Department of Graduate Nursing, Winona State University, Rochester, MN, United States; University of Minnesota Medical Center, Minneapolis, MN, United States.
Department of Graduate Nursing, Winona State University, Rochester, MN, United States; University of Minnesota Medical Center, Minneapolis, MN, United States.
Intensive Crit Care Nurs. 2021 Apr;63:102974. doi: 10.1016/j.iccn.2020.102974. Epub 2020 Nov 28.
Improving care of critically ill patients requires using an interprofessional care model and care standardisation.
Determine whether collaborative patient care rounds in the intensive care unit increases practice consistency with respect to common considerations such as delirium prevention, device use, and indicated prophylaxis, among others. Secondary objective to assess whether collaborative interprofessional format improved nursing perceptions of collaboration.
Single centre, pre- and post- intervention design. collaborative patient care rounding format implemented in three intensive care units in an academic tertiary care centre. format consisted of scripted nursing presentation, provider checklist of additional practice considerations, and daily priority goals documentation. measurements included nursing participation, consideration of selected practice items, daily goal verbalisation, and nursing perception of collaboration.
Pre- and post-intervention measurements indicate gains in consideration of eight of thirteen bundle items (p < 0.05), with the greatest gains seen in nurse-presented items. Increases were observed in verbalisation of daily goals (59.8% versus 89.1%, p < 0.0001), nurse participation (83.9% versus 91.8%, p = 0.056), and nurse collaboration ratings (p < 0.0001).
This study describes implementation of collaborative patient care rounds with corresponding increases in consideration of selected practice items, verbalisation of daily goals, and perceptions of collaboration.
提高危重症患者的护理质量需要采用跨专业护理模式和护理标准化。
确定重症监护病房的协作患者护理查房是否能提高对预防谵妄、使用器械和预防用药等常见问题的实践一致性。次要目标是评估协作式跨专业模式是否能改善护理人员对协作的看法。
单中心、干预前后设计。协作患者护理查房模式在学术性三级护理中心的三个重症监护病房实施。模式包括护理人员的脚本式介绍、护理人员检查其他实践考虑因素的检查表以及日常优先目标记录。测量指标包括护理人员的参与度、考虑选定的实践项目、日常目标的口头表达以及护理人员对协作的看法。
干预前后的测量结果表明，在考虑 13 项捆绑项目中的 8 项方面有了提高（p<0.05），在护士介绍的项目中，提高幅度最大。每天目标的口头表达（59.8%比 89.1%，p<0.0001）、护理人员参与度（83.9%比 91.8%，p=0.056）和护理人员协作评分（p<0.0001）都有所增加。
本研究描述了协作式患者护理查房的实施情况，以及对选定实践项目的考虑、日常目标的口头表达和协作的看法有所增加。
