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新型急诊普通外科交接班评估:一项前瞻性可行性研究。

Evaluation of a Novel Emergency General Surgery Handover: A Prospective Feasibility Study.

机构信息

Wake Forest University School of Medicine, Winston-Salem, North Carolina.

Division of Public Health Sciences, Department of Biostatistics and Data Science, WFUSM, Winston-Salem, North Carolina.

出版信息

J Surg Res. 2024 Oct;302:715-723. doi: 10.1016/j.jss.2024.07.111. Epub 2024 Aug 29.

Abstract

INTRODUCTION

High-quality health information handovers are critical to optimal patient care and trainee education. The purposes of this study were to assess the feasibility of implementing an emergency general surgery (EGS) morning handover and to explore its impact upon markers of clinical care.

METHODS

This prospective feasibility study was conducted at a single academic tertiary-care medical center following implementation of a novel EGS morning handover process. We assessed organizational perspective through a two-part anonymous survey delivered to the EGS service staff (n = 29) and collected feasibility metrics daily at the morning handover meetings. Exploratory clinical metrics of quality improvement were compared between parallel 5-month periods preimplementation and postimplementation of the handover. Data were compared by descriptive statistics.

RESULTS

One hundred and seventeen patients from March 1, 2022, to July 31, 2022, and 185 patients from March 1, 2023, to July 31, 2023, were identified prehandover and posthandover implementation, respectively, with an increase in time to operating room posting by 49% (95% confidence interval [CI]: 1.03-2.14) and no statistically significant change in length of stay. The average duration of the formalized EGS morning handover was 14 min (95% CI: 12:18-15:42) having an average of 12 questions asked (95% CI: 9.98-14.02) and an average attendance of 70% from essential personnel. Eighty-four percent of postimplementation survey responses indicated positive regard toward the new EGS handover.

CONCLUSIONS

The implementation of an EGS morning handover is feasible, necessitating further studies to define the impact of the EGS morning handover upon clinical outcomes.

摘要

简介

高质量的健康信息交接对优化患者护理和培训生教育至关重要。本研究旨在评估实施急诊普通外科(EGS)晨间交接的可行性,并探讨其对临床护理指标的影响。

方法

本前瞻性可行性研究在一家学术性三级医疗中心进行,在实施新的 EGS 晨间交接流程后进行。我们通过向 EGS 服务人员(n=29)进行的两部分匿名调查评估组织观点,并在晨间交接会议上每天收集可行性指标。在交接前和交接后实施的 5 个月平行期间,比较了探索性临床质量改进指标。数据通过描述性统计进行比较。

结果

2022 年 3 月 1 日至 7 月 31 日期间,117 名患者在交接前接受治疗,2023 年 3 月 1 日至 7 月 31 日期间,185 名患者在交接后接受治疗,手术室挂牌时间增加了 49%(95%置信区间 [CI]:1.03-2.14),住院时间没有统计学意义的变化。形式化 EGS 晨间交接的平均持续时间为 14 分钟(95% CI:12:18-15:42),平均有 12 个问题(95% CI:9.98-14.02),基本人员的平均出席率为 70%。84%的交接后调查回复表示对新的 EGS 交接持积极态度。

结论

EGS 晨间交接的实施是可行的,需要进一步研究来确定 EGS 晨间交接对临床结果的影响。

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