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Objective: To report the pre-deployment analysis of a digital system to transfer patient information during physicians' obstetric shift sessions. Methods: A literature review explored evidence concerning electronic handover applications in hospitals. A survey met local approaches used to shift changing and the expectations of managers' stakeholders. To explore local practices, we analyzed a sample 251 obstetric handovers. Finally, requirements for the system were listed, and end-users evaluated mockups of the proposed design. Results: From the literature review, easy-to-use and integration with existing systems were the most critical requests to achieve user adherence. The main system requirement was using the hospital infrastructure to ensure full access to the current medical record. Mockup validation by end-users pinpointed items to improve a complete implementation and the positive acceptance of prefilled structured entries. Conclusions: There are blockages to overcome deficits in the quality of the information in clinical handovers to safely transfer patient care between doctors' shifts.
Objetivo: Relatar a análise pré-implantação de um sistema para transferência de dados clínicos durante as sessões de plantão obstétrico. Métodos: Uma revisão de literatura explorou evidências sobre sistemas hospitalares em uso. Um questionário levantou abordagens empregadas e as expectativas das partes interessadas. Para explorar as práticas, analisamos uma amostra de 251 transferências de plantão. Os requisitos para o sistema foram listados e os usuários finais avaliaram protótipos de interface. Resultados: A partir da revisão da literatura, a facilidade de uso e a integração com sistemas eletrônicos existentes foram os quesitos mais críticos para alcançar a adesão dos usuários. O principal requisito de sistema foi utilizar a infraestrutura do hospital para garantir o acesso ao prontuário eletrônio. Na validação das interfaces, identificaram-se itens de melhoria antes da implementação plena e uma aceitação de entradas estruturadas, pré-preenchidas. Conclusões: Há desafios para superar déficits na qualidade da informação clínica trocada em sessões de transferência de plantões médicos, para garantir a segurança do atendimento ao paciente.
Objetivo: Reportar el análisis previo al despliegue de un sistema digital para transferir información de pacientes durante las sesiones de turno de médicos obstétricos. Métodos: Uma revisión de literatura explorou evidencias sobre sistemas hospitalares em uso. Um questionário levantou abordagens empregadas e as expectativas das partes interessadas. Para explorar las prácticas, analizamos una muestra de 251 transferencias de planta. Los requisitos para el sistema de listados y los usuarios finales para evaluar los prototipos de la interfaz. Resultados: partir de la revisión de la literatura, la facilidad de uso y la integración de los sistemas electrónicos existentes para las preguntas más críticas para alcanzar el objetivo de los usuarios. O principal requisito de sistema para utilizar una infraestructura del hospital para garantizar o acesso ao prontuário eletrônio. Na validação das interfaces, identificaram-se itens de melhoria antes da implementação plena e uma aceitação de entradas estruturadas, pré-preenchidas. Conclusiones: Há desafios para superar los déficits en la calidad de la información clínica trocada en sesiones de transferencia de plantas médicas, para garantizar una atención segura al paciente.
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Humans , Patient Care Team , Hospital Information Systems , Communication , Electronic Health Records , Patient Handoff , User-Computer Interface , Feasibility StudiesABSTRACT
To analyze how the handover were effected by the conditions of manned spaceflight medical support mission through the practice of medical equipment and drugs in Shenzhou-12 and Shenzhou-13 manned spaceflight medical rescue support missions, this article discussed the preparation, organization and implementation in the handover of medical equipment and drugs in the changing of medical rescue teams, summarized the notices in the work of handover, and provided experience for the smooth handover of different manned spaceflight medical rescue teams in the future.
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OBJETIVO: El objetivo de este estudio es describir las características del pase de guardia de los alumnos de enfermería en sus prácticas hospitalarias. MATERIALES Y MÉTODOS: Estudio observacional, descriptivo, transversal de pases de guardia registrados en una base de datos secundaria. Los pases de guardia documentados fueron llevados a cabo por alumnos de enfermería durante sus prácticas hospitalarias en 5 hospitales públicos y privados de Argentina. La base de datos incluye las dimensiones de la escala I-PASS para evaluar la completitud del pase. RESULTADOS: Se analizaron 452 pases de guardia; a) Tiempo promedio de 2,1 minutos, b) Completitud: 33 (7%) pases fueron completos, c) Seguridad del paciente: en 308 (72%) pases mencionaron la medicación del paciente, en 111 (27%) la identificación inequívoca del paciente, en 95 (21%) las alergias, en 93 (21%) las medidas sobre la prevención de caídas y en 68 (15%) el aislamiento; d) Forma en que se realizó el pase: 444 (100%) fueron verbales, 277 (62%) sucedieron en el pasillo, 152 (34%) en el office de enfermería y 5 (1%) en la cama, e) Interrupciones: el 74% de las interrupciones fueron producidas por personal de enfermería. CONCLUSIONES: Los resultados arrojan un alto porcentaje de pases de guardia incompletos, siendo el nombre y apellido del paciente, junto con el motivo de ingreso, constantes vitales y aspectos relacionados con la medicación los que estuvieron presentes en la mayoría de los pases. Es necesario integrar el aprendizaje de habilidades comunicacionales del pase de guardia en la carrera de Enfermería.
