Dewan Maya, Prideaux Jonelle, Loeb Daniel, Patel Ruchit V, Zackoff Matthew, Kudchadkar Sapna R, Vaughn Lisa M, Schondelmeyer Amanda C
From the Department of Pediatrics, College of Medicine, University of Cincinnati, Cincinnati, Ohio.
Division of Critical Care Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.
Pediatr Qual Saf. 2024 Sep 3;9(5):e757. doi: 10.1097/pq9.0000000000000757. eCollection 2024 Sep-Oct.
We aimed to investigate facilitators and barriers that impact the sustainability of an interprofessional situation awareness bundle.
This is a single-center qualitative study at a tertiary care pediatric center examining the sustainability of an interprofessional situation awareness bundle to reduce in-hospital cardiac arrests. The bundle includes an automated clinical decision support tool, twice-daily safety huddles, and a bedside mitigation plan. A trained research staff member interviewed participants in October 2022. Interviews were audio recorded and transcribed verbatim, and recruitment continued until data saturation. Inductive and deductive analyses were used here.
The authors interviewed twelve staff members via individual semistructured interviews: registered nurses (RN, n = 2) and clinicians [(advanced practice providers, n = 2), pediatric critical care fellows, n = 4 and attendings, n = 4)]. Five main themes were identified: (1) the situation awareness bundle is into daily practice and culture, (2) the bundle has communication, decision-making, and improved outcomes, (3) standardized processes, stakeholder buy-in, and support of team members are key to adoption and , (4) variation in processes and fast-changing clinical context remains a for reliable use, and (5) the situation awareness bundle families.
The situation awareness bundle has become ingrained, strengthened, and sustained over the last 5 years through integration into daily practice and culture and leveraging standardized processes, tools and technology. It is associated with improved communication and shared decision-making. Understanding the key components for implementation and sustainability is necessary for ongoing spread and improvement in the future.
我们旨在调查影响跨专业态势感知综合措施可持续性的促进因素和障碍。
这是一项在三级护理儿科中心进行的单中心定性研究，考察跨专业态势感知综合措施对减少院内心脏骤停的可持续性。该综合措施包括一个自动化临床决策支持工具、每日两次的安全碰头会以及床边缓解计划。2022年10月，一名经过培训的研究人员对参与者进行了访谈。访谈进行了录音并逐字转录，招募工作持续到数据饱和。这里采用了归纳和演绎分析方法。
作者通过个人半结构化访谈对12名工作人员进行了访谈：注册护士（RN，n = 2）和临床医生[（高级执业提供者，n = 2）、儿科重症监护住院医师，n = 4和主治医师，n = 4]。确定了五个主要主题：（1）态势感知综合措施融入日常实践和文化，（2）该综合措施改善了沟通、决策并提高了结果，（3）标准化流程、利益相关者的认可和团队成员的支持是采用和可持续性的关键，（4）流程的差异和快速变化的临床环境仍然是可靠使用的障碍，（5）态势感知综合措施涉及家庭。
在过去5年中，态势感知综合措施通过融入日常实践和文化以及利用标准化流程、工具和技术，已根深蒂固、得到强化并得以持续。它与改善沟通和共同决策相关。了解实施和可持续性的关键组成部分对于未来的持续推广和改进是必要的。
