利用儿科复苏小组成员的反馈来提高护理质量

IF 1.7 4区 医学 Q2 EMERGENCY MEDICINE
Erin Mills BMedSci, MBBS, FRACP-PEM, Jessica Nooney CCRN, MN, PhD, Annmarie Bermundo CCRN, BN, Phyllis Lin MSBA, Celia Bagshaw MBChB, FACEM, Tobias van Hest MBBS, FACEM-PEM, Adam West MBBS, FACEM, MHSM, Shameera Navaratnam MBBS, DrEmMed, Clifford Connell PhD, BN(Hons), RN, Harshika Herath MBBS, Simon Craig MBBS, FACEM, MPH, MHPE, PhD
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引用次数: 0

摘要

目的急诊科的儿科复苏是在不可预测的环境下发生的高压事件。传统上,只有结果不佳的病例才会被审查,以防止未来的失败。采用“安全ii”的思维方式,使团队能够反思积极和消极的经历,从而提高护理质量。本研究旨在从急诊室儿科复苏后的员工反馈中确定主题,并描述系统变化的结果。方法对一所三级儿科急诊科进行了为期31个月的前瞻性质量改进研究。向参与儿科复苏的临床工作人员发送调查问卷,征求对成功的反馈和改进建议。使用定向内容分析对答复进行分析:使用《伦敦议定书》(一种以系统为重点的审查方法)进行初始编码,然后进行归纳专题分析。在部门死亡率和发病率以及质量和安全会议上讨论反馈,导致系统改进。结果89例小儿复苏病例,256名工作人员反馈1320个具体问题。反馈涉及卫生系统的所有层面,关键主题集中在团队、环境和任务/技术上。改进包括运输清单,开始轮班气道拥挤和标准化的药物制备方法。结论:参与儿科复苏的工作人员的非同步反馈确定了整个卫生系统的积极和建设性主题。这些反馈已成功转化为若干以系统为重点的行动,以改善患者安全和护理。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Using feedback from paediatric resuscitation team members to improve quality of care

Using feedback from paediatric resuscitation team members to improve quality of care

Objective

Paediatric resuscitations in the ED are high-pressure events in unpredictable settings. Traditionally, only cases with poor outcomes are reviewed to prevent future failures. Adopting a Safety-II mindset allows teams to reflect on both positive and negative experiences, enhancing care quality. The present study aimed to identify themes from staff feedback after paediatric resuscitations in the ED and describe system changes as a result.

Methods

A prospective quality improvement study was conducted over 31 months in a tertiary paediatric ED. Surveys were sent to clinical staff involved in paediatric resuscitations, requesting feedback on successes and suggestions for improvement. Responses were analysed using directed content analysis: initial coding using the London Protocol, a systems-focused review methodology, followed by inductive thematic analysis. Feedback was discussed in departmental Mortality and Morbidity and Quality and Safety Meetings, leading to systemic improvements.

Results

Eighty-nine paediatric resuscitation cases yielded 1320 specific feedback items from 256 staff members. Feedback covered all layers of the health system, with key themes focussed on the team, the environment and tasks/technology. Improvements included a transport checklist, a start-of-shift airway huddle and standardised medication preparation methods.

Conclusions

Asynchronous feedback from staff involved in paediatric resuscitations identified positive and constructive themes across the health system. This feedback was successfully translated into a number of systems-focused actions to improve patient safety and care.

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来源期刊
Emergency Medicine Australasia
Emergency Medicine Australasia 医学-急救医学
CiteScore
3.70
自引率
13.00%
发文量
217
审稿时长
6-12 weeks
期刊介绍: Emergency Medicine Australasia is the official journal of the Australasian College for Emergency Medicine (ACEM) and the Australasian Society for Emergency Medicine (ASEM), and publishes original articles dealing with all aspects of clinical practice, research, education and experiences in emergency medicine. Original articles are published under the following sections: Original Research, Paediatric Emergency Medicine, Disaster Medicine, Education and Training, Ethics, International Emergency Medicine, Management and Quality, Medicolegal Matters, Prehospital Care, Public Health, Rural and Remote Care, Technology, Toxicology and Trauma. Accepted papers become the copyright of the journal.
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