OBJECTIVE: Describe the characteristics of the nursing shift handovers by nursing students in their hospital practices. METHOD: Observational, descriptive, and cross-sectional study of handoff recorded in a secondary database. The documented shift handovers were carried out by nursing students during their practices/internships in 5 Argentinean hospitals. The I-PASS scale was used. RESULTS: 452 nursing shift handovers were observed; a) Average time of 2.1 minutes, b) Completeness: 33 (7%) of the handovers were complete, c) Patient's safety: in 308 (72%) handovers the patients' medication was mentioned, correct identification of patient 111 (27%), allergies 95 (21%), fall prevention safety measures in 93 (21%) and isolation in 68 (15%), d) Way in which the handover was done: 444 (100%) verbally, and 277 (62%) happened in the hallway, 152 (34%) in the office, and 5 (1%) at the patients' bedside, e) Interruptions: 74% of the interruptions were caused by nurses. CONCLUSION: The results show a big percentage of incomplete nursing shift handovers. Being, the patients' name and last name together with the hospital admission reason and medication related issues present in most of the handovers. The I-PASS scale evaluates the nursing students shift handovers in a simple way, easy to fill out and accepted by the whole team. The Safety syllabus at Nursing schools need to include the learning of nursing shift handovers communicational skills.
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Humans , Male , Female , Observational StudyABSTRACT
Objective:To explore the application effect of SBAR (situation, background, assessment and recommendation) standard communication mode in the training of morning shift handover ability of nursing interns in gynecology and obstetrics, so as to provide reference for improving the ability of morning shift handover of nursing interns.Methods:This study included in 30 nursing interns in Xuanwu Hospital in 2018 who were selected as the observation group, and 31 nursing interns in 2017 who were selected as the control group. The control group was trained in the traditional way of teaching, while the observation group was trained with SBAR standard communication mode on the basis of traditional teaching. After one month's teaching, the evaluation standard of nursing morning shift handover formulated by our hospital was used as the evaluation index to observe the effectiveness of SBAR mode in improving the morning shift handover ability of nursing interns in obstetrics and gynecology. The scores of morning shift handover of the nursing interns in two groups were compared by independent sample t test. Results:The total average score of nursing interns in the observation group was higher than that of the control group, with statistical significance ( P<0.05). Among them, the scores of shift handover environment, complete content, reasonable process and reasonable time control were higher and the difference was statistically significant ( P<0.05), but there was no significant difference in the scores of emphasis, specialty characteristics and language fluency ( P>0.05). The total average score of bedside handover ability in the observation group was significantly higher than that in the control group, with significant difference ( P<0.05). The scores of shift handover environment, complete content, outlining key points, reflecting specialty characteristics, reasonable process, material preparation and humanistic care were higher than those of the control group, with statistical significance ( P<0.05). Conclusion:SBAR mode can improve the bedside and collective shift handover ability of obstetrics and gynecology nursing interns, and nursing managers can use SBAR mode to cultivate nursing interns' ability of morning shift handover.
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Objective:In order to analyze the current research status of handover shift in nursing management, summarize, analyze and judge the existing literature, in order to provide reference for clinical nursing practice.Methods:Through literature review, it is planned to review the current situation, shortcomings and future development of nursing handover classes.Results:The handover process was generally divided into four stages, of which SBAR was the best practice tool for handing over key information. For the performance of handover shifts, NASR, PVNC-BR, HES and Handoff CEX were often used to evaluate the performance of shifts, and for the results of shifts, evaluations were mostly conducted at the levels of patient safety, process elements, and organizational management. At present, the use of electronic information systems, benign organizational culture and patient and family-centered clinical practice could effectively improve the efficiency and effectiveness of handover.Conclusions:The process and elements of the current shift mode are relatively complete, and the communication strategy is reasonable, but there are still many shortcomings and defects. This suggests that nursing managers should adopt scientific intervention methods and evaluation tools when paying attention to and reforming nursing handover in the future to continuously improve the quality of handover.
