运用“在场圈”法确定提高护士出院时在场感的策略：一项针对护生的焦点小组研究
Using Presence Circles to identify strategies to enhance nurse presence at discharge: a focus group study with nursing students.
作者信息
Haverfield Marie C, Nayeem Sara, Sterk Meaghan, Demertzis Stacy, Szeto Deborah, Whitney Robin
机构信息
Department of Communication Studies, San José State University, Hugh Gillis Hall (HGH), 220 E. San Fernando Street, San Jose, CA 95112, United States.
Department of Biology, San José State University, One Washington Square, San Jose, CA 95112, United States.
出版信息
Int J Nurs Stud Adv. 2025 May 3;8:100338. doi: 10.1016/j.ijnsa.2025.100338. eCollection 2025 Jun.
BACKGROUND
Nurse communication of patient needs at discharge is critical to ongoing care, but system-level demands often prohibit comprehensive discharge conversations. Caregivers of discharged patients frequently report feeling underprepared to meet patient needs. Meaningful interpersonal encounters, or , are known to enhance clinical interactions amidst system-level demands, which could help improve caregiver preparedness and patient care.
PURPOSE
To explore and synthesize examples of nurse presence during discharge conversations through Presence Circles (structured focus groups) to provide recommendations for enhancing high-quality information at discharge.
METHODS
In a secondary analysis of data from a larger study based on the Nurse Presence Framework, nursing students ( = 14) from a Northern California school were asked to participate in two Nurse Presence Circles. Audio recordings from 10 Presence Circles were transcribed and analysis was conducted according to the five practices of the Nurse Presence framework: Prepare with Intention, Listen Intently and Completely, Agree on What Matters Most, Connect with the Story, and Evolve System-Level Change.
RESULTS
Within each of the five nurse presence practices, strategies and challenges were collapsed into broader themes that served as recommendations for enhancing the exchange of high-quality information at discharge.
CONCLUSIONS
Presence Circles offered a useful space to share strategies and identify system changes that could advance the exchange of high-quality information at discharge. We have provided a synthesis of recommendations for nurses, particularly those new to discharge conversations or early in their nursing career, demonstrating the need to engage nursing students about discharge conversations and introduce considerations related to health care systems and policy to better support the discharge conversation experience.
背景
护士在出院时传达患者需求对于持续护理至关重要，但系统层面的要求常常使全面的出院谈话难以实现。出院患者的护理人员经常表示，他们觉得自己在满足患者需求方面准备不足。已知有意义的人际互动，即，在系统层面的要求下能增强临床互动，这有助于提高护理人员的准备程度和患者护理质量。
目的
通过“在场圈”（结构化焦点小组）探索并综合出院谈话中护士在场的实例，为提高出院时的高质量信息提供建议。
方法
在一项基于护士在场框架的大型研究数据的二次分析中，来自北加利福尼亚一所学校的护理专业学生（n = 14）被要求参加两个护士在场圈。对10个在场圈的录音进行转录，并根据护士在场框架的五项实践进行分析：有意准备、专注且完整地倾听、就最重要的事项达成一致、与故事建立联系以及推动系统层面的变革。
结果
在护士在场的五项实践中，策略和挑战被归纳为更广泛的主题，这些主题可作为提高出院时高质量信息交流的建议。
结论
在场圈提供了一个有用的空间，用于分享策略并确定可促进出院时高质量信息交流的系统变革。我们为护士提供了一份建议综述，特别是那些刚接触出院谈话或处于护理职业生涯早期的护士，表明有必要让护理专业学生参与出院谈话，并引入与医疗保健系统和政策相关的考量，以更好地支持出院谈话体验。
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