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护士-领导协作改进项目:改善急诊科患者体验

Nurse-Leader Collaborative Improvement Project: Improving Patient Experience in the Emergency Department.

作者信息

McFarlan Susan, O'Brien Danielle, Simmons Eryn

出版信息

J Emerg Nurs. 2019 Mar;45(2):137-143. doi: 10.1016/j.jen.2018.11.007. Epub 2018 Dec 24.

Abstract

INTRODUCTION

Studies show that nurse rounding is an effective means to increase patient satisfaction and quality of care and decrease patient-safety events. There is evidence to support that daily leader rounding improves patients' hospital experience as well. Patients' experience increased confidence in their care providers, and leaders are able to address service concerns proactively. Furthermore, recent studies have addressed patient satisfaction in the ED setting as having an impact on patients' perceptions of the health care institution as a whole. Our objective was to demonstrate the effect of hourly nursing rounds and daily leader rounds on the ED patient experience.

METHODS

We used a pre- and postintervention evaluation of Hospital Consumer Assessment of Healthcare Providers and Services (HCAHPS) survey scores. Two groups of stakeholders developed standard work for rounding. The leader group and the bedside nursing care groups used the evidence cited in this article to create their standard processes.

RESULTS

During the 2-month pilot period, patient experience scores-as measured by 5 survey questions-all improved. Results will continue to be tracked monthly and reported to all stakeholders in real time to help hardwire the process change.

DISCUSSION

Through collaboration and a participative approach, nurses and leaders used the current evidence from scholarly nursing literature as well as Lewin's theory of change to guide a successful approach to rounding and improving patients' experiences when receiving emergency care.

摘要

引言

研究表明,护士查房是提高患者满意度和护理质量、减少患者安全事件的有效手段。有证据支持每日领导查房也能改善患者的住院体验。患者的体验增强了他们对护理人员的信心,而且领导能够主动解决服务问题。此外,最近的研究指出,急诊科环境中的患者满意度会影响患者对整个医疗机构的看法。我们的目标是证明每小时一次的护士查房和每日领导查房对急诊科患者体验的影响。

方法

我们对医院医疗服务提供者和系统消费者评估(HCAHPS)调查分数进行了干预前和干预后的评估。两组利益相关者制定了查房的标准流程。领导组和床边护理组利用本文引用的证据创建了他们的标准流程。

结果

在为期2个月的试点期间,通过5个调查问题衡量的患者体验分数均有所提高。结果将继续每月跟踪,并实时向所有利益相关者报告,以帮助巩固流程变革。

讨论

通过合作和参与式方法,护士和领导利用护理学学术文献中的现有证据以及Lewin的变革理论,指导了一种成功的查房方法,并改善了患者接受急诊护理时的体验。

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