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结构化术后交接方案可提高外科重症监护病房跨学科交流和护理质量:一项随机对照试验。

Structured postoperative handover protocol improves efficiency and quality of interdisciplinary communication and nursing care in surgical intensive care unit: a randomized controlled trial.

机构信息

Department of Critical Care Medicine, The First Affiliated Hospital of Sun Yat-Sen University, No.58, Zhongshan 2nd Road, Yuexiu District, Guangzhou, 510080, Guangdong Province, China.

Department of Anesthesiology, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, China.

出版信息

Updates Surg. 2024 Jan;76(1):289-298. doi: 10.1007/s13304-023-01551-2. Epub 2023 Jun 5.

DOI:10.1007/s13304-023-01551-2
PMID:37277673
Abstract

This study aimed to evaluate the effectiveness of a structured postoperative handover protocol for postoperative transfer to the SICU. This study was a randomized controlled trial conducted in a comprehensive teaching hospital in China. Patients who were transferred to the SICU after surgery were randomly divided into two groups. The intervention group underwent postoperative structured handover protocol, and the control group still applied conventional oral handover. A total of 101 postoperative patients and 50 clinicians were enrolled. Although the intervention group did not shorten the handover duration (6.18 ± 1.66 vs 5.94 ± 1.91; P = 0.505), the handover integrity was significantly improved, mainly reflected in fewer information omissions (1.44 ± 0.97 vs 0.67 ± 0.62; P < 0.001), fewer additional questions raised by ICU physicians (1.06 ± 1.04 vs 0.24 ± 0.43; P < 0.001) and fewer additional handovers via phone call (16% vs 3.9%; P = 0.042). The total score of satisfaction of the intervention group was significantly higher than that of the control group (76.44 ± 7.32 vs 81.24 ± 6.95; P = 0.001). With respect to critical care, the incidence of stage I pressure sore within 24 h was lower in the intervention group than in the control group (20% vs 3.9%, P = 0.029). Structured postoperative handover protocol improves the efficiency and quality of interdisciplinary communication and clinical care in SICU.Trial registration This study was registered in China on January 8th, 2022 at Chinese Clinical Trial Registry (ChiCTR2200055400).

摘要

本研究旨在评估术后交接方案在术后转入 SICU 中的效果。本研究是在中国一家综合性教学医院进行的一项随机对照试验。手术后转入 SICU 的患者被随机分为两组。干预组采用术后结构化交接方案,对照组仍采用常规口头交接。共纳入 101 例术后患者和 50 名临床医生。虽然干预组并未缩短交接时间(6.18±1.66 与 5.94±1.91;P=0.505),但交接完整性明显提高,主要表现为信息遗漏减少(1.44±0.97 与 0.67±0.62;P<0.001),ICU 医生提出的附加问题减少(1.06±1.04 与 0.24±0.43;P<0.001)和电话转接减少(16%与 3.9%;P=0.042)。干预组的满意度总评分明显高于对照组(76.44±7.32 与 81.24±6.95;P=0.001)。在重症护理方面,干预组术后 24 小时内 I 期压疮的发生率低于对照组(20%与 3.9%;P=0.029)。术后交接方案可提高 SICU 中跨学科沟通和临床护理的效率和质量。

试验注册 本研究于 2022 年 1 月 8 日在中国临床试验注册中心(ChiCTR2200055400)注册。

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本文引用的文献

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Standardizing postoperative handoffs using the evidence-based IPASS framework through a multidisciplinary initiative improves handoff communication for neurosurgical patients in the neuro-intensive care unit.通过多学科举措,使用基于证据的 IPASS 框架标准化术后交接,可改善神经重症监护病房神经外科患者的交接沟通。
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A Partially Structured Postoperative Handoff Protocol Improves Communication in 2 Mixed Surgical Intensive Care Units: Findings From the Handoffs and Transitions in Critical Care (HATRICC) Prospective Cohort Study.部分结构化术后交接班协议可改善 2 个混合外科重症监护病房的沟通:来自重症监护交接班和过渡(HATRICC)前瞻性队列研究的结果。
Ann Surg. 2020 Mar;271(3):484-493. doi: 10.1097/SLA.0000000000003137.
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Improving cardiac operating room to intensive care unit handover using a standardised handover process.使用标准化交接流程改善心脏手术室至重症监护病房的交接。
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Effect of Standardized Handoff Curriculum on Improved Clinician Preparedness in the Intensive Care Unit: A Stepped-Wedge Cluster Randomized Clinical Trial.标准化交接班课程对提高重症监护病房临床医生准备度的效果:一项阶梯式楔形集群随机临床试验。
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