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@#practice and care environments are important aspects ofnursing care. The use of a reliable and valid scale canmonitor the quality of handover and provide information forcontinuous improvement of practice. This study aims todescribe the perception of nurses, on the domains of qualityof information, efficiency, interaction and support andpatient involvement. Method: A cross-sectional descriptive study was conductedamong 450 nurses from 37 wards in Hospital Kuala Lumpur.Nurses on shift duty were recruited by conveniencesampling from the Medical, Surgery, Obstetrics &Gynaecology, Orthopaedic and Paediatric wards. Using avalidated questionnaire (Handover Evaluation Scale), nursesself-rated their perceptions using a 7-point scale andprovided open-ended responses to the strengths andchallenges that they faced. Descriptive and inferentialanalyses were done while open-ended questions weresummarised based on key themes. Results: A total of 414 nurses completed the survey (92.0%response rate). Nurses had an overall mean (SD) perceptionscore of 5.01 (SD 0.56). They perceived good interaction andsupport during handover and on the quality of informationthat they received, with mean scores of 5.54 (SD 0.79) and5.19 (SD 0.69), respectively. There was an associationbetween the departments where the nurses worked and theiroverall perceptions on nursing handover (p<0.001).Interruptions being the most common theme emerged fromthe open-ended section.Conclusion: Despite having substantial interaction andsupport amongst nurses, opportunities for improvementswere noted. Improvements in the quality of handoverinformation and reducing interruptions should be the mainemphases as these were perceived to be essential in thecurrent handover practices by nurses.
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@#Introduction: In several studies it was described that ineffective communication during patient handover between the hospital departments or during shift-to-shift transfer result in discontinuity of care, inappropriate treatment, and potential risks of injury for patients. The patient handover is a professional responsibility and accountability related to nursing care. SBAR (Situation - Background - Assessment – Recommendation) method as part of the international patient safety goals(IPSGs) was developed to improve communication breakdown. Knowledge and attitude are essential factors associated with the implementation of patient handover, yet limited research was done on this. The purpose of this study was to examine the relationship between nurse knowledge and attitude toward a patient handover. Methods: A cross-sectional approach was applied in this study. A total of 61 nurses consisting of the head nurse, and team leaders participated in sampling technique done by simple random sampling method from the hospital database. Data collection used a structured questionnaire with a good result of validity and reliability. Univariate and bivariate test were used for data analyzing with Statistical Package for the Social Science (SPSS) Version 18. Results: There is a relationship between nurses' knowledge and attitude toward patient handover with OR 5.280 (1.063-26.227); OR 5.333 (1.351-21.062), respectively and statistically significant (p<0.000). Conclusion: Handover is a dynamic process and impacts directly on patient care. Increasing nurse knowledge and attitude are essential to enhance the implementation of patient handover. Training, seminar and intensive practice are strongly needed to build the culture of patient safety.
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Resumen El paso de guardia en enfermería es una actividad fundamental para dar continuidad al cuidado de los pacientes, se realiza como cumplimiento obligatorio de una tarea en el quehacer laboral. Objetivo Describir la producción científica publicada entre 2007-2017, referente a la temática de paso de guardia de enfermería en los servicios de urgencias. Metodología Se desarrolló una revisión sistemática en seis bases de datos, se incluyeron estudios en idiomas inglés, español y portugués que estuvieran publicados en revistas indexadas con acceso a texto completo. Se realizó un análisis crítico de cada uno de los artículos con las Herramientas CASPe y STROBE, los resultados se ordenaron en una matriz que facilitó la obtención de información y categorías. Resultados De un total de 430 artículos, se incluyeron a la investigación únicamente 19, de los cuales 17 están escritos en idioma inglés y dos en español. Después del análisis de los artículos seleccionados se estructuraron dos categorías: Características del paso de guardia y Estandarización del proceso. Conclusiones Las brechas en la comunicación se perfilan como uno de los principales aspectos a tener en cuenta, para mejorar el paso de guardia. El lugar más recomendable para que se lleve a cabo el proceso debe ser en la habitación del paciente y verificado por los dos equipos de enfermería. En la actualidad es necesario realizar investigaciones para mejorar el nivel de evidencia de los estudios.
