Burgess Annette, van Diggele Christie, Roberts Chris, Mellis Craig
The University of Sydney, Faculty of Medicine and Health, Sydney Medical School - Education Office, The University of Sydney, Edward Ford Building A27, Sydney, NSW, 2006, Australia.
The University of Sydney, Faculty of Medicine and Health, Sydney Health Professional Education Research Network, The University of Sydney, Sydney, Australia.
BMC Med Educ. 2020 Dec 3;20(Suppl 2):459. doi: 10.1186/s12909-020-02285-0.
Clinical handover is one of the most critical steps in a patient's journey and is a core skill that needs to be taught to health professional students and junior clinicians. Performed well, clinical handover should ensure that lapses in continuity of patient care, errors and harm are reduced in the hospital or community setting. Handover, however, is often poorly performed, with critical detail being omitted and irrelevant detail included. Evidence suggests that the use of a structured, standardised framework for handover, such as ISBAR, improves patient outcomes. The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework, endorsed by the World Health Organisation, provides a standardised approach to communication which can be used in any situation. In the complex clinical environment of healthcare today, ISBAR is suited to a wide range of clinical contexts, and works best when all parties are trained in using the same framework. It is essential that healthcare leaders and professionals from across the health disciplines work together to ensure good clinical handover practices are developed and maintained. Organisations, including universities and hospitals, need to invest in the education and training of health professional students and health professionals to ensure good quality handover practice. Using ISBAR as a framework, the purpose of this paper is to highlight key elements of effective clinical handover, and to explore teaching techniques that aim to ensure the framework is embedded in practice effectively.
临床交接班是患者就医过程中最关键的环节之一，是一项需要传授给医学生和初级临床医生的核心技能。如果执行得当，临床交接班应能确保在医院或社区环境中减少患者护理连续性的失误、错误和伤害。然而，交接班往往执行得很差，关键细节被遗漏，无关细节却被包含在内。有证据表明，使用结构化、标准化的交接班框架，如ISBAR，可改善患者的治疗结果。ISBAR（介绍、情况、背景、评估、建议）框架得到了世界卫生组织的认可，提供了一种可在任何情况下使用的标准化沟通方法。在当今复杂的医疗临床环境中，ISBAR适用于广泛的临床情境，当所有各方都接受使用同一框架的培训时效果最佳。医疗保健领域各学科的领导者和专业人员必须共同努力，以确保建立并维持良好的临床交接班规范。包括大学和医院在内的机构需要对医学生和医疗专业人员进行教育和培训投资，以确保高质量的交接班规范。本文以ISBAR为框架，旨在突出有效临床交接班的关键要素，并探讨旨在确保该框架有效融入实践的教学技巧。
