Costa Deena Kelly, Lee Kathryn A, Wright Nathan C, Boltey Emily M, Ratliff Hannah C, Marriott Deanna J, Yakusheva Olga
Yale School of Nursing, West Haven CT, USA; Yale School of Medicine, Section on Pulmonary, Critical Care & Sleep Medicine, New Haven CT, USA.
University of Michigan School of Nursing, Ann Arbor, MI, USA.
Heart Lung. 2025 May-Jun;71:1-6. doi: 10.1016/j.hrtlng.2025.01.012. Epub 2025 Feb 1.
Backup behavior-when clinicians help each other via verbal assistance or task completion in their roles-is essential for effective teamwork in the intensive care unit (ICU) but is not well understood. Exploring how interprofessional team members provide backup may guide future interventions.
To examine who, how often, why, and under what circumstances ICU clinicians provide backup in mechanical ventilation care.
Using a convergence, triangulation mixed methods design in 2 medical ICUs (2017-2019), we collected qualitative data (observation, shadowing, interviews) to understand how ICU teams provide backup; and patient-shift level surveys of ICU nurses, physicians, and respiratory therapists, to identify whom clinicians contacted for help that shift. We analyzed and compared these data to gain insight into the frequency, and circumstances surrounding ICU clinicians' requests for and receipt of backup when providing mechanical ventilation care.
Backup behavior was common. Interprofessional backup (e.g. nurse to respiratory therapist) related to specific patient care tasks. Intraprofessional backup (e.g. nurse to nurse) involved team members 'checking in' to assist their colleague. Most (57%) survey respondents reported at least one interprofessional contact on day and night shifts, and approximately 25% reported at least one intraprofessional backup contact. We identified distinct backup behavior patterns on day and night shifts.
While backup behavior was common, interprofessional backup focused on care aligning with professional roles whereas intraprofessional backup entailed checking-in with team members. Examining how to enhance interprofessional backup through trainings or interventions may improve how teams work and patient care.
在重症监护病房（ICU）中，当临床医生通过言语协助或完成任务来互相帮助时，这种支持行为对于有效的团队协作至关重要，但目前尚未得到充分理解。探索跨专业团队成员如何提供支持可能会为未来的干预措施提供指导。
研究ICU临床医生在机械通气护理中由谁、多频繁、为何以及在何种情况下提供支持。
在2个医疗ICU（2017 - 2019年）采用融合、三角测量混合方法设计，我们收集了定性数据（观察、跟班、访谈）以了解ICU团队如何提供支持；以及对ICU护士、医生和呼吸治疗师进行患者轮班水平调查，以确定临床医生在该轮班中向谁寻求帮助。我们分析并比较这些数据，以深入了解ICU临床医生在提供机械通气护理时请求和获得支持的频率及相关情况。
支持行为很常见。跨专业支持（如护士对呼吸治疗师）与特定的患者护理任务相关。专业内支持（如护士对护士）涉及团队成员“询问情况”以协助同事。大多数（57%）调查受访者报告在白班和夜班至少有一次跨专业联系，约25%报告至少有一次专业内支持联系。我们确定了白班和夜班不同的支持行为模式。
虽然支持行为很常见，但跨专业支持侧重于与专业角色相符的护理，而专业内支持则需要与团队成员询问情况。研究如何通过培训或干预来加强跨专业支持可能会改善团队协作和患者护理。
