急诊科与重症监护室护士之间交接班流程的有效性。
Effectiveness of handover practices between emergency department and intensive care unit nurses.
作者信息
Mamalelala Tebogo T, Schmollgruber Shelley, Botes Meghan, Holzemer William
机构信息
School of Nursing, University of Botswana, School of Nursing, Rutgers, The State University of New Jersey, NJ, United States.
Department of Nursing Education, Faculty of Health Sciences, University of the Witwatersrand, Gauteng, South Africa.
出版信息
Afr J Emerg Med. 2023 Jun;13(2):72-77. doi: 10.1016/j.afjem.2023.03.001. Epub 2023 Mar 20.
BACKGROUND
Nurses from the emergency department (ED) and the intensive care unit (ICU) must interact during the handover procedure. Factors such as unit boundaries, the interaction between different specialities, patient acuities, and treatment adjustments generate specific negotiating and teamwork problems during the transition of patients from ED to ICU.
OBJECTIVE
This study aimed to describe the opinions of nurses regarding the effectiveness of handover practices between nurses in the ED and ICU in a major academic hospital in Gauteng province, South Africa.
METHOD
An analytical cross-sectional survey design was used. Data were collected using a 16-item handover evaluation tool. It comprises two sections (1) biographical details and (2) 16 statements about handover quality divided into five constructs, namely information transfer, shared understanding, working atmosphere, overall handover quality, and circumstances of handover. Data analysis was done utilising descriptive and non-parametric statistics.
RESULTS
The majority (51.8%; n = 115) of the handovers occurred during the day. Out of 171 nurses, there were specialist practice emergency (19.2%; n = 33) and intensive care (28.0%; n = 48) nurses. There was statistical significance in information transfer between the ED and ICU nurses. (Me = 4.0, p < 0.05), compared to ICU nurses (Me = 3.0). Nurse specialist and non-specialist nurses' handovers differed statistically significantly on 12 of the 16 items on the rating scale, compared to 10 for non-specialist nurses' handovers.
CONCLUSION
The study showed that ED and ICU nurses have significantly different requirements and expectations for handover procedures. In addition to completed documentation, subtle interpretations of the information provided and received also impact the need. The ED and ICU nurses would need to agree on the contents of a structured handover framework because different specialities and departments have varied expectations to achieve an effective handover.
背景
急诊科（ED）和重症监护病房（ICU）的护士在交接班过程中必须进行互动。诸如科室界限、不同专业之间的互动、患者病情严重程度以及治疗调整等因素，在患者从急诊科转至重症监护病房的过程中会产生特定的协商和团队合作问题。
目的
本研究旨在描述南非豪登省一家大型学术医院的护士对急诊科和重症监护病房护士之间交接班实践有效性的看法。
方法
采用分析性横断面调查设计。使用一份包含16项内容的交接班评估工具收集数据。该工具包括两个部分：（1）个人信息详情；（2）关于交接班质量的16条陈述，分为五个结构维度，即信息传递、共同理解、工作氛围、整体交接班质量以及交接班情况。数据分析采用描述性统计和非参数统计方法。
结果
大多数（51.8%；n = 115）交接班发生在白天。在171名护士中，有急诊专科护士（19.2%；n = 33）和重症监护专科护士（28.0%；n = 48）。急诊科和重症监护病房护士在信息传递方面存在统计学差异（中位数 = 4.0，p < 0.05），而重症监护病房护士的中位数为3.0。在评分量表的16项内容中，专科护士和非专科护士的交接班在12项上存在统计学显著差异，非专科护士的交接班在10项上存在差异。
结论
该研究表明，急诊科和重症监护病房护士对交接班程序有显著不同的要求和期望。除了完整的文件记录外，对所提供和接收信息的细微解读也会影响需求。由于不同专业和科室有不同期望以实现有效的交接班，急诊科和重症监护病房护士需要就结构化交接班框架的内容达成一致。
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