Felizardo Helena, Cardoso Daniela, Nogueira Paula, Bastos Joana, Casimiro Daniela, Nogueira Pedro, Cardoso Ana Filipa, Apóstolo João, Vrbová Tereza, Klugar Miloslav, Klugarová Jitka
Nursing School of Coimbra (ESEnfC), Coimbra, Portugal.
Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Coimbra, Portugal.
JBI Evid Implement. 2025 Jan 1;23(S1):S1-S8. doi: 10.1097/XEB.0000000000000482.
In health care, effective communication enhances teamwork and safety by minimizing adverse events. Evidence suggests that ongoing education should include communication skills training, as interprofessional communication relies on tools that facilitate seamless interaction.
This project aimed to improve communication practices among nurses in a long-term care unit by promoting evidence-based recommendations.
This project followed the seven phases proposed by the JBI Evidence Implementation Framework. This framework is grounded in an audit, feedback, and re-audit process, along with a structured approach to addressing barriers to compliance with best practices. JBI's Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) approach were also used.
A baseline audit was conducted focusing on three audit criteria. Compliance was measured by observing 250 handovers and administering a questionnaire to 14 nurses. After analyzing the results, the nursing team identified barriers and designed strategies to promote change, such as educational sessions and a focus group. The results of the follow-up audit showed significant improvements across all criteria. Nurses received training in communication for Criterion 1, which improved from 0% to 78%. For Criterion 2, training in teamwork and conflict management improved from 21% to 50%. For Criterion 3, the use of a structured communication tool (ISBAR) during handovers improved from 43.6% to 91%.
The nursing team's involvement enabled effective change. Adapting ISBAR to a long-term care unit was an unexpected goal. The next objective is to refine and share it with similar units. Integrating communication training into health care institutions' priorities is crucial, and future audits will ensure sustainability.
在医疗保健领域，有效的沟通通过减少不良事件来增强团队合作并提高安全性。有证据表明，持续教育应包括沟通技能培训，因为跨专业沟通依赖于促进无缝互动的工具。
本项目旨在通过推广循证建议来改善长期护理病房护士之间的沟通实践。
本项目遵循了JBI循证实施框架提出的七个阶段。该框架基于审核、反馈和重新审核过程，以及解决遵守最佳实践障碍的结构化方法。还使用了JBI的临床证据实践应用系统（PACES）和将研究应用于实践（GRiP）方法。
进行了一次基线审核，重点关注三个审核标准。通过观察250次交接班并向14名护士发放问卷来衡量合规情况。分析结果后，护理团队确定了障碍并设计了促进变革的策略，如教育课程和焦点小组。后续审核结果显示所有标准均有显著改善。护士接受了针对标准1的沟通培训，该标准的合规率从0%提高到了78%。对于标准2，团队合作和冲突管理培训从21%提高到了50%。对于标准3，交接班期间使用结构化沟通工具（ISBAR）从43.6%提高到了91%。
护理团队的参与促成了有效的变革。将ISBAR应用于长期护理病房是一个意外收获。下一个目标是对其进行完善并与类似病房分享。将沟通培训纳入医疗机构的优先事项至关重要，未来的审核将确保可持续性。
