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通过改进患者交接流程提高手术护理质量。

Enhancing the quality of surgical care through improved patient handover processes.

作者信息

Ryan Jessica M, McNamara Deborah A

机构信息

RCSI StAR PhD Programme, School of Postgraduate Studies, 123 St. Stephen's Green, Co, Dublin, Ireland.

The Bon Secours Hospital, Glasnevin Hill, Glasnevin, Co Dublin, Ireland.

出版信息

Patient Saf Surg. 2025 Mar 14;19(1):7. doi: 10.1186/s13037-025-00428-0.

Abstract

Surgical handover remains a high-risk process with no gold standard for practice despite 20 years of available guidance. Variability in practice is common, and poorly performed handover poses significant, yet avoidable, risk to patients. Research in this domain is underfunded with widely heterogenous methodology, meaning that the evidence base for better handover is deficient. In this correspondence, recommendations are made to address these shortcomings, including standardised operating procedures supported by electronic health records to enable staff training and audit. Prioritisation of the sickest patients at the handover outset and two-way, verbal communication, including a "read-back" to confirm that information is both transmitted and received. Rigorous evaluation of handover interventions before use, and discontinuation of practices that add no value. Lastly, a core outcome set for surgical handover is urgently needed to improve the comparability of studies. By clearly defining best practices and demonstrating the impact of interventions on patient outcomes, surgeons will be more inclined to adopt meaningful improvements in handover processes.

摘要

尽管已有20年的可用指南,但手术交接仍然是一个高风险过程,且没有实践的金标准。实践中的差异很常见,交接执行不佳会给患者带来重大但可避免的风险。该领域的研究资金不足,方法广泛异质,这意味着改善交接的证据基础不足。在这篇通信文章中,提出了一些建议来解决这些不足,包括由电子健康记录支持的标准化操作程序,以促进员工培训和审核。在交接开始时对病情最严重的患者进行优先排序,并进行双向口头沟通,包括“复述”以确认信息已发送和接收。在使用前对接交干预措施进行严格评估,并停止无价值的做法。最后,迫切需要一套手术交接的核心结局指标集,以提高研究的可比性。通过明确界定最佳实践并证明干预措施对患者结局的影响,外科医生将更倾向于在交接过程中采用有意义的改进措施。

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