Sharp Lena, Dahlén Carina, Bergenmar Mia
Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.
Regional Cancer Centre, Stockholm-Gotland, Sweden.
Scand J Caring Sci. 2019 Dec;33(4):892-901. doi: 10.1111/scs.12686. Epub 2019 Apr 8.
Nursing shift-to-shift handovers are important as they impact the care quality indicators such as safety, patient satisfaction and continuity. However, nurses' handovers have also been criticised and described as unstructured and ineffective. To improve the handovers and involve patients and their loved ones in the process, a person-centred handover (PCH) model performed at bedside has been developed and tested at Karolinska University Hospital, Sweden. This study reports on the nursing staffs' compliance to a checklist used for the newly introduced PCH model. A total of 43 PCH sessions were observed at two acute care wards, using a structured observation protocol. None of the observed handover sessions included all the 13 PCH checklist subcomponents. The checklist was used in 18 (44%) of the observed handover sessions. A statistically significant higher number of subcomponents were observed when the nurses used the PCH checklist (6.4 vs. 4.5 subcomponents, p < 0.05). The mean time spent on each PCH was 6 minutes. In 56% of the sessions, the patients were observed to actively participate in the handover. Overall, the nursing staffs' compliance to the PCH checklist needs to be improved. The observations suggest that training on communication-oriented tasks would be beneficial to establish a person-centred handover process.
护理班次之间的交接很重要，因为它们会影响护理质量指标，如安全性、患者满意度和连续性。然而，护士的交接也受到了批评，被描述为无组织且无效。为了改进交接并让患者及其亲人参与其中，瑞典卡罗林斯卡大学医院开发并测试了一种在床边进行的以患者为中心的交接（PCH）模式。本研究报告了护理人员对新引入的PCH模式所使用清单的遵守情况。使用结构化观察方案，在两个急性护理病房共观察了43次PCH会议。在观察到的交接会议中，没有一次涵盖了PCH清单的所有13个组成部分。在18次（44%）观察到的交接会议中使用了该清单。当护士使用PCH清单时，观察到的组成部分数量在统计学上显著更多（6.4个组成部分对4.5个组成部分，p<0.05）。每次PCH的平均用时为6分钟。在56%的会议中，观察到患者积极参与交接。总体而言，护理人员对PCH清单的遵守情况需要改进。观察结果表明，针对沟通导向任务的培训将有助于建立以患者为中心的交接流程。