Abstract Nursing shift handover is an obligatory and a fundamental activity to ensure continuity in the process of patient care. Objective To describe the scientific production published between 2007-2017 regarding nursing shift handover within medical emergency services. Methodology A systematic review was conducted on six databases. Articles with full texts written in English, Spanish, and Portuguese, and published in indexed journals were included. A critical analysis on each article was conducted using the Critical Appraisal Skills Programme spanish, and the Strengthening the Reporting of Observational Studies in Epidemiology tools. Articles were clustered in a matrix of categories. Results From a total of 430 possible articles, 19 were included for this study - 17 written in English and 2 written in Spanish. From the corresponding analysis, two categories were structured: Nursing Shift Handover Characteristics, and Process Standardization. Conclusions Communication gaps seem to be one of the main issues to address while improving the nursing shift handover process. The patient room should be the place for the shift handover, and this process must be acknowledged by both nursing teams.
Resumo A passagem de plantão em enfermagem é uma atividade fundamental para dar continuidade ao cuidado dos pacientes, realiza-se como cumprimento obrigatório de uma tarefa no trabalho laboral. Objetivo Descrever a produção científica publicada entre 2007-2017, referente à temática de passagem de plantão de enfermagem nos serviços de urgências. Metodologia Desenvolveu-se uma revisão sistemática em seis bases de dados, incluíram-se estudos em idiomas inglês, espanhol e português que estiveram publicados em revistas indexadas com acesso a texto completo. Realizou-se uma análise crítica de cada um dos artigos com as Ferramentas CASPe e STROBE, os resultados ordenaram-se em uma matriz que facilitou a obtenção de informação e categorias. Resultados De um total de 430 artigos, incluíram-se à pesquisa unicamente 19, dos quais 17 estão escritos em idioma inglês e dois em espanhol. Depois da análise dos artigos selecionados estruturaram-se duas categorias: Caraterísticas da passagem de plantão e Padronização do processo. Conclusões Os abismos na comunicação perfilam-se como um dos principais aspectos a ter em conta, para melhorar a passagem de plantão. O lugar mais recomendável para se efetuar o processo deve ser no quarto do paciente e verificado pelas duas equipes de enfermagem. Na atualidade é necessário realizar pesquisas para melhorar o nível de evidência dos estudos.
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Objective@#To explore the effect of ISBAR communication mode on the bed shift in severe patients.@*Methods@#The "ISBAR Nursing Delivery Card near the Bed of Severe Diseases Medicine" was formulated. 100 cases of severe patients admitted from February 2018 to March 2018 were set up as control group by experimental research methods. 100 cases of severe patients admitted from April 2018 to May 2018 were set up as experimental group and non-random control was established. The patients in the experimental group were treated with ISBAR nursing shift card for bed shift, and the control group were treated with normal oral shift. Observe and compare the incidence of nurse shift problems, the score of nurse shift assessment scale and the nurse′s knowledge of the patient′s condition "ten know" score between the two groups.@*Results@#The incidence of nurse shift problems dropped from 39.50% (79/200) of control group to 16.50% (33/200) of experimental group, which had a significant difference (χ2=42.938, P<0.01). The score of the nurse′s succession assessment table was increased from (57.80 ± 3.61) points of control group to (73.96 ± 2.33) points of experimental group, which had a significant difference (t=-26.10, P<0.05). The nurse′s knowledge of the patient′s condition "ten know" had been increased from (72.14±4.13) points of control group to (87.75±2.54) points of experimental group, which had a significant difference (t=-32.01, P<0.05).@*Conclusion@#The use of ISBAR communication mode for serious patients in the severe medical department can effectively reduce the incidence of nurse shift problems, effectively improve nurses 'satisfaction with shift and the degree of mastery of patients′ conditions, and the effect of shift is better.
