“安全PT”交接:开发一种促进安全病人交接的临时工具的定性研究

Ahmed Mikky, Mohamed Al Busafi, I. Salmi
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引用次数: 1

摘要

目的:本研究的目的是确定并建立一个有效和标准化的工具,该工具易于复制,用于急诊科(ED)轮班结束时患者的安全交接,以实现护理的连续性、平稳过渡和最小化错误。这个工具的目的是帮助急诊医生和护士建立一种安全的病人文化,这种文化是可靠的,并坚持以国际目标为指导的质量和改进标准。方法:研制该工具;通过小组讨论、访谈和对不同级别急诊医师和护士的调查,咨询最终用户,了解需求。通过审查有关国际公认工具的文献,进一步加强了这一点。基于以上收集到的信息;我们开发了一种工具,它简单实用,并以简单和结构化的格式包含了患者的所有必要细节。结果:小组讨论、访谈和调查表明,目前的交接实践需要改进,轮班之间的信息传递不足。这是大多数与会者关心的问题,他们认为缺乏可靠的工具会导致不安全的移交。时间需求是一种可靠的工具,它将以安全的方式规范和平滑轮班之间的病人交接。与会者列举了目前实践中信息泄露的例子,这将改变他们对病人的态度,并对所提供的护理质量产生直接影响。对于什么是安全交接,之前接受过交接过程的培训,以及缺乏良好交接的内容,也有不同的反应。为了根据国际公认的方法和急诊科最终用户的具体需求,使交接过程标准化,我们开发了SAFE PT工具,纳入了患者护理的相关细节,以促进轮班之间护理的顺利和安全连续性。结论:在医疗保健中,临床交接是患者安全和质量的高风险领域,因此对急诊科来说是高度优先考虑的。SAFE PT工具的衍生是为了强调患者安全的文化,也为了在急诊科轮班之间更快、更安全地保持护理的连续性,从而提高患者满意度。Mikky et al. ISSN: 2474-3674。国际急救医学2019,5:082•第2页10••病人集中护理•病人护理计划•病人护理团队•医疗质量安全•••团队关系回归•改变•临床信息转移•回归实践•转变交接•工具和交接•床头交接•转变简报报告••转变转变年底报告•转变变化报告•病人交接••回归实践团队的协调管理入选标准包含的所有文献的回顾以下特征。该论文是:•发表不早于1995年•以英文撰写•与搜索条件相关•基于定性或定量数据•综述,研究论文或报告,指南或案例研究,描述切换变量与患者或客户结果之间的交接或沟通关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The ‘SAFE PT’ Handover: A Qualitative Study for Developing an Improvised Tool Facilitating Safe Patient Handover
Objectives: The aim of this study is to identify and establish an effective and a standardized tool that is easily reproducible for the safe handover of patients at end of shift at the emergency department (ED) for continuity of care, smooth transition and minimising errors. This tool is designed to assist emergency physician and nurses in building a safe patient culture one that is reliable and upholds the standards of quality and improvement guided by international goals. Methods: To develop this tool; the end users were consulted for understanding the requirements through group discussion, interviews and surveys involving emergency physicians and nurses of different grades. This was further augmented by reviewing literature on international accepted tools. Based on the above information gathered; a tool was developed which was simple, practical and included all necessary details of the patient in an easy and structured format. Results: Group discussions, interviews and survey conducted showed that current handover practice needed improvement and there was inadequate information being passed on between shifts. This was of concern to most participants and they felt that absence of a reliable tool led to unsafe handovers. The need of the hour was a reliable tool which would standardize and smoothen the handover of patients between shifts in a safe manner. Participants cited examples of leak of information in the current practice which would have changed their approach to patient and having a direct impact on the quality of care delivered. There was also varied responses regarding what was a safe handover practice and prior training received on handover process and the contents of a good handover were found lacking. In order to standardize the handover process based on internationally acclaimed approach and specific to needs as received by end users of the ED, the SAFE PT tool was developed incorporating the relevant details of patient care to facilitate the smooth and safe continuity of care between shifts. Conclusions: Clinical handover is a high-risk area for patient safety and quality in health care and therefore of high priority for the ED. The SAFE PT tool was derived to emphasize on a culture of patient safety and also for easy recollection of the desired information to be included for a quicker and safer continuity of care between shifts in the ED leading to improved patient satisfaction. ISSN: 2474-3674 DOI: 10.23937/2474-3674/1510082 Mikky et al. Int J Crit Care Emerg Med 2019, 5:082 • Page 2 of 10 • • Patient centred care • Patient care planning • Patient care team • Quality of health care • Inter-professional relations • Safety • Handover • Shift change • Clinical information transfer • Handover practice • Shift handover • Tools and handover • Bedside handover • Shift briefings • Shift report • End of shift reports • Shift change reports • Handover practices • Patient handover • Team handoffs Inclusion criteria All literature included in the review had the following characteristics. The paper was: • Published not earlier than 1995 • Written in English • Related to the search terms • Based on either qualitative or quantitative data • A review, research paper or report, guideline, or case study that describes the relationship between handover or communication between shift variables and patient or customer outcomes.
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