利用 SBAR 培训计划的计划-执行-研究-行动循环来改善养老院的沟通。
Improving Communication in Nursing Homes Using Plan-Do-Study-Act Cycles of an SBAR Training Program.
机构信息
12250Indiana University School of Medicine, Indianapolis, IN, USA.
Regenstrief Institute, Indiana University Center for Aging Research, Indianapolis, IN, USA.
出版信息
J Appl Gerontol. 2023 Feb;42(2):194-204. doi: 10.1177/07334648221131469. Epub 2022 Oct 7.
BACKGROUND
Incomplete communication between staff and providers may cause adverse outcomes for nursing home residents. The Situation-Background-Assessment-Recommendation (SBAR) tool is designed to improve communication around changes in condition (CIC). An adapted SBAR was developed for the Centers for Medicare and Medicaid Services demonstration project, OPTIMISTIC, to increase its use during a resident CIC and to improve documentation.
METHODS
Four Plan-Do-Study-Act (PDSA) cycles to develop and refine successive protocol implementation of the OPTIMISTIC SBAR were deployed in four Indiana nursing homes. Use of SBAR, documentation quality, and participant surveys were assessed pre- and post-intervention implementation.
RESULTS
OPTIMISTIC SBAR use and documentation quality improved in three of the four buildings. Participants reported improved collaboration between nurses and providers after SBAR intervention.
CONCLUSION
Successive PDSA cycles implementing changes in an OPTIMISTIC SBAR protocol for resident CIC led to an increase in SBAR use, improved documentation, and better collaboration between nursing staff and providers.
背景
员工与医护人员之间沟通不完整可能会对养老院居民的康复造成不良影响。Situation-Background-Assessment-Recommendation（SBAR）工具旨在改善病情变化时的沟通。医疗保险和医疗补助服务中心的示范项目 OPTIMISTIC 针对该工具进行了改编，以便在居民病情变化期间增加其使用，并改善文档记录。
方法
在印第安纳州的四家养老院中，采用了四个计划-执行-研究-行动（PDSA）循环来开发和完善 OPTIMISTIC SBAR 的逐步实施。在干预实施前后，评估了 SBAR 的使用情况、文档质量和参与者的调查结果。
结果
在四家养老院中的三家，OPTIMISTIC SBAR 的使用和文档质量得到了改善。参与者报告称，在 SBAR 干预后，护士和医护人员之间的协作得到了改善。
结论
在居民病情变化期间，通过连续的 PDSA 循环实施 OPTIMISTIC SBAR 协议的更改，增加了 SBAR 的使用，改善了文档记录，并加强了护理人员和医护人员之间的协作。
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