使用EBP作为解决问题的方法来提高患者满意度,同时克服COVID大流行障碍

Berryman J*
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摘要

背景:医疗保险和医疗补助服务中心要求医院在报销时严格满足患者满意度要求。用于患者满意度的一个指标是在一个单位内呼叫光响应。目的:达到磁石®指定医院内45张病床遥测医疗外科护理单元的呼叫光响应基准。方法:采用循证实践(EBP)项目模型。首席护士长与EBP的护士导师一起工作。制定PICOT(人口、干预、比较、结果和时间)问题来指导文献检索。对文献进行了批判性评价,并建立了相应的干预措施。护理教育者教导单位护士如何进行干预,并通过直接观察评估干预的整合程度。收集呼叫光响应数据以评估是否达到目标。结果:有5篇文章被认为适用于PICOT问题,最好的证据表明,在结构化注册护士(RN)护理期间每2小时进行一次检查,使用4Ps(疼痛、存在、“如厕”和体位)可以改善患者的预后。经过护士教育和实施后,医院呼叫光反应开始改善。将证据与行动联系起来:无意的舍入增加了注册护士的工作量,并不能改善患者的预后或使患者满意。每2小时进行一次RN四舍五入是有效和高效的(即,坚持4Ps)。注册护士每2小时对患者进行一次查房,目的是提高患者满意度和其他患者结果,如减少呼叫灯的使用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Use of EBP as a Problem Solving Approach to Improve Patient Satisfaction, while Overcoming the COVID Pandemic Barrier
Background: The Centers for Medicare & Medicaid Services requires hospitals to meet rigorous patient satisfaction requirements for reimbursement. One metric used for patient satisfaction is call light responsiveness within a unit. Aims: To meet target call light responsiveness benchmarks at a 45- bed telemetry, medical– surgical nursing unit within a Magnet ® designated hospital. Methods: An evidence- based practice (EBP) project model was utilized. The chief nursing officer worked with an EBP nurse mentor. A PICOT (Population, Intervention, Comparison, Outcome, and Time) question was developed to guide the literature search. Literature was critically appraised, and a resulting intervention was established. Nurse educators taught the unit nurses how to perform the intervention, and intervention integration was assessed via direct observation. Call light responsiveness data were collected to assess whether targets were met. Results: Five articles were deemed as applicable to the PICOT question, and the best evidence determined that using the 4Ps (pain, presence, “potty,” and positioning) during structured registered nurse (RN) care rounding every 2 hours improved patient outcomes. After RN education and implementation, hospital call light responsiveness began to improve. Linking Evidence to Action: Rounding without intention increases RN workload and does not result in improved patient outcomes or a satisfied patient. RN rounding every 2 h is effective and efficient when done with intention (i.e., adhering to the 4Ps). RN patient rounds had done every 2 hours with intention improved patient satisfaction and other patient outcomes such as a decrease in call light usage.
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