCOPUS and WEB of SCIENCE were searched to identify research studies published in English between January 2006-January 2017 that reported on intentional rounding and patient and nursing staff outcomes. Studies were assessed for methodological quality. The findings were synthesised into themes using a narrative approach.

RESULTS

Twenty-one studies were included in the review. Six studies reported a reduction in the number of falls, and a further five studies reported a reduction in call bell use following the introduction of intentional rounding. Nurses' satisfaction and attitudes towards intentional rounding were reported in seven studies with equivocal results. The quality of the studies was weak making comparisons difficult.

CONCLUSIONS

While results suggest positive outcomes for falls and call bell use, conclusions on the available data are overshadowed by the quality of the studies. Well-designed studies are required to advance evidence in this field.

RELEVANCE TO CLINICAL PRACTICE

The evidence on intentional rounding is mixed and suggests that the introduction of intentional rounding should be accompanied by a protocol for robust evaluation to measure the impact of this process change. This should be accompanied by standardised reporting measures to enable comparisons and contribute to the quality of available evidence on intentional rounding.

摘要

目的和目标

确定有意轮班对患者和护理结果的影响,并确定实施过程中的障碍和促进因素。

背景

有意轮班是一种有组织的方法,通过这种方法,卫生专业人员定期检查患者,以确保满足他们的基本护理需求。尽管广泛采用了有意轮班,但实践中可供参考的证据有限。

方法

本系统混合方法综述使用 Joanna Briggs 研究所的方法进行。检索 CINAHL、MEDLINE、EMBASE、COCHRANE、SCOPUS 和 WEB of SCIENCE 数据库,以确定 2006 年 1 月至 2017 年 1 月期间以英文发表的报告有意轮班和患者及护理人员结果的研究。对研究进行了方法学质量评估。使用叙述性方法将研究结果综合成主题。

结果

综述纳入了 21 项研究。6 项研究报告称,引入有意轮班后,跌倒的人数有所减少,另有 5 项研究报告称,使用呼叫铃的次数有所减少。有 7 项研究报告了护士对有意轮班的满意度和态度,但结果存在分歧。研究的质量较差,使得比较困难。

结论

虽然结果表明在跌倒和呼叫铃使用方面有积极的结果,但由于研究的质量,对现有数据的结论受到了影响。需要进行精心设计的研究来推进这一领域的证据。

临床相关性

有意轮班的证据喜忧参半,这表明在引入有意轮班时,应同时制定一个稳健评估的方案,以衡量这一流程变化的影响。还应制定标准化的报告措施,以实现比较,并有助于提高关于有意轮班的现有证据的质量。

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