Division of Neonatology, Department of Pediatrics, St Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
Division of Neonatology, Department of Pediatrics, St Christopher's Hospital for Children, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA.
BMJ Open Qual. 2021 Jan;10(1). doi: 10.1136/bmjoq-2020-001014.
Neonatal intensive care unit (NICU) patients are at increased risk for handoff communication failures due to complexity and prolonged length of stay. We report a quality initiative aimed at reducing avoidable interruptions during neonatal handoffs while monitoring handoff duration and provider satisfaction.
Observational time series between August 2015 and March 2018 in an academic level IV NICU. NICU I-PASS and process changes were implemented using plan-do-study-act cycle, and statistical process control charts were used in the analysis. Unmatched preintervention and postintervention satisfaction surveys were compared using Mann-Whitney U tests.
There was special cause variation in the mean number of avoidable interruptions per handoff from 4 to 0.3 (92% reduction). The mean duration of handoff was reduced ~1 min/patient. Provider satisfaction with the quality of handoffs also improved from a mean of 3.36 to 3.75 on a 1-5 Likert scale (p=0.049).
Standardisation of NICU handoff with NICU I-PASS and process changes led to the sustained reduction in avoidable interruptions with the added benefit of reduced handoff length and improved provider satisfaction.
由于复杂性和延长的住院时间，新生儿重症监护病房（NICU）患者在手递交接期间更容易出现沟通失败。我们报告了一项旨在减少新生儿交接期间可避免中断的质量改进措施，同时监测交接时间和提供者满意度。
2015 年 8 月至 2018 年 3 月在一家学术四级 NICU 进行观察性时间序列研究。使用计划-执行-研究-行动循环实施 NICU I-PASS 和流程变更，并在分析中使用统计过程控制图。使用曼-惠特尼 U 检验比较未匹配的干预前后满意度调查。
从每个交接 4 次到 0.3 次（92%减少）的可避免中断的平均值存在特殊原因变化。交接时间平均减少了约 1 分钟/患者。提供者对交接质量的满意度也从 1-5 分制的 3.36 分提高到 3.75 分（p=0.049）。
通过 NICU I-PASS 和流程变更对手递交接进行标准化，可持续减少可避免的中断，同时还缩短了交接时间并提高了提供者的满意度。
