Department of Nurse Anaesthesia, Divisions of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
J Clin Nurs. 2019 Feb;28(3-4):663-676. doi: 10.1111/jocn.14662. Epub 2018 Sep 24.
(a) To explore the factors affecting quality in postoperative handovers as perceived by the different professional groups of clinicians involved. (b) To explore possible differences in perceptions of postoperative handover quality across professional groups and level of experience.
High quality patient handovers after surgery and anaesthesia are important to ensure patient safety. There is a paucity of research describing contextual factors related to handover quality and the perspectives of different professional groups involved.
A qualitative exploratory design was applied.
A total of eight focus group interviews with 37 participants (29 nurses, eight doctors) were conducted. Anaesthesiologists, resident anaesthesiologists, nurse anaesthetists, postoperative care nurses and operating room nurses participated in the study. The interviews were conducted according to profession with two groups per profession: one with experienced clinicians and one with less experienced clinicians. The data were analysed using thematic analysis. The study adheres to the COREQ guidelines.
The data analysis identified the following factors affecting postoperative handover quality: "timing and concurrency conflicts," "handover structure," "patient conditions," "individual characteristics of clinicians involved" and "team composition." Differences across professional groups and level of experience were related to responsibility, structure and adaptation.
The professional groups involved describe the postoperative patient handover as a complex and variable process that needs to be carefully planned and executed according to the influencing factors. Variability exists across professional groups and level of experience.
Health care providers need to be aware that postoperative handovers are affected by a set of factors related to internal (patient conditions, individual characteristics of clinicians involved and team composition) and external (timing and concurrency conflicts, handover structure) characteristics. These issues need to be acknowledged when procedures and routines for handover quality are designed, implemented and used.
(a) 探讨不同临床专业群体对术后交接质量的影响因素。(b) 探讨不同专业群体和经验水平对术后交接质量的感知可能存在的差异。
手术后和麻醉后的高质量患者交接对于确保患者安全至关重要。目前，描述与交接质量相关的背景因素以及不同专业群体观点的研究很少。
采用定性探索性设计。
共进行了 8 次焦点小组访谈，共有 37 名参与者（29 名护士，8 名医生）参与。麻醉师、住院麻醉师、护士麻醉师、术后护理护士和手术室护士参加了这项研究。访谈根据专业进行，每个专业有两组：一组是有经验的临床医生，另一组是经验较少的临床医生。使用主题分析对数据进行分析。该研究遵循 COREQ 指南。
数据分析确定了影响术后交接质量的以下因素：“时间和并发冲突”、“交接结构”、“患者情况”、“参与临床医生的个体特征”和“团队组成”。专业群体和经验水平之间的差异与责任、结构和适应有关。
所涉及的专业群体将术后患者交接描述为一个复杂且多变的过程，需要根据影响因素进行仔细的规划和执行。不同专业群体和经验水平之间存在差异。
医疗保健提供者需要意识到，术后交接受到一系列与内部（患者状况、参与临床医生的个体特征和团队组成）和外部（时间和并发冲突、交接结构）特征相关的因素的影响。在设计、实施和使用交接质量程序和例程时，需要认识到这些问题。
