实施以家庭为中心的循环干预,使用新的导师三人组.
Alisa Khan1,2, Shilpa J Patel3,4, Michele Anderson5,6
1Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital, Boston, Massachusetts.
Pediatrics
|January 2, 2024
概括
以患者和家庭为中心的I-PASS (PFC I-PASS) 改善了儿科医院的沟通和安全. 导师三人组方法增强了护士和家庭的参与,从而减少了患者的伤害,特别是在更大的设施中.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全研究的研究.
- 在儿科中实施科学.
背景情况:
- 患者和家庭为中心的I-PASS (PFC I-PASS) 在以家庭为中心的轮次期间促进家庭参与,健康素养和结构化的沟通.
- I-PASS框架 (疾病严重程度-患者总结-行动项目-情境意识-接受者的综合) 指导这些轮.
- 一种新的"导师三重奏"实施方法利用多学科的家长,护士和医生团队来指导参与站点.
研究的目的:
- 评估PFC I-PASS的实施后的遵守,安全和患者/家庭体验结果.
- 评估不同儿科医院的Mentor-Trio实施战略的有效性.
- 确定与改善安全和遵守相关的因素.
主要方法:
- 从2019年2月到2022年3月进行了一项混合动力II型有效性实施研究.
- 数据来自21家美国儿科教学医院,包括社区和高等教育中心.
- 方法包括直接观察护士,医生和患者/家属在多种语言中的轮次和调查.
主要成果:
- 实施后,遵守PFC I-PASS组件,床边圆形化和家庭/护士参与显著改善 (13.0%-60.8%的增长).
- 居民报告的伤害在较大的医院,那些护士参与度更高的医院,以及更高的I-PASS遵守率下降.
- 在所有12项措施中,员工安全气候分数均有所改善,患者/家庭体验或教学没有显著变化.
结论:
- 导师三重奏方法在整个儿科医院成功实施了PFC I-PASS.
- 参与度,安全气候和减少伤害的改善与医院规模,护士参与度和干预坚持相关.
- PFC I-PASS的实施没有对患者/家庭体验或教学产生负面影响,这表明对患者安全和沟通的净益.
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