Ghosh Kaushik, Dohan Michael S, Curl Eileen, Goodwin Mary, Morrell Patricia, Guidroz Paul
Health Care Manage Rev. 2022;47(2):100-108. doi: 10.1097/HMR.0000000000000296.
Effectiveness of end-of-shift patient handover between nurses may be impacted by poor communication. This can be improved with the use of information tools, either electronic or paper-based. Few studies have investigated the activities that support patient handover, and fewer have explored how several of these tools used together affects the handover process.
The aim of this study was to understand coordination challenges in end-of-shift patient handover between nurses and the influence of multiple information tools used in that context.
A qualitative methodology to investigate phenomena in an acute care hospital in the United States was used in this study. Semistructured interviews were used to elicit insights from 16 nurses. Data were analyzed by coding three types of task dependencies (prerequisite, simultaneous, and shared) and three information tools (electronic medical records [EMRs], Kardex, and printouts of EMR data).
In preparation for a handover, nurses were burdened by ensuring that information in the EMR was correct and complete. A one-sheet Kardex was the tool nurses in the study preferred, because the essential information was at hand and it provided structure to the communication. Printouts of EMR data were often physically cumbersome and not useful in their current form, although they may be useful for communicating anomalous data.
This study provides insights regarding the challenges of care coordination in end-of-shift patient handover between nurses and the usages of a variety of information tools in preparation for handover, as well as the actual handover process.
Multiple interrelated information tools may be used to support patient handover. Health leaders should focus efforts on further advancing protocols for end-of-shift nurse handovers. Health system designers should design information tools to align them with their defined purpose in the handover process. Future work should consider both the information needs of nurses and the goal of improving nurse workflows.
护士交接班时患者信息交接的有效性可能会受到沟通不畅的影响。使用电子或纸质信息工具可以改善这种情况。很少有研究调查支持患者信息交接的活动，更少有人探讨这些工具一起使用如何影响交接过程。
本研究的目的是了解护士交接班时护理协调方面的挑战以及在此背景下使用多种信息工具的影响。
本研究采用定性方法对美国一家急症护理医院的现象进行调查。通过半结构化访谈从16名护士那里获取见解。通过对三种类型的任务依赖关系（前提、同步和共享）以及三种信息工具（电子病历[EMR]、 Kardex和EMR数据打印件）进行编码来分析数据。
在准备交接时，护士们要确保电子病历中的信息正确完整，负担很重。单页Kardex是本研究中护士们更喜欢的工具，因为关键信息近在手边，并且为沟通提供了结构。EMR数据打印件通常在实际操作中很麻烦，以其当前形式并无用处，尽管它们可能对传达异常数据有用。
本研究提供了有关护士交接班时护理协调挑战、为准备交接而使用的各种信息工具的使用情况以及实际交接过程的见解。
可以使用多种相互关联的信息工具来支持患者交接。卫生保健领导者应集中精力进一步推进护士交接班协议。卫生系统设计师应设计信息工具，使其与在交接过程中所确定的用途保持一致。未来的工作应考虑护士的信息需求以及改善护士工作流程的目标。
