Department of English, The City University of Hong Kong, Hong Kong, China.
School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China.
Nurse Educ Today. 2020 Jan;84:104212. doi: 10.1016/j.nedt.2019.104212. Epub 2019 Oct 19.
To explore the perceptions and practices of nurses on handovers.
At handover, accountability must be transferred to ensure a consistent quality of patient care. Studies highlighted unstructured handovers as a major factor contributing to critical incidents. The design of handover training requires a systematic method for evaluating nurses' practices.
An explorative case study, qualitative design that combined ethnography with discourse analysis.
A training programme based on these practices was administered to 50 nurses, and a protocol focused on CARE was implemented. The nurses' perceptions and practices were evaluated, and 80 handovers were recorded.
Three areas likely to enhance the continuity of care emerged: 1) explicit transfer of responsibility by outgoing nurses; 2) responsible engagement of incoming nurses in the handover and 3) adherence to a systematic handover structure.
The change in practice from monologic handovers with passive incoming nurses before training to interactive and collaborative handovers, where all nurses appeared to take an active role in clarifying patients' cases, after training was significant.
探讨护士交接班的认知和实践。
在交接班时,必须进行责任交接,以确保患者护理的质量始终保持一致。研究表明,交接班不规范是导致重大事件的一个主要因素。交接班培训的设计需要一种系统的方法来评估护士的实践情况。
一项探索性案例研究,定性设计,将民族志学与话语分析相结合。
对 50 名护士进行了基于这些实践的培训计划,并实施了以 CARE 为重点的方案。评估了护士的认知和实践情况,并记录了 80 次交接班情况。
有三个方面可能会增强护理的连续性:1)即将交班的护士明确移交责任;2)接班护士负责参与交接班;3)遵守系统的交接班结构。
培训前,交接班模式是独白式的,接班护士被动参与,培训后,交接班模式转变为互动式和协作式,所有护士都积极参与澄清患者的情况,这种实践模式的改变意义重大。