重症监护病房高级护士交接班期间的干扰：一项质量改进研究。
Interruptions During Senior Nurse Handover in the Intensive Care Unit: A Quality Improvement Study.
作者信息
Spooner Amy J, Chaboyer Wendy, Aitken Leanne M
机构信息
Adult Intensive Care Services, The Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia (Ms Spooner); School of Nursing and Midwifery, Griffith University, Queensland, Australia (Ms Spooner and Drs Chaboyer and Aitken); Menzies Health Institute Queensland, Gold Coast, Queensland, Australia (Drs Chaboyer and Aitken); and School of Health Sciences, City, University of London, London, United Kingdom (Dr Aitken).
出版信息
J Nurs Care Qual. 2019 Jan/Mar;34(1):E15-E21. doi: 10.1097/NCQ.0000000000000345.
BACKGROUND
Interruptions during handover may compromise continuity of care and patient safety.
LOCAL PROBLEM
Interruptions occur frequently during handovers in the intensive care unit.
METHODS
A quality improvement study was undertaken to improve nursing team leader handover processes. The frequency, source, and reason interruptions occurred were recorded before and after a handover intervention.
INTERVENTIONS
The intervention involved relocating handover from the desk to bedside and using a printed version of an evidence-based electronic minimum data set. These strategies were supported by education, champions, reminders, and audit and feedback.
RESULTS
Forty handovers were audiotaped before, and 49 were observed 3 months following the intervention. Sixty-four interruptions occurred before and 52 after the intervention, but this difference was not statistically significant. Team leaders were frequently interrupted by nurses discussing personal or work-specific matters before and after the intervention.
CONCLUSIONS
Further work is required to reduce interruptions that do not benefit patient care.
背景
交接班过程中的干扰可能会损害护理的连续性和患者安全。
当地问题
重症监护病房的交接班过程中频繁出现干扰。
方法
开展了一项质量改进研究，以改善护理团队负责人的交接班流程。在交接班干预前后，记录干扰发生的频率、来源和原因。
干预措施
干预措施包括将交接班地点从办公桌转移到床边，并使用基于证据的电子最小数据集的打印版本。这些策略得到了教育、倡导者、提醒以及审核和反馈的支持。
结果
干预前对40次交接班进行了录音，干预3个月后观察了49次。干预前发生64次干扰，干预后发生52次，但这种差异无统计学意义。干预前后，团队负责人经常被讨论个人或工作特定事项的护士打断。
结论
需要进一步努力减少对患者护理无益的干扰。
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