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Objective@#To explore the application experience of integrated nursing mode in the treatment of extremely severe burn patients in August 2nd Kunshan factory aluminum dust explosion accident.@*Methods@#On August 2nd, 2014, 35 extremely severe burn patients involved in the August 2nd Kunshan factory aluminum dust explosion accident were admitted to Wuxi Third People′s Hospital, including 18 males and 17 females, aged 21-50 years. According to the characteristics of the wounded, the situation of the nursing staff, and the characteristics of the nursing work, the integrated nursing mode was constructed and implemented to improve overall nursing quality. The standardized management measures such as cluster management of facilities and equipments in wards, improving and unifying nursing system, standardized training, drawing up " Nurses Compulsory Reading" , optimizing nursing shift handover and so on were taken. Professional quality control groups such as continuous renal replacement therapy (CRRT) group, static therapy group, airway group, and burn group were established, and standardized writing nursing group, wound nursing group, psychological nursing group, and enteral nutrition nursing group were set up under burn group. The treatment outcomes of patients and effects of nursing management, nursing methods, and specialty nursing were recorded.@*Results@#Twenty-seven patients survived the shock period, infection period, and recovery period smoothly. The success rate of rescue was 77.14%. During the treatment, the ward was in good order. The implementation rate of disinfection and isolation system, the completion rate of shift handover, the standard rate of intravenous therapy, the implementation rate of bed head elevation, the correct rate of posture placement, and the success rate of CRRT were all 100%. Successful turn over of rotating bed without interruption of CRRT for 24 hours was implemented in two patients. In many cases, the single filter for hemodialysis continuously run for more than 72 hours. The airway mucosa of patients healed around 20 days after injury. No adverse nursing events such as tracheal cannula detachment/blockage, respiratory distress, atelectasis, lung consolidation, aspiration by mistake, rotating bed rollover, ear chondritis, nasal septal pressure ulcer, vacuum sealing drainage (VSD) catheter blockage, VSD dressing leakage, severe abdominal distension/diarrhea, non-planned extubation/blockage of various intravenous treatment catheters implanted into deep veins and arteries were observed.@*Conclusions@#The integrated nursing mode significantly optimizes the nursing work process in the treatment of extremely severe mass burns, clarifies the duties of nursing staff, and improves the quality of nursing. This mode is worthy of taking reference by other burn treatment units.
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Objective@#To explore the impact of multidisciplinary quality improvement handover system on handover errors and medical staff satisfaction.@*Methods@#The study group consisted of a team of nurses, surgeons, anesthesiologists, ICU doctors and nurses in the operating room of Yangzhou Friendship Hospital. From May 2015 to May 2016, the team transferred from the operating room to the ICU. After the patient handover, the traditional oral handover was followed as the normal handover group. From June 2016 to June 2017, the standardized quality improvement handover system was adopted as the quality improvement. Handover group. 50 patients with elective surgery were randomly selected from the two groups. The errors that occur during the handover process are recorded during each handover. After the handover of all patients in each group, an anonymous questionnaire was provided to the operating room medical staff, anesthesiologists, and ICU medical staff.@*Results@#Compared with the quality improvement handover group (50 cases), the number of errors in the handover process, the number of errors in the process of handover, the number of interruptions in the handover, the delivery of the ICU to the medical staff. The organization of medical staff reported that there was a statistically significant difference in the treatment plan of the patients (t=5.34, 4.53, 3.34, χ2=23.45, 14.94, 16.28, P<0.05). The two groups of medical staff were satisfied with the handover, satisfied with the report of the operating room doctor, and reported to the anesthesiologist, I was able to get all the reports of the patients, satisfied the evaluation of the anesthesia of the preoperative patients, and provided effective patient information before the operation. Regarding the information on potential problems, the satisfactory score for the interruption of the handover, the idea of the handover process is clear from beginning to end, the time of the medical personnel is tight, and the responsible doctors and nurses feel the statistically significant difference in the handover time(t=2.32-6.34, P < 0.05).@*Conclusions@#Multidisciplinary quality improvement handover system can reduce handover errors and improve the satisfaction of medical staff.
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Objective@#To explore the effects of checklist for nursing handover in emergency department.@*Methods@#A total of 48 emergency department nurses were recruited by convenient sampling method. We implemented nursing bedside handover checklist four months, the quality of the nursing handover and nurses′ mastery of the patients′ condition and the patients′ satisfaction were compared before and after the implementation.@*Results@#After four-month intervention, the score of the nursing handover quality increased from 60.39±3.22 to 67.73±3.09, the difference was statistically significant (t=-14.377, P<0.01). The score of the nurses′ mastery of the patients′ condition increased from 23.89±2.34 to 27.08±1.82, and there was significant difference (t=-7.287, P<0.01). Patients′ satisfaction improved from 91.163% (111/121) to 96.67% (116/120), the difference was statistically significant (χ2=10.66, P<0.05).@*Conclusions@#Implementation of nursing bedside-handover checklist in emergency department can reduce individual cognitive defects, decrease the information missing of the nursing handover,improve the quality of nursing work and ensure the safety of patients.
