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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@#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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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
Objective To study the shift handover experience of ICU clinical nurses. Method About 19 ICU nurses were enrolled in the investigation using semi-structured interviews and the results were analyzed with phenomenological analysis. Result Their shift handover experience were summarized into 6 themes, that is high recognition on the importance of shift handover, lack of standardized processes, incomplete contents of shift handover, frequent interruption, forgotten information and repeated information. Conclusions Shift handover is an important part of ICU nursing function but there are many problems in the practical operation. The nurse managers need to standard the handover process, stipulate handover contents and enhance the training on shift handover with specialist examination and positive results for the purpose of improving the quality of the shift handover.
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Objective To observe the application of SBAR communication model in beside shift hand-over for the perioperative nursing of aneurysmall subarachnoid hemorrhage (aSAH). Methods A total of 72 cases who were diagnosed with aSAH were divided into the control group (36 cases)and observation group(36 cases).The traditional shift-change method was used in control group. The SBAR communication model was adopted in the observation group. To compare the time spent on handover, the incidence of care issues, the satisfaction of both patients and shift nurses and the incidence of complications between observation group and control group. Results Time consuming in shift change in observation group was (5.43 ± 0.44) min, lower than that in control group (7.81 ± 0.54) min, and the difference was significant (t=39.496, P<0.01). The incidence of care issues was 27.41％(37/135) in control group and 9.63％(13/135) in observation group, and there was significant difference (χ2=14.138, P<0.01). The satisfaction rate of shift nurses in observation group was higher than that in control group, and there was significant difference (t=-15.193--4.971, P<0.05). The satisfaction rate of caregivers and patients in observation group was higher than that in control group, and there was significant difference (t =--2.580--2.120, P<0.05) . Besides, the incidence of complications was 27.78％(10/36) in control group and 8.33％(3/36) in observation group, and there was significant difference (χ2=4.600, P<0.05). Conclusions The SBAR communication model in beside shift hand-over has improved the efficiency of shift change,reduced nursing risks and collaboration effect of nurse team.