主动会议和个人责任对护理遗漏的影响:随机对照设计。

IF 1.7 3区 医学 Q3 HEALTH POLICY & SERVICES
Health Care Management Review Pub Date : 2025-07-01 Epub Date: 2025-05-09 DOI:10.1097/HMR.0000000000000446
Marina Vexler, Anat Drach-Zahavy, Einav Srulovici
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引用次数: 0

摘要

背景:有效干预减少错过护理的证据是有限的。虽然有各种各样的策略存在,但积极的抱团干预仍未得到充分探索。目的:本研究旨在发展,实施和评估主动会议作为一个有效的过程,以减少护理病房的错过护理。第二个目的是调查个人护士问责制对主动会议和错过护理之间关系的调节作用。方法:在一家中型医院进行随机对照研究,涉及6个内科病房和4个外科病房的180名护士。方法:在2022年3月至2023年5月期间,参与者被随机分配到为期3个月的干预组(n = 85)和对照组(n = 95)。干预包括每天开会,包含四个关键要素:任务状态、潜在延迟、可能无法完成的任务以及需要的帮助。MISSCARE调查(在三个不同的场合测量)和3D问责问卷在基线和干预3个月后立即进行评估。结果:共纳入602次分组,每次分组时间约5分钟。69%的会议发现了分歧,57%的会议解决了分歧。干预组显示,与对照组相比,护理遗漏减少,其有效性受到个人问责制的影响,受益于低问责制的护士更多。结论:会议需要最少的资源投入来减少护理遗漏,特别是对于个人责任较低的护士。使会议成为标准做法可以提高护理质量。实践启示:鼓励护理管理人员支持在医院环境中始终如一地实施会议。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The impact of proactive huddles and personal accountability on missed nursing care: A randomized controlled design.

Background: Evidence on effective interventions to reduce missed care is limited. While various strategies exist, proactive huddle intervention remains underexplored.

Objectives: This study aimed to develop, implement, and evaluate proactive huddles as an effective process to reduce missed care in nursing wards. A secondary objective was to investigate the moderating effect of personal nurse accountability on the relationship between proactive huddles and missed care.

Methodology: A randomized controlled study was conducted in a medium-sized hospital, involving 180 nurses across six internal and four surgical wards.

Methods: Participants were randomly assigned to a 3-month intervention ( n = 85) and control ( n = 95) groups between March 2022 and May 2023. The intervention consisted of daily huddles, incorporating four key elements: status of tasks, potential delays, tasks that might not be completed, and assistance needed. The MISSCARE Survey (measured on three different occasions) and the 3D Accountability Questionnaire were assessed at baseline and immediately after the 3-month intervention.

Results: A total of 602 huddles, each lasting about 5 minutes, were included. Gaps were identified in 69% of huddles, with 57% resolved. The intervention group showed reduced missed nursing care compared to the control, with effectiveness moderated by personal accountability-benefiting nurses with lower accountability more.

Conclusions: Huddles require minimal resource investment to reduce missed nursing care, especially for nurses with lower personal accountability. Making huddles a standard practice can improve nursing care quality.

Practice implications: Nursing managers are encouraged to support consistently implementing huddles in hospital settings.

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来源期刊
Health Care Management Review
Health Care Management Review HEALTH POLICY & SERVICES-
CiteScore
4.70
自引率
8.00%
发文量
48
期刊介绍: Health Care Management Review (HCMR) disseminates state-of-the-art knowledge about management, leadership, and administration of health care systems, organizations, and agencies. Multidisciplinary and international in scope, articles present completed research relevant to health care management, leadership, and administration, as well report on rigorous evaluations of health care management innovations, or provide a synthesis of prior research that results in evidence-based health care management practice recommendations. Articles are theory-driven and translate findings into implications and recommendations for health care administrators, researchers, and faculty.
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