Tran Louise Dung, Neil Bronwyn, Taylor Christine
Liverpool Hospital, South-Western Sydney Local Health District, Sydney, NSW, Australia.
Camden and Campbelltown Hospitals, South-Western Sydney Local Health District, Sydney, NSW, Australia.
JBI Evid Implement. 2024 Oct 4. doi: 10.1097/XEB.0000000000000471.
Ambulatory care settings are at high risk for errors when identifying patients and matching them to their intended care.
The objective of this project was to improve correct and consistent patient identification and matching to their intended care by nurses in ambulatory care settings.
The seven-phase JBI Evidence Implementation Framework was used to guide this project. JBI tools were used to audit current practices and implement best practices in four ambulatory care units. The implementation plan included a baseline audit and two follow-up audits. Feedback was obtained through interviews with ambulatory care nursing staff, educational sessions were conducted for nursing staff, and unit guidelines were developed.
In the baseline audit, compliance with best practice criteria for patient matching and identification was below 62% for 7/13 criteria. After conducting education sessions and other strategies, 1/3 pre- and post-clinical intervention criteria improved in compliance, while 2 were unchanged. For blood product administration criteria, 2/5 improved, 1 was unchanged, and 2 were lower than baseline. Nurses' education in patient identification procedures improved (1/1) and knowing where to access relevant policies remained unchanged at 100%. Criteria for patients knowing the importance of patient identification (2/2) and the identification band following national standards (1/1) improved from baseline.
The results support the use of education sessions and infrastructure changes to promote and sustain change in evidence-based practice in ambulatory care units. Not all criteria improved, and the audit team identified strategies to improve the implementation of evidence-based practice in ambulatory care units.
门诊护理机构在识别患者并将其与预期护理进行匹配时存在很高的错误风险。
本项目的目的是提高门诊护理机构中护士对患者的正确且一致的识别,并使其与预期护理相匹配。
采用七阶段的循证卫生保健国际协作中心(JBI)证据实施框架来指导本项目。使用JBI工具对当前实践进行审核,并在四个门诊护理单元实施最佳实践。实施计划包括一次基线审核和两次跟进审核。通过与门诊护理人员进行访谈获得反馈,为护理人员举办教育课程,并制定科室指南。
在基线审核中,13项标准中有7项在患者匹配和识别方面符合最佳实践标准的比例低于62%。在开展教育课程和其他策略后,临床干预前后1/3的标准在合规性方面有所改善,2项保持不变。对于血液制品给药标准,5项中有2项有所改善,1项保持不变,2项低于基线水平。护士在患者识别程序方面的教育有所改善(1/1),知道在哪里获取相关政策的比例保持不变,为100%。患者了解患者识别重要性的标准(2/2)以及识别带符合国家标准的标准(1/1)较基线有所改善。
结果支持通过教育课程和基础设施变革来促进和维持门诊护理单元基于证据的实践变革。并非所有标准都有所改善,审核团队确定了提高门诊护理单元基于证据的实践实施效果的策略。