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Objective To explore the impact of multidisciplinary quality improvement handover system on handover errors and medical staff satisfaction. Methods The study group consisted of a team of nurses, surgeons, anesthesiologists, ICU doctors and nurses in the operating room of Yangzhou Friendship Hospital. From May 2015 to May 2016, the team transferred from the operating room to the ICU. After the patient handover, the traditional oral handover was followed as the normal handover group. From June 2016 to June 2017, the standardized quality improvement handover system was adopted as the quality improvement. Handover group. 50 patients with elective surgery were randomly selected from the two groups. The errors that occur during the handover process are recorded during each handover. After the handover of all patients in each group, an anonymous questionnaire was provided to the operating room medical staff, anesthesiologists, and ICU medical staff. Results Compared with the quality improvement handover group (50 cases), the number of errors in the handover process, the number of errors in the process of handover, the number of interruptions in the handover, the delivery of the ICU to the medical staff. The organization of medical staff reported that there was a statistically significant difference in the treatment plan of the patients (t=5.34, 4.53, 3.34, χ2=23.45, 14.94, 16.28, P<0.05). The two groups of medical staff were satisfied with the handover, satisfied with the report of the operating room doctor, and reported to the anesthesiologist, I was able to get all the reports of the patients, satisfied the evaluation of the anesthesia of the preoperative patients, and provided effective patient information before the operation. Regarding the information on potential problems, the satisfactory score for the interruption of the handover, the idea of the handover process is clear from beginning to end, the time of the medical personnel is tight, and the responsible doctors and nurses feel the statistically significant difference in the handover time( t=2.32-6.34, P < 0.05). Conclusions Multidisciplinary quality improvement handover system can reduce handover errors and improve the satisfaction of medical staff.
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Objective To explore the effects of checklist for nursing handover in emergency department. Methods A total of 48 emergency department nurses were recruited by convenient sampling method. We implemented nursing bedside handover checklist four months, the quality of the nursing handover and nurses′ mastery of the patients′ condition and the patients′ satisfaction were compared before and after the implementation. Results After four-month intervention, the score of the nursing handover quality increased from 60.39 ± 3.22 to 67.73 ± 3.09, the difference was statistically significant (t=-14.377, P＜0.01). The score of the nurses′mastery of the patients′condition increased from 23.89 ± 2.34 to 27.08 ± 1.82, and there was significant difference(t=-7.287, P＜0.01). Patients′ satisfaction improved from 91.163% (111/121) to 96.67% (116/120), the difference was statistically significant (χ2=10.66, P＜0.05). Conclusions Implementation of nursing bedside-handover checklist in emergency department can reduce individual cognitive defects, decrease the information missing of the nursing handover,improve the quality of nursing work and ensure the safety of patients.
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Objective To explore the effect of ISBAR communication mode on the bed shift in severe patients. Methods The "ISBAR Nursing Delivery Card near the Bed of Severe Diseases Medicine" was formulated. 100 cases of severe patients admitted from February 2018 to March 2018 were set up as control group by experimental research methods. 100 cases of severe patients admitted from April 2018 to May 2018 were set up as experimental group and non-random control was established. The patients in the experimental group were treated with ISBAR nursing shift card for bed shift, and the control group were treated with normal oral shift. Observe and compare the incidence of nurse shift problems, the score of nurse shift assessment scale and the nurse′s knowledge of the patient′s condition "ten know"score between the two groups. Results The incidence of nurse shift problems dropped from 39.50 % (79/200) of control group to 16.50 % (33/200) of experimental group, which had a significant difference (χ2=42.938, P＜0.01). The score of the nurse′s succession assessment table was increased from (57.80 ± 3.61) points of control group to (73.96 ± 2.33) points of experimental group, which had a significant difference (t=-26.10, P＜0.05). The nurse′s knowledge of the patient′s condition "ten know" had been increased from (72.14 ± 4.13) points of control group to (87.75 ± 2.54) points of experimental group, which had a significant difference (t=-32.01, P＜0.05). Conclusion The use of ISBAR communication mode for serious patients in the severe medical department can effectively reduce the incidence of nurse shift problems, effectively improve nurses 'satisfaction with shift and the degree of mastery of patients′conditions, and the effect of shift is better.
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Objective To explore the application value of JCI standard and HIMSS 7 grade clinical closed loop system in pathological specimen handover. Methods The First Affiliated Hospital of Xiamen University adopted the traditional way to transfer pathological specimen in 2014, and improved the process under guidance of JCI standard in 2015. Then HIMSS 7 level clinical closed-loop system was applied to pathological handover on the basis of JCI standard guidance in 2017. Comparative analysis was made on the failure rate of the pathological specimen,the average handover time of pathological specimen and the timely rate of pathological frozen reports in the above 3 years. Results A comparison of the failure rate of pathological specimens found the following: That of 2015 was significantly lower than that of 2014 (P <0.05);and that of 2017(Jan. -Sept.) was significantly lower than that of 2015(P<0.01). A comparison of the handover timeliness of frozen digestive endoscopy specimens and a single frozen specimen handover duration found the following:That of 2015 was significantly shorter than that of 2014 (P< 0.01),and that of 2017 (Jan. - Sept.) was significantly shorter than that of 2015 (P < 0.01). A comparison of the timeliness of frozen specimen pathological reports found the following: that of 2015 was significantly better than that of 2014 (P< 0.05),and that of 2017 (Jan. -Sept.) was significantly better than that of 2015 (P< 0.05). Conclusions The guidance of JCI concept has reduced the failure rate of pathological specimen, shortened the average handover during, and improved the timeliness of pathological frozen specimen reports. Under the JCI standard guidance, the HIMSS 7 level clinical closed-loop system was applied to the pathological specimen handover process. This practice could significantly reduce the failure rate of pathological specimen and improve the pathological specimen handover efficiency. Furthermore,it is conducive to full-course tracking and dynamic management of such specimen.
