Faculty of Nursing, Université de Montréal, C.P. 6128, succ. Centre-Ville, Montreal, QC H3C 3J7, Canada; Montreal Heart Institute Research Center, 5000 rue Bélanger, Montreal, QC H1T 1C8, Canada.
Rory Meyers College of Nursing, New York University, 433 First Avenue, New York, NY 10010, USA.
Heart Lung. 2020 Jul-Aug;49(4):420-425. doi: 10.1016/j.hrtlng.2020.02.037. Epub 2020 Feb 25.
Nurses begin forming judgments regarding patients' clinical stability during change-of-shift handoffs.
To examine the agreement between incoming and outgoing nurses' judgments of deterioration risk following handoff and compare these judgments to commonly used early warning scores (MEWS, NEWS, ViEWS).
Following handoffs on three medical/surgical units, nurses completed the Patient Acuity Rating. Nurse ratings were compared with computed early warning scores based on clinical data. In follow-up interviews, nurses were invited to describe their experiences of using the rating scale.
Sixty-two nurses carried out 444 handoffs for 158 patients. While the agreement between incoming and outgoing nurses was fair, correlations with early warning scores were low. Nurses struggled with predicting risk and used their impressions of differential risk across all the patients to whom they had been assigned to arrive at their ratings.
Nurses shared information that influenced their clinical judgments at handoff; not all of these cues may necessarily be captured in early warning scores.
护士在交接班时开始对患者的临床稳定情况做出判断。
检查交接班后接班护士和交班护士对病情恶化风险判断的一致性，并将这些判断与常用的早期预警评分（MEWS、NEWS、ViEWS）进行比较。
在三个内科/外科病房交接班后，护士完成了患者病情严重程度评分。护士的评分与基于临床数据的计算预警评分进行了比较。在后续访谈中，护士被邀请描述他们使用评分量表的经验。
62 名护士为 158 名患者进行了 444 次交接班。尽管接班护士和交班护士之间的一致性是中等的，但与早期预警评分的相关性较低。护士在预测风险方面存在困难，他们使用对所有分配到的患者的不同风险的印象来得出他们的评分。
护士在交接班时分享了影响他们临床判断的信息；并非所有这些线索都一定能在早期预警评分中捕捉到。
