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在创伤外科重症监护病房实施标准化的护士主导查房方案:单机构经验

Implementing a Standardized Nurse-driven Rounding Protocol in a Trauma-surgical Intensive Care Unit: A Single Institution Experience.

作者信息

Marshall Clement D, Fay Maureen E, Phillips Brian, Faurote Robert, Kustudia Jamie, Ransom Ryan C, Henley Christine, DiConstanzo Lisa, Jopling Jeffrey K, Sang Adam X, Spain David A, Tisnado Julie A, Weiser Thomas G

机构信息

Surgery, Stanford Hospital, Stanford, USA.

Critical Care, Stanford Hospital, Stanford, USA.

出版信息

Cureus. 2018 Oct 8;10(10):e3422. doi: 10.7759/cureus.3422.

Abstract

Introduction Patient care in the trauma-surgical intensive care unit (SICU) requires trust and effective communication between nurses and physicians. Our SICU suffered from poor communication and trust between nurses and physicians, negatively impacting the working environment and, potentially, patient care. Methods A SICU Task Force studied communication practices and identified areas for improvement, leading to several interventions. The daily physician rounding was altered to improve communication and to enhance the role of the registered nurses (RN) in rounds. Additionally, a formal night resident rounding time was implemented. Results A post-intervention survey focusing on cooperation, teamwork, and appreciation between nurses and physicians revealed improvement in these domains. Informal feedback from nurses and physicians indicated improved working relationships and satisfaction with the SICU environment. However, results of a national survey performed after the intervention did not show the same level of improvement. Conclusions A Task Force consisting of SICU nurses and physicians can effectively study a widespread communication issue and implement targeted interventions. While informal feedback may indicate improvement, it can be difficult to demonstrate improvement using formal surveys.

摘要

引言 创伤外科重症监护病房(SICU)的患者护理需要护士与医生之间的信任和有效沟通。我们的SICU存在护士与医生之间沟通不畅和缺乏信任的问题,对工作环境产生了负面影响,并可能影响患者护理。方法 一个SICU特别工作组研究了沟通实践并确定了改进领域,从而采取了多项干预措施。调整了每日医生查房方式,以改善沟通并加强注册护士(RN)在查房中的作用。此外,还实施了正式的夜间住院医师查房时间。结果 一项针对护士与医生之间合作、团队协作和相互认可的干预后调查显示,这些方面有所改善。护士和医生的非正式反馈表明工作关系得到改善,对SICU环境的满意度提高。然而,干预后进行的全国性调查结果并未显示出同样程度的改善。结论 由SICU护士和医生组成的特别工作组可以有效地研究普遍存在的沟通问题并实施有针对性的干预措施。虽然非正式反馈可能表明有所改善,但使用正式调查可能难以证明改善情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/585f/6289560/75e420a6b25f/cureus-0010-00000003422-i01.jpg

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