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Objective To investigate status quo of handover evaluation of nurses and analysis the related factors. Methods Study was administered to 505 nurses, using Handover Evaluation Scale, Perceived Organizational Support Scale, General Self-Efficacy Scale, Maslach Burnout Inventory and Nurse′s Work Pressure Sources Scale. Results The handover evaluation of nurses was in a high level (6.35±0.74)points,quality of information(6.39±0.89)points,interaction and support(6.23±0.88)points, efficiency (6.43 ± 0.69) points. Education background were influence factors of handover evaluation (F=31.97-53.65, P<0.01). Handover evaluation, organizational support and self-efficacy were positive correlation(r=0.263, 0.139, P<0.01). Handover evaluation, burnout and work pressure were negative correlation (r=-0.270,-0.257, P<0.01). Conclusions Nursing administrators should take effective measures to improve nurses′organizational support and self-efficacy level,decrease burnout and burnout for enhancing nurses′handover evaluation.
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Objective To explore the effect of SBAR communication mode in handover between delivery room and neonatal department. Methods A total of 100 cases of neonates transferred from neonatal intensive care unit from March to June 2016 were selected as the control group.The traditional oral transfer mode was used. From June to September 2016, 106 cases of newborn infants who were transferred to neonatal intensive care unit were observed in the observation group. The newborns were transferred with SBAR structural framework. The differences of the integrity, the correct rate, the proportion of adverse events,the transfer time and the satisfaction of the medical staff in the 2 groups were compared. Results The integrity, the correct rate, the proportion of adverse events, the satisfaction of the medical and nursing staff on the integrity of the handover, the accuracy of the description of the disease,the practicality,and the operability were 99.06%(105/106), 99.06%(105/106), 15.09%(16/106), 93.33%(28/30), 90.00%(27/30), 96.67%(29/30), 93.33%(28/30) in the observation group, 89.00%(89/100), 94.00%(94/100),2.00%(2/100),63.33%(19/30),60.00%(18/30),73.33%(22/30),26.67%(8/30)in the control group,the differences were significant(χ2=4.008-27.778,P<0.05 or 0.01).There was no significant difference in the transit time (P> 0.05). Conclusions The design and application of the handover record based on SBAR communication mode in the delivery room and neonatal department improve the integrity of the patient′s condition,the correct rate,can detect adverse events in time.The staff were more comprehensive,more accurate description of the disease description, this form is simple and practical, operable, by the clinical staff of the trust,it is worth in the delivery room and the promotion of the use of newborns.
