Red Cross College of Nursing, Chung-Ang University, Seoul, Korea.
College of Nursing, Hanyang University, Seoul, Korea.
J Nurs Manag. 2021 May;29(4):623-634. doi: 10.1111/jonm.13207. Epub 2020 Dec 1.
To review and synthesize qualitative studies to gain a deeper understanding of critical care nurses' inter-departmental and shift-to-shift handover challenges.
Good-quality nurse-to-nurse handover promotes patient safety, while poor handover has been associated with medical errors. However, systematic reviews of qualitative approaches for better understanding the handover experiences of critical care nurses are lacking.
Systematic review methods incorporating meta-synthesis were used. A comprehensive search of seven databases was conducted. Two independent reviewers performed data extraction and evaluated ten studies using the Critical Appraisal Screening Program. Findings were analysed and synthesized using thematic analysis. The transactional model of communication was used to guide the analysis.
A total of 10 qualitative studies were included. Seven major handover themes were identified: (a) expectations of perfection, (b) need for partnership, (c) unilateral communication, (d) obstacles to information acquisition, (e) lack of pertinent patient information, (f) need for a structured handover and (g) interruptions/distractions.
Handovers should be considered an essential part of patient-centred care for ensuring continuity of care.
Poor communication during a handover could increase the nurse's burden or stress and adversely affect patient care. Therefore, training should be provided on explicit handover communication.
回顾和综合定性研究，以更深入地了解重症监护护士跨部门和轮班交接挑战。
高质量的护士到护士交接可促进患者安全，而交接不良与医疗错误有关。然而，缺乏系统地审查定性方法以更好地了解重症监护护士交接体验的综述。
使用系统综述方法结合元综合。对七个数据库进行了全面检索。两名独立审查员使用批判性评估筛选程序进行数据提取和评估十项研究。使用主题分析对结果进行分析和综合。使用沟通的交易模型指导分析。
共纳入 10 项定性研究。确定了 7 个主要交接主题：(a) 追求完美的期望，(b) 需要合作，(c) 单向沟通，(d) 获取信息的障碍，(e) 缺乏相关患者信息，(f) 需要结构化交接，(g) 中断/干扰。
交接应被视为以患者为中心的护理的重要组成部分，以确保护理的连续性。
交接过程中的沟通不畅可能会增加护士的负担或压力，并对患者护理产生不利影响。因此，应提供关于明确交接沟通的培训。
