在急性病房设置中成功启动护理升级 - - 一项定性观察性研究
J Ede1,2, B Kent2, P Watkinson1,3
1Oxford University Hospital NHS Foundation Trust, Oxford, UK.
Journal of advanced nursing
|June 27, 2024
概括
一半的患者升级发生在没有触发早期预警分数的情况下,突出显示需要更好的系统支持. 了解不同的沟通类型,如以结果为中心和信息化的升级,是改善患者护理的关键.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 临床沟通 临床沟通
- 患者安全 患者安全
背景情况:
- 病情恶化的患者的升级对于及时干预至关重要.
- 现有的理论框架可能无法完全捕捉临床升级事件的细微差别.
- 关于影响患者升级成功的因素存在知识差距.
研究的目的:
- 发展对临床升级过程的理论理解.
- 确定有助于成功患者升级的关键因素.
- 分析患者升级事件期间的沟通模式.
主要方法:
- 对临床工作人员进行了无参与者观察.
- 在两个国家卫生服务信托中捕获了151起升级事件.
- 用框架分析和层次任务分析来分析数据.
主要成果:
- 在151个观察到的升级事件中,有一半不是由早期预警得分启动的.
- 他们确定了四种沟通表型:以结果为中心,信息化,普遍关注和自发互动.
- 最常见的是以结果为中心的升级,预计需要具体干预.
结论:
- 很大一部分升级工作负载发生在没有触发早期预警分数的情况下,需要改进系统支持.
- 识别不同的升级通信表型对于优化护理至关重要.
- 减少信息升级和增加自发交互升级可能会提高患者安全和组织效率.
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