使用结构化交接协议在医院内单位的过渡:从医疗保健更安全 IV 的系统审查
Sean McCarthy1, Aneesa Motala2,3, Emily Lawson2
1West Los Angeles Vet Adm, Los Angeles, California, USA Sean.McCarthy1@va.gov.
BMJ quality & safety
|April 30, 2025
概括
像I-PASS和SBAR这样的结构化交接协议可能会在医院护理过渡期间提高患者的安全性. I-PASS显示了减少医疗错误和不良事件的更强有力的证据.
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 患者安全研究
- 临床交流 临床沟通
背景情况:
- 移交是住院护理中的关键但脆弱点.
- 越来越多的单位内部交换需要标准化的通信.
- 行业最佳实践强调了结构化报告的必要性.
研究的目的:
- 审查结构化移交协议对患者安全影响的证据.
- 在过去的十年中,专注于急性护理医院单位.
- 评估对患者安全结果的影响.
主要方法:
- 在四个数据库中系统搜索相关研究.
- 包括任何设计的系统审查和原始研究.
- 重复选和数据提取与叙事合成.
- 建议评估,发展和评价 (GRADE) 框架的评级,以确保证据的确定性.
主要成果:
- 情况,背景,评估,建议 (SBAR) 工具:改善患者安全的低确定性证据.
- I-PASS (疾病严重程度,患者总结,行动清单,情况意识,综合到接收者) 工具:减少医疗错误和不良事件的中等确定性证据.
- 对其他结构化移交工具的证据有限.
结论:
- SBAR和I-PASS结构化工具可能会在单位内部交接时提高患者安全.
- I-PASS证明了证据的更强的确定性.
- 没有足够的证据证明其他工具可以得出结论.
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