为什么生命体征观察在急性病房被延迟和中断:一项多站点观察研究
Joanna Hope1, Chiara Dall'Ora1, Oliver Redfern2
1National Institute for Health and Care Research Applied Research Collaboration, Health Sciences, Faculty of Environmental and Health Science, University of Southampton, Hampshire, United Kingdom; Nursing and Midwifery, Health Sciences, Faculty of Environmental and Health Science, University of Southampton, Hampshire, United Kingdom.
International journal of nursing studies
|February 13, 2025
概括
由于相互竞争的任务,护理团队往往会推迟对生命体征的监测. 灵活的护理,就像生命体征观察一样,具有较低的"时间地位",并被推迟到优先级较高的活动.
科学领域:
- 提供医疗保健服务.
- 护理实践的护理实践
- 患者安全 患者安全
背景情况:
- 在医院中,遵守生命体征监测协议是不一致的.
- 错过或延迟的生命体征观察阻碍了病情恶化的患者的识别.
- 之前的研究已经描述,但没有概念化任务优先级,而不是生命体征监测.
研究的目的:
- 探索护理团队如何在急性病房进行生命体征观察.
- 概念化导致生命体征监测延迟或中断的工作类型.
主要方法:
- 在英格兰的四家医院进行了一项无参与者观察性研究.
- 在随机抽样的医疗和外科病房中,在128小时内收集了数据.
- 对1127个中断和延迟生命体征的观察进行了定性内容分析.
主要成果:
- 发现了8种延迟或中断生命体征观察的原因.
- 提出了"时间状态"的新概念,以解释任务优先级.
- 灵活的护理,包括生命体征观察,具有较低的时间状态,并且经常延迟固定例行程序或时间关键活动.
结论:
- "时间状态"框架解释了为什么生命体征观察在白天班次中经常被推迟.
- 早晨和晚上的观测可能不太可能因为较少的竞争性高时间状态任务而延迟.
- 这项研究挑战了对中断的简单观点,突出了护理决策的复杂性.
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