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在新冠疫情及非新冠临床环境中使用“介绍、情况、背景、评估和建议”交接方式:一项系统评价和荟萃分析

The use of Introduction, Situation, Background, Assessment, and Recommendation handover in the COVID-19 pandemic and non-COVID clinical settings: a systematic review and meta-analysis.

作者信息

Lazzari Carlo, Rabottini Marco

机构信息

Department of Health Sciences, International Centre for Healthcare and Medical Education, Bristol, United Kingdom.

出版信息

Front Health Serv. 2025 Aug 7;5:1380948. doi: 10.3389/frhs.2025.1380948. eCollection 2025.

DOI:10.3389/frhs.2025.1380948
PMID:40851885
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12367679/
Abstract

INTRODUCTION

The Introduction, Situation, Background, Assessment, and Recommendation (ISBAR) approach to clinical handovers assists healthcare providers in sharing information about patients within clinical teams and across health sectors while reducing information gaps and medical errors. However, despite its significance, uncertainties remain about the clear outcomes of applying ISBAR and training, especially in settings managing COVID-19 and those not dealing with the pandemic.

METHODS

This review was conducted following the PRISMA guidelines. All the selected articles underwent a progressive check for bias and validity using GRADEpro GDT and RoB-2 as per Cochrane guidelines. This review utilized a meta-analysis of 29 studies and a critical narrative review of seminal articles to condense the non-numerical findings. All articles were checked for heterogeneity with the coefficient. The extracted effect size was the common language effect size (CLES), with 95% confidence intervals.

RESULTS

ISBAR strengthens communication skills in clinical teams, increases self-confidence and efficacy among healthcare practitioners, improves interprofessional communication, reduces medical errors, and enhances patient safety.

CONCLUSIONS

Our systematic review confirms that ISBAR handover improved the quality of care during the COVID-19 pandemic and non-COVID clinical practice. The limitation of this study is related to the lack of randomized controlled trials and blinding. Almost all studies were cross-sectional, which only provides information regarding associations but not causation.

摘要

引言

临床交接班的“引言、情况、背景、评估及建议”(ISBAR)方法有助于医疗服务提供者在临床团队内部及跨卫生部门共享患者信息,同时减少信息差距和医疗差错。然而,尽管其意义重大,但对于应用ISBAR及培训的明确结果仍存在不确定性,尤其是在管理新冠肺炎的环境以及未应对该疫情的环境中。

方法

本综述遵循PRISMA指南进行。所有选定的文章均按照Cochrane指南,使用GRADEpro GDT和RoB-2进行了偏倚和有效性的逐步检查。本综述对29项研究进行了荟萃分析,并对重要文章进行了批判性叙述性综述,以汇总非数值性研究结果。所有文章均使用I²系数检查异质性。提取的效应量为通用语言效应量(CLES),并带有95%置信区间。

结果

ISBAR增强了临床团队的沟通技能,提高了医护人员的自信心和效能,改善了跨专业沟通,减少了医疗差错,并提高了患者安全性。

结论

我们的系统评价证实,ISBAR交接班在新冠肺炎大流行期间及非新冠肺炎临床实践中提高了护理质量。本研究的局限性与缺乏随机对照试验和盲法有关。几乎所有研究都是横断面研究,仅提供有关关联而非因果关系的信息。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/ba96ec63185a/frhs-05-1380948-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/b3efdd56d0aa/frhs-05-1380948-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/8813d8ed3b6a/frhs-05-1380948-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/ba96ec63185a/frhs-05-1380948-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/b3efdd56d0aa/frhs-05-1380948-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/8813d8ed3b6a/frhs-05-1380948-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64af/12367679/ba96ec63185a/frhs-05-1380948-g003.jpg

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本文引用的文献

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Implementing the Verbal and Electronic Handover in General and Psychiatric Nursing Using the Introduction, Situation, Background, Assessment, and Recommendation Framework: A Systematic Review.使用“介绍、情况、背景、评估和建议”框架在普通护理和精神科护理中实施口头和电子交接班:一项系统综述
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Interdisciplinary Collaboration and Communication Among Doctors and Nurses in ICUs During the COVID-19 Pandemic and Their Importance in Professional Life Quality Improvement.新冠疫情期间重症监护病房医护人员的跨学科协作与沟通及其对职业生活质量提升的重要性
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Impact of the implementation of Identification-Situation-Background-Assessment-Recommendation (ISBAR) tool to improve quality and safety measure in a lithotripsy and endourological unit.
身份-情况-背景-评估-建议(ISBAR)工具的实施对提高碎石和内窥镜泌尿外科单位质量和安全措施的影响。
PLoS One. 2023 Jun 2;18(6):e0286565. doi: 10.1371/journal.pone.0286565. eCollection 2023.
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The effects of electronic nursing handover on patient safety in the general (non-COVID-19) and COVID-19 intensive care units: a quasi-experimental study.电子护理交接班对普通(非 COVID-19)和 COVID-19 重症监护病房患者安全的影响:一项准实验研究。
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Usability Evaluation of the Preoperative ISBAR (Identification, Situation, Background, Assessment, and Recommendation) Desktop Virtual Reality Application: Qualitative Observational Study.术前ISBAR(识别、情况、背景、评估和建议)桌面虚拟现实应用的可用性评估:定性观察研究。
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