术后向儿科重症监护病房的护理过渡标准化可提高效率并增强交接的全面性。
Standardization of Postoperative Transitions of Care to the Pediatric Intensive Care Unit Enhances Efficiency and Handover Comprehensiveness.
作者信息
Sochet Anthony A, Siems Ashley, Ye Grace, Godiwala Nihal, Hebert Lauren, Corriveau Christiane
机构信息
Division of Critical Care Medicine, Johns Hopkins All Children's Hospital, St. Petersburg, Fla.; Division of Critical Care Medicine, Children's National Health System, The George Washington University School of Medicine and Health Sciences, Wash.; Division of Critical Care Medicine, Louisiana State University, New Orleans, La.; and Division of Critical Care Medicine, Children's Hospital of Savannah, Savannah, Ga.
出版信息
Pediatr Qual Saf. 2016 Nov 29;1(2):e004. doi: 10.1097/pq9.0000000000000004. eCollection 2016 Nov-Dec.
INTRODUCTION
To determine the impact of standardization of postoperative transitions of care to the pediatric intensive care unit on handover efficiency and the quality of healthcare data exchange.
METHODS
This was a prospective, pre-post observational study after standardization of postoperative transitions in a 44-bed pediatric intensive care unit in a 313-bed tertiary care pediatric hospital from April to July 2015. Standardization was completed using a multidisciplinary handover checklist. Primary outcomes were efficiency expressed as mean handover duration and the comprehensiveness of healthcare data exchange.
RESULTS
Forty-seven postoperative transitions were observed of which 23 were preintervention and 24 were postintervention. After standardization, efficiency improved from 10.5 ± 5.4 to 7.8 ± 2.7 minutes ( < 0.05). Healthcare data exchanged between surgical, anesthesia, and critical care providers were more robust including intraoperative, historical, and anticipatory guidance (all < 0.05). After intervention, attendance through completion of handover for surgical services increased from 13% to 88% ( < 0.05).
CONCLUSIONS
Standardization of postoperative transitions improved efficiency, healthcare data exchange, and anticipatory planning. Future research is required to link standardization of transitions to improved patient outcomes and measure the development of shared mental models.
引言
确定儿科重症监护病房术后护理转接标准化对交接效率及医疗数据交换质量的影响。
方法
这是一项前瞻性的前后对照观察性研究，于2015年4月至7月在一家拥有313张床位的三级儿科医院中44张床位的儿科重症监护病房进行术后转接标准化。使用多学科交接检查表完成标准化。主要结局指标为以平均交接时长表示的效率以及医疗数据交换的全面性。
结果
观察了47次术后转接，其中23次为干预前，24次为干预后。标准化后，效率从10.5±5.4分钟提高至7.8±2.7分钟（<0.05）。外科、麻醉和重症监护医护人员之间交换的医疗数据更加全面，包括术中、既往史及预期指导（均<0.05）。干预后，外科服务交接完成时的参与率从13%增至88%（<0.05）。
结论
术后转接标准化提高了效率、医疗数据交换及预期规划。未来需要开展研究以将转接标准化与改善患者结局相联系，并衡量共享心智模式的发展。
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