Katz M H, Schroeder S A
Department of Medicine, University of California, San Francisco.
N Engl J Med. 1988 Dec 15;319(24):1585-9. doi: 10.1056/NEJM198812153192406.
To examine the influence of hospital paging systems on residency training, nursing services, and patient care, we asked medical interns (first-year residents) in three teaching hospitals to keep logs of pages they received during a three-day period. Thirty-one logs from 26 interns were completed; a total of 1206 pages were recorded on 91 days (1095 hours). Interns were paged an average of once an hour; on 24 occasions, interns were paged five or more times an hour. The majority of pages (65 percent) occurred when interns were engaged in patient care. Only 34 percent of the pages were judged both to require a response within one hour and to result in a change in patient care. Twenty-four percent were clinically indicated and required a response within one hour but did not result in a change in patient care. Sixteen percent of pages resulted in a change in patient care or were clinically indicated but could have been postponed for more than an hour. An additional 26 percent of pages neither resulted in a change in clinical management nor were clinically indicated. Reducing the number of unnecessary pages and postponing nonurgent ones could result in as much as a 42 percent decrease in disruptions of patient care and more rest for interns.
为研究医院传呼系统对住院医师培训、护理服务及患者护理的影响，我们让三家教学医院的医学实习生（一年级住院医师）记录他们在三天时间内接到的传呼信息。共收到26名实习生的31份记录；在91天（1095小时）内共记录到1206次传呼。实习生平均每小时接到一次传呼；有24次，实习生每小时接到5次或更多次传呼。大多数传呼（65%）发生在实习生进行患者护理时。只有34%的传呼被判定既需要在一小时内回复又会导致患者护理发生变化。24%的传呼有临床指征且需要在一小时内回复，但未导致患者护理发生变化。16%的传呼导致患者护理发生变化或有临床指征，但本可推迟一小时以上。另外26%的传呼既未导致临床管理发生变化，也无临床指征。减少不必要的传呼次数并推迟非紧急传呼，可使患者护理中断次数减少多达42%，实习生也能得到更多休息。
