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围手术期护士之间的有效沟通和患者安全:最佳实践实施项目。

Effective communication and patient safety among nurses in perioperative settings: a best practice implementation project.

机构信息

The Order of Nurses, Midwives and Medical Assistants in Romania Bucharest Branch, Romanian Centre for Nursing Research: A JBI Affiliated Group.

The Fundeni Clinical Institute.

出版信息

JBI Evid Implement. 2022 Aug 1;20(S1):S3-S14. doi: 10.1097/XEB.0000000000000316.

Abstract

OBJECTIVES

The aim of this implementation project was to promote evidence-based best practice regarding effective communication and patient safety amongst nurses in perioperative settings.

INTRODUCTION

One of the main causes of surgical errors is inadequate communication. To address this issue, published research has shown that effective communication among healthcare professionals (HCPs) within and between all phases of perioperative care, as well as the proper transfer of all patient information at all transition points, are essential for ensuring patient safety and quality of care.

METHODS

This best practice implementation project was conducted based on the JBI implementation model and included three phases of activity: a baseline audit, a strategies implementation stage and a follow-up audit. The audit criteria used were based on a JBI evidence summary and referred to: education, interdisciplinary team, conflict resolution, team communication, transfer of patient information and safety intraoperative processes. The project was carried out in the perioperative environment of a university hospital, and the sample included 52 nurses.

RESULTS

Eleven audit criteria were used in the baseline audit. For four of these criteria (on education and information transfer) the compliance was zero, for five criteria (on intraoperative processes) the compliance had values between 31 and 66% and for two criteria (on interdisciplinary team/conflict resolution documentation and team communication monitoring), the identified compliance was maximum (100%). Following the identification of four barriers to compliance and the implementation of targeted strategies, the follow-up audit showed complete compliance (100%) for all criteria except three, for which the identified compliance values were 96, 95 and 25%.

CONCLUSION

The implementation of appropriate strategies in this project has led to a significant improvement in nurses' compliance with all audit criteria except one, regarding the verbal transfer of patient information. However, future audits and strategies are needed not only to support the improvements obtained but also to significantly increase the compliance rate for the audit criterion for which only a slight increase in compliance was recorded.

摘要

目的

本实施项目旨在促进围手术期护士之间基于证据的最佳实践,以实现有效沟通和患者安全。

简介

手术失误的主要原因之一是沟通不足。为了解决这个问题,已发表的研究表明,医护人员在围手术期护理的所有阶段内部和之间进行有效的沟通,以及在所有过渡点正确传递所有患者信息,对于确保患者安全和护理质量至关重要。

方法

本最佳实践实施项目基于 JBI 实施模型进行,包括三个活动阶段:基线审核、策略实施阶段和后续审核。审核标准基于 JBI 证据摘要,涉及:教育、跨学科团队、冲突解决、团队沟通、患者信息转移和术中安全流程。该项目在一所大学医院的围手术期环境中进行,样本包括 52 名护士。

结果

基线审核使用了 11 项审核标准。其中四项标准(教育和信息转移)的合规性为零,五项标准(术中流程)的合规性在 31%至 66%之间,两项标准(跨学科团队/冲突解决记录和团队沟通监测)的合规性为 100%。在确定了四项合规障碍并实施了有针对性的策略后,后续审核显示,所有标准的合规性均达到 100%,除了三项标准,其合规性分别为 96%、95%和 25%。

结论

本项目实施的适当策略显著提高了护士对所有审核标准的合规性,除了患者信息口头传递的审核标准。然而,未来还需要进行审核和实施策略,不仅要支持已获得的改进,还要显著提高仅略有提高合规性的审核标准的合规率。

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