Lee Seung Eun, Dahinten V Susan, Kim Eunkyung, Lee Sang Hwa, Han Soo Young, Kim Phill Ja, Kim Jung Yeon
Mo-Im KIM Nursing Research Institute, College of Nursing, Yonsei University, Seoul 03722, Republic of Korea.
School of Nursing, University of British Columbia, Vancouver V6T 2B5, Canada.
J Nurs Manag. 2023 Jul 5;2023:8929993. doi: 10.1155/2023/8929993. eCollection 2023.
Open communication about patient safety concerns is necessary to enable a learning environment where lessons can be learned to improve patient safety, but nurses often hesitate to speak up even in situations where their patients may be at risk. One way to create a safe environment for speaking up is through the use of unit-level daily huddles. This study aimed to assess the effects of a 12-week huddle intervention on nine unit, nurse and patient care outcomes and describe nurses' experiences with the intervention. We used a single group, pre- and post-test mixed-methods design, with a dominant quantitative thread, and a final sample of 89 staff nurses. The intervention was conducted in four surgical units in a tertiary teaching hospital in Seoul, Korea. The intervention included two educational workshops for huddle leaders, two workshops for staff nurses, and 12-week huddles with coaching visits. We collected quantitative data on nine outcomes using online surveys before and after the intervention and qualitative data on nurse experiences of the intervention after the intervention. Paired -tests were used for quantitative data analysis, and content analysis was used for qualitative data. We examined four unit-level outcomes (organizational learning, situation monitoring, mutual support, and speaking-up climate), three nurse-level outcomes (promotive and prohibitive voice behaviors and job satisfaction), and two patient care outcomes (patient safety and quality of care). Significant improvements were found in six of the nine outcomes. Findings from the qualitative data confirmed the benefits of the intervention but also identified challenges to huddle participation. Patient safety huddles can contribute to a learning environment by flattening hierarchies and encouraging nurses to speak up regarding safety issues. Leadership is a key in role modelling and creating the foundation for a more collaborative patient safety culture in healthcare organizations, for example, through the use of daily huddles.
就患者安全问题进行开放沟通对于营造一个能汲取经验教训以提高患者安全的学习环境而言是必要的，但护士们即便在患者可能面临风险的情况下也常常不愿直言。营造一个能让护士直言的安全环境的一种方法是通过开展科室层面的每日碰头会。本研究旨在评估为期12周的碰头会干预对九个科室、护士及患者护理结果的影响，并描述护士对该干预措施的体验。我们采用了单组前后测混合方法设计，以定量研究为主线，最终样本为89名注册护士。该干预措施在韩国首尔一家三级教学医院的四个外科科室实施。干预措施包括为碰头会负责人举办两场教育工作坊、为注册护士举办两场工作坊，以及为期12周的碰头会并安排指导访问。我们在干预前后通过在线调查收集了关于九个结果的定量数据，并在干预后收集了关于护士对干预措施体验的定性数据。定量数据分析采用配对检验，定性数据分析采用内容分析法。我们考察了四个科室层面的结果（组织学习、情况监测、相互支持及直言氛围）、三个护士层面的结果（促进性和抑制性建言行为及工作满意度）以及两个患者护理结果（患者安全和护理质量）。九个结果中有六个出现了显著改善。定性数据的研究结果证实了该干预措施的益处，但也发现了参与碰头会存在的挑战。患者安全碰头会可通过消除等级制度并鼓励护士就安全问题直言不讳，从而有助于营造一个学习环境。领导力是树立榜样并为医疗保健机构中更具协作性的患者安全文化奠定基础的关键，例如，通过开展每日碰头会。
