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从医生和护士的定性角度增强围手术期的多专业协作。

Enhancing Interprofessional Collaboration in Perioperative Setting from the Qualitative Perspectives of Physicians and Nurses.

机构信息

Nursing School of Mar (ESimar), University of Pompeu Fabra, 08003 Barcelona, Spain.

Department of Perioperative Nursing, Hospital de la Santa Creu i Sant Pau, 08025 Barcelona, Spain.

出版信息

Int J Environ Res Public Health. 2021 Oct 14;18(20):10775. doi: 10.3390/ijerph182010775.

Abstract

Communication failures were a leading cause of sentinel events in the operation room due to frequently the communication breakdown occurs between physicians and nurses. This study explored the perspectives of surgical teams (nurses, physicians, and anaesthesiologists) on interprofessional collaboration and improvement strategies. A surgical team comprising eight perioperative nurses, four surgeons, and four anaesthesiologists from a university-affiliated hospital participated in this qualitative and phenomenological research from December 2018 to April 2019. Data were collected in in-depth interviews and were used in a thematic analysis according to Colaizzi to extract themes and categorised codes with the ATLAS.ti software. The result is presented in three generic categories: Barrier-like disruptive behaviours and lack of coordination of care; consequences by safety threats to the patient; overcoming barriers by shared decision making among professionals, flattened hierarchies, and teamwork/communication training. The conclusion is that different teams' perspectives can facilitate genuine reflection, discussion, and implementation of targeted interventions to improve operating room interprofessional collaboration and overcome barriers and their consequences. Currently, there is a need to change towards interprofessional collaboration for optimal patient outcomes and to ensure all professionals' expectations are met.

摘要

沟通失败是手术室中哨兵事件的主要原因,因为医生和护士之间经常发生沟通中断。本研究探讨了手术团队(护士、医生和麻醉师)对专业间合作和改进策略的看法。从 2018 年 12 月到 2019 年 4 月,一家大学附属医院的一个由八名围手术期护士、四名外科医生和四名麻醉师组成的手术团队参与了这项定性和现象学研究。通过深入访谈收集数据,并根据科莱兹进行主题分析,使用 ATLAS.ti 软件提取主题和分类代码。结果以三个通用类别呈现:具有破坏性的障碍行为和护理协调不足;对患者安全构成威胁的后果;通过专业人员之间的共同决策、扁平化层级和团队合作/沟通培训来克服障碍。结论是,不同团队的观点可以促进真正的反思、讨论和实施有针对性的干预措施,以改善手术室的专业间合作,克服障碍及其后果。目前,需要朝着以患者为中心的目标进行专业间合作,以确保满足所有专业人员的期望。

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