Before-After Study of a Checklist to Improve Acute Care to ICU Handoffs.

IF 1 4区医学 Q4 HEALTH CARE SCIENCES & SERVICES

American Journal of Medical Quality Pub Date : 2023-01-01 Epub Date: 2022-11-10 DOI:10.1097/JMQ.0000000000000091

Katherine G Hicks, Lois Downey, Addy Elketami, Elizabeth L Nielsen, Ruth A Engelberg, Ann L Jennerich

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引用次数: 0

Abstract

Transferring care of a patient is a critical process. The objective of this study was to evaluate a checklist to standardize handoffs from acute care to the intensive care unit (ICU). This was a single-center, before-after study of a checklist to standardize transfers of patients from acute care to the medical-cardiac ICU. Clinicians completed surveys about handoffs before and after checklist implementation. The association between study period and survey data was analyzed using multivariable logistic regression with cross-classified multilevel models. Surveys were completed by 179 clinicians. After checklist implementation, handoffs were more likely to occur in the ICU (OR 17.23; 95% CI, 1.81-164.19) and cover patient treatment preferences (OR 2.73; 95% CI, 1.12-6.66). However, checklist uptake was suboptimal (30% of responses indicated checklist use). Implementation of a checklist during acute care to ICU transfers is challenging. Signals suggesting process improvement warrant additional study.

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改善急症护理与重症监护室交接的核对表前后对比研究。

病人的护理交接是一个至关重要的过程。本研究的目的是对一份核对表进行评估，以规范从急症监护室到重症监护室（ICU）的交接工作。这是一项单中心、前后对比研究，研究对象是用于规范从急症监护室向内科-心脏重症监护室转运病人的核对表。临床医生在核对表实施前后完成了有关交接的调查。采用交叉分类多层次模型的多变量逻辑回归分析了研究期间与调查数据之间的关联。共有 179 名临床医生完成了调查。实施核对表后，交接更有可能发生在重症监护室（OR 17.23；95% CI，1.81-164.19），并涵盖患者的治疗偏好（OR 2.73；95% CI，1.12-6.66）。然而，核对表的使用率并不理想（30% 的回复表示使用过核对表）。在急诊转入重症监护室的过程中实施核对表是一项挑战。建议改进流程的信号值得进一步研究。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Medical Quality 医学-卫生保健

CiteScore

1.90

自引率

7.10%

发文量

124

审稿时长

6-12 weeks

期刊介绍： The American Journal of Medical Quality (AJMQ) is focused on keeping readers informed of the resources, processes, and perspectives contributing to quality health care services. This peer-reviewed journal presents a forum for the exchange of ideas, strategies, and methods in improving the delivery and management of health care.