交接班时的床边交接：一项混合方法研究。
Bedside handover at the change of nursing shift: A mixed-methods study.
机构信息
Bon Secours Hospital, Cork, Ireland.
Catherine McAuley School of Nursing and Midwifery, University College Cork, Cork, Ireland.
出版信息
J Clin Nurs. 2020 Oct;29(19-20):3731-3742. doi: 10.1111/jocn.15403. Epub 2020 Jul 30.
AIM
To describe the structures, processes and content of bedside handover at the change of nursing shift in an acute-care context.
BACKGROUND
The handover of patient information and care at the change of nursing shift is an essential, albeit risk-laden, time-consuming activity in clinical practice.
DESIGN
A convergent parallel mixed-methods design was used.
METHODS
Thirty episodes of bedside handover were concurrently audio-recorded and observed using a researcher-developed tool modelled on the five domains of the British Medical Association's Safe Handover-Safe Patients framework. The audio recordings were analysed using content analysis. Quantitative and qualitative data generated were then triangulated to develop a more complete interpretation of the structure, process and content of information transferred at the patient's bedside during the change of nursing shift. This study followed Good Reporting of Mixed Methods Study guidelines.
RESULTS
Bedside handover was observed to be mainly conducted at a fast pace. However, within these timeframe large volumes of complex information were shared and important nurse-patient interactions occurred. Analysis of the audio recordings provided evidence that the dialogue during handover was nurse-dominated and the outgoing nurse appeared to influence the degree of patient participation.
CONCLUSION
Bedside handover at the change of nursing shift involves three key stakeholders: outgoing nurse, incoming nurse and the patient. A combination of intricate communication skills both verbal and nonverbal facilitates the rapid sharing of large volumes of complex information which is necessary for the continuity and safety of patient care across nursing shifts.
RELEVANCE TO CLINICAL PRACTICE
The comprehensive description of the complexities of bedside handover in this study provides an insight into this frequently occurring, important nursing practice and can be used to support nurse education and practice development.
目的
描述在急性护理环境中，护理交接班时床边交接的结构、过程和内容。
背景
在护理交接班时交接患者信息和护理是临床实践中一项必不可少但存在风险且耗时的活动。
设计
采用收敛并行混合方法设计。
方法
使用研究人员根据英国医学协会的安全交接-安全患者框架的五个领域开发的工具，对 30 个床边交接进行了同步录音和观察。使用内容分析法分析音频记录。生成的定量和定性数据随后进行了三角分析，以更完整地解释在护理交接班期间在患者床边进行的信息传递的结构、过程和内容。本研究遵循混合方法研究的良好报告指南。
结果
观察到床边交接主要在快速进行。然而，在这些时间框架内，大量复杂的信息被共享，并且发生了重要的护患互动。对录音的分析提供了证据，表明交接期间的对话主要由护士主导，并且即将离职的护士似乎影响了患者参与的程度。
结论
护理交接班时的床边交接涉及三个关键利益相关者：即将离职的护士、即将入职的护士和患者。复杂的沟通技巧，包括口头和非口头沟通，有助于快速共享大量复杂信息，这对于护理交接班期间患者护理的连续性和安全性是必要的。
临床意义
本研究对床边交接复杂性的全面描述提供了对这一经常发生的重要护理实践的深入了解，并可用于支持护士教育和实践发展。
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