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制定和实施呼叫和升级指南,以改善外科单位的专业间沟通
Michael A Kochis1, Lynze R Franko2, Kathleen Swierzewski2
1Massachusetts General Hospital Department of Surgery, Boston, Massachusetts, USA mkochis@mgh.harvard.edu.
BMJ open quality
|May 6, 2025
概括
实施标准化呼叫和升级指南改善了护士对与外科住院生和高级实践提供者的沟通和响应能力的看法. 这一举措通过澄清预期和简化临床担忧,提高了患者的安全性.
科学领域:
- 医疗保健的沟通 医疗保健的沟通
- 患者的安全性 患者安全性
- 手术性住院护理医疗服务
背景情况:
- 在手术环境中,低于最佳的专业间沟通会影响患者的安全.
- 在护士和应答临床医生 (RCs) 之间存在沟通障碍,包括住院人员和高级实践提供者 (APPs).
- 当前的字母数字呼叫方式有机会提高效率.
研究的目的:
- 改善护士和RC之间的沟通和响应能力的看法.
- 建立一个共同的语言和对页面紧迫性,响应时间和升级的期望.
- 减少因通信故障引起的安全事件.
主要方法:
- 根据护士,住院人员,APP和护理人员的意见,制定了页面化和升级指南.
- 指南分类页面 (STAT,紧急,请打电话,FYI) 预期的响应时间和升级路径.
- 在实施3个月后通过随访调查对一般外科病房评估所感知影响.
主要成果:
- 护士报告说,夜班的响应能力显著提高,与白天班的RC相比,夜班的响应能力和及时性有所改善.
- 居民和护理人员认为中性到轻微的积极影响沟通.
- 该指南提供了一种可行的方法来加强沟通.
结论:
- 页面化和升级指南有效地提高了护士和RC之间的沟通感知.
- 这些指导方针协调了预期,简化了反应,并降低了升级障碍.
- 这种干预是一种可行的策略,可以改善外科住院患者的专业间沟通.
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