Leiden University Medical Center, Leiden, The Netherlands.
Leiden University Medical Center, Leiden, The Netherlands.
J Surg Educ. 2024 Aug;81(8):1034-1043. doi: 10.1016/j.jsurg.2024.05.017. Epub 2024 Jun 14.
The aim of this study was to explore local practices and perceptions of effective nurse-resident communication during shifts. Subsequently, effective communication was sought to be reinforced by implementing an initiative for improvement.
A mixed-methods study was performed, combining a questionnaire with focus groups. Following qualitative analysis, 3 initiatives for improvement of nurse-resident communication were scrutinized, after which 1 initiative was implemented. Overall contentment with the implementation and effectiveness of communication was reassessed through a questionnaire at 3 months postimplementation.
This study took place between 2022 and 2023 at the Department of Surgery of the Leiden University Medical Center, a tertiary center in the Netherlands.
All surgical nurses (n = 150) and residents (n = 20) were invited to participate, by responding to the questionnaire and take part in the focus groups. A total of 38 nurses (response rate 25.3%) and 12 residents (60%) completed the questionnaire, and 31 nurses and 13 residents participated in the focus groups.
The themes "clarity," "mutual respect," "accessibility" and "approach" were critical for effective communication, in which there were interdisciplinary differences in the interpretation and needs regarding "clarity." In response, structured moments for interdisciplinary consultation during shifts were implemented, which were foremostly useful according to nurses (73.9%), compared to residents (40.0%). A majority of the nurses agreed that communication during shifts improved through fixed moments (60.9%).
Differences in the perception of critical elements for efficient nurse-resident communication during shifts can be found, which could possibly be explained by differences in training and culture. Mutual awareness for each other's tasks, responsibilities and background seems vital for the ability to deliver good patient care during shifts. To improve interprofessional practice and overcome concerns of quality of care, attention for local practices is imperative. Practical arrangements, such as fixed moments for peer communication, can strengthen partnership during shift work.
本研究旨在探讨轮班期间护士与住院医师有效沟通的当地实践和认知。随后，通过实施一项改进措施，寻求加强有效的沟通。
采用混合方法研究，将问卷调查和焦点小组相结合。经过定性分析，确定了 3 项改善护士与住院医师沟通的改进措施，然后实施了 1 项措施。在实施后 3 个月，通过问卷调查再次评估对沟通实施和效果的总体满意度。
本研究于 2022 年至 2023 年在荷兰莱顿大学医学中心外科系进行，该中心为三级医疗中心。
所有外科护士（n=150）和住院医师（n=20）受邀参与，通过回复问卷和参加焦点小组。共有 38 名护士（回应率 25.3%）和 12 名住院医师（60%）完成了问卷，31 名护士和 13 名住院医师参加了焦点小组。
“清晰”、“相互尊重”、“可及性”和“方法”是有效沟通的关键主题，其中“清晰”的解释和需求存在跨学科差异。作为回应，在轮班期间实施了结构化的跨学科咨询时刻，根据护士（73.9%）的说法，这些时刻非常有用，而根据住院医师（40.0%）的说法则用处不大。大多数护士认为通过固定时刻改善了轮班期间的沟通（60.9%）。
轮班期间护士与住院医师有效沟通的关键要素的认知存在差异，这可能是由于培训和文化的差异造成的。相互了解对方的任务、责任和背景对于在轮班期间提供良好的患者护理至关重要。为了改善专业间的实践并解决对护理质量的担忧，必须关注当地的实践。固定的同伴沟通时刻等实际安排可以加强轮班工作中的伙伴关系。