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A passagem de plantão é uma atividade da equipe de enfermagem que possibilita o planejamento do cuidado e a continuidade da assistência, além de promover a comunicação efetiva entre os membros da equipe e a segurança do paciente. A utilização de instrumentos padronizados para auxiliar esta atividade, pode minimizar falhas e garantir que informações essenciais, referentes aos cuidados, sejam transmitidas. Nesta pesquisa objetivou-se padronizar a passagem de plantão em uma Unidade de Terapia Intensiva (UTI) adulto por meio da elaboração e validação de um instrumento de registro de informações e um Procedimento Operacional Padrão (POP). Trata-se de uma Pesquisa-Ação realizada no período de agosto de 2015 a junho de 2017. Os participantes foram 15 enfermeiros, sendo 11 atuantes no serviço e quatro enfermeiros especialistas em Cuidados Intensivos e Urgências e Emergências. Para a coleta de dados utilizou-se um questionário semiestruturado com questões acerca da temática de interesse, foram realizadas reuniões com os participante e validação com especialistas. Nesta etapa foi utilizada Técnica Delphi on-line modificada. Para o tratamento dos dados foi utilizado Discurso do Sujeito Coletivo (DSC), análise descritiva e Índice de Validade de Conteúdo. Foi desenvolvido três DSC, com as ideias centrais: "A passagem de plantão como garantia da continuidade da assistência", "A passagem de plantão como meio para o planejamento da assistência de enfermagem" e "A passagem de plantão como ferramenta para a organização do trabalho". Foi elaborado um checklist que após testagem, resultou em um instrumento semiestruturado. O instrumento foi validado em aparência, clareza, adequabilidade e conteúdo com IVC=1,0. Os itens que compuseram o instrumento foram, identificação, diagnóstico, estado clínico, medicações, dieta, eliminações, pele, dispositivos, drenos, cateteres, observações e intercorrência, também foi desenvolvido um POP que definiu a modalidade, o tempo dispendido para a atividade e quais informações administrativas e organizacionais da unidade deveriam ser transmitidas na passagem de plantão. Concluiu-se que o instrumento auxilia na transmissão de informações durante a passagem de plantão fortalecendo a segurança do paciente mediante a padronização dessa atividade. O instrumento de passagem de plantão vem ao encontro do objetivo do estudo e das necessidades do serviço. Acredita-se que se utilizada corretamente, essa ferramenta pode melhorar o processo de passagem de plantão da UTI, minimizando os riscos de falhas no processo comunicativo.
The shift handover is a nursing team activity that makes possible the patient care planning and patient care continuity, still It can promote the effective communication among team members and patient safety. The utilization of standardized tools to help this activity, can minimize errors and ensure that essential information related to patient care, is communicated. The aim of this research was to standardize the shift handover in an adult Intensive Care Unit (ICU) through the elaboration and validation of an information record instrument and a Standard Operational Procedure (SOP). It is a research-action carried out from August 2015 to June 2017. The participants were fifteen nurses, of whom 11 were assistants and four were specialists in Intensive Care and Urgencies and Emergencies. For the data collection, a semi-structured questionnaire was used with questions about the theme of interest, meetings were held with the participants and validation with specialists, in this stage it was used the Modified Online Delphi Technique. For the data treatment It was used the Discourse of the Collective Subject (DCS), descriptive analysis and the Content Validity Index. Three DCS's were developed, with the main ideas: "The shift handover as a way to guarantee the continuity of care", "The shift handover as a way for the planning of nursing care" and "The shift handover as a tool for the organization of the duty". A checklist was created which, after testing, resulted in a semi-structured instrument. The instrument was validated in appearance, clarity, suitability and content with IVC = 1.0. The items that composed the instrument were: identification, diagnosis, clinical status, drugs, diet, eliminations, skin, devices, drains, catheters, observations and intercurrence, a SOP was also developed that defined the modality, the time spent for the activity and which administrative and organizational information from the unit should be communicated on the shift handover. It was concluded that the instrument helps in the transmission of information during the shift handover, enhancing patient safety through the standardization of this activity. The instrument of shift handover meets the aim of the study and the needs of the service. It is believed that using correctly, this tool can improve the ICU shift handover process, minimizing the risks of communicative process failures.
Subject(s)
Humans , Male , Female , Adult , After-Hours Care , Nursing , Nursing, Team , Patient Safety , Intensive Care Units , Continuity of Patient Care , Communication , Nursing Care , Quality of Health CareABSTRACT
PURPOSE: Advocates for societal change and consumerism have been instrumental in popularizing patient involvement in various aspects of health care. Patient involvement in bedside handovers during shift changes should facilitate patient-centered care. This study's purpose was to explore Malaysian nurses' opinions about patient involvement during bedside handovers, and whether patient involvement during bedside handovers reflected patient-centered care. METHODS: A qualitative study with four focus-group discussions was conducted with 20 registered nurses from general wards in a Malaysian public hospital. Semi-structured interviews were used to elicit participants' opinions. NVivo 10 software was used for data management and content analysis was used to analyze the data. RESULTS: Several participants used inconsistent methods to involve patients in bedside handovers and others did not involve the patients at all. The participants' interpretations of the concept of patient-centered care were ambiguous; they claimed that patient involvement during bedside handovers was impractical and, therefore, not reflective of patient-centered care. Some nurses' subjective views of patient involvement as impractical during bedside handovers were manifested in their deliberate exclusion of patients from the handover process. CONCLUSIONS: Changes in patient involvement and nursing practices congruent with patient-centered care require that nurse educators in hospital settings reform nursing education to focus on fostering of communication skills needed to function in nurse-patient partnerships. Guidelines for patient involvement consistent with patient-centered values should be developed using ward nurses' subjective views and introduced to all registered nurses in practice.