Herling Suzanne Forsyth, Brix Helene, Andersen Lise, Jensen Liz Daugaard, Handesten Rie, Knudsen Heidi, Bove Dorthe Gaby
Research Unit: ACES, Department of Anesthesiology, Copenhagen University Hospital Herlev Gentofte, Herlev, Denmark.
The Neuroscience Center, Rigshospitalet, Copenhagen University Hospital, Copenhagen Ø, Denmark.
Scand J Caring Sci. 2022 Dec;36(4):947-956. doi: 10.1111/scs.12990. Epub 2021 Apr 28.
The transition process from the intensive care unit (ICU) to hospital ward may impact the illness trajectory and compromise the continuity of safe care for ICU survivors. ICU and ward nurses are involved with the transition and are responsible for the quality of the transitional care.
The aim was to explore ICU and ward nurses' views on assignments in relation to patients' transition between ICU and hospital ward.
We conducted a qualitative study with 20 semi-structured interviews with ICU nurses and ward nurses and analysed data by content analysis.
A university hospital with 690 beds and an 11-bed mixed medical/surgical ICU.
The overarching themes were (1) 'Ritual of hand over' with the categories: (a) 'Ready, able and willing', (b) 'Transfer of responsibility' and (c) 'Nice to know versus need to know' and (2) 'From lifesaving care to rehabilitative care' with the categories: (a) 'Complex care needs persist', (b) 'Fight or flight mode' and (c) '"Weaning" the family'. Nurses were highly focused on the ritual of the actual handover of the patient and discussed readiness as an indicator of quality and the feeling of passing on the responsibility. Nurses had different opinions on what useful knowledge was and thus necessary to communicate during handover. Although patients' complex care needs may not have been resolved when exiting the ICU, ward nurses had to receive patients in a setting where nurses were mostly comfortable within their own specialty - this was worrying for both type of nurses. Patients could enter the ward very exhausted and weak or in 'fight mode' and demand rehabilitation at a pace the ward was not capable of delivering. ICU nurses encouraged families to be demanding after the ICU stay, and ward nurses asked them to trust them and steep back.
从重症监护病房（ICU）向医院普通病房的过渡过程可能会影响疾病发展轨迹，并危及ICU幸存者安全护理的连续性。ICU护士和普通病房护士参与了这一过渡过程，并对过渡护理的质量负责。
旨在探讨ICU护士和普通病房护士对于患者在ICU和医院普通病房之间过渡时任务安排的看法。
我们进行了一项定性研究，对20名ICU护士和普通病房护士进行了半结构化访谈，并通过内容分析法对数据进行了分析。
一家拥有690张床位的大学医院，以及一个拥有11张床位的内科/外科混合ICU。
首要主题包括（1）“交接仪式”，其类别有：（a）“准备好、有能力且愿意”，（b）“责任转移”，（c）“了解需求与必需知晓”；以及（2）“从救命护理到康复护理”，其类别有：（a）“复杂护理需求依然存在”，（b）“战斗或逃跑模式”，（c）“让家属‘断奶’”。护士们高度关注患者实际交接的仪式，并将准备情况视为质量指标以及责任传递的感受进行讨论。护士们对于什么是有用的知识以及因此在交接期间需要沟通的内容存在不同意见。尽管患者在离开ICU时其复杂护理需求可能尚未得到解决，但普通病房护士必须在一个护士们大多对自身专业感到舒适的环境中接收患者——这让两类护士都感到担忧。患者进入病房时可能非常疲惫虚弱，或者处于“战斗模式”，并以普通病房无法提供的速度要求进行康复治疗。ICU护士鼓励家属在患者离开ICU后提出要求，而普通病房护士则要求他们信任并退后一步。
