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儿科重症监护病房医生和护士领导人之间的冲突管理观点
Aleksandra E Olszewski1, Seema K Shah2, Leonardo Barrera3
1Department of Pediatric Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania.
JAMA network open
|May 15, 2025
概括
儿科重症监护室 (PICU) 的冲突管理有很大差异. 追踪冲突和结果与更客观的干预有关,这表明需要采用标准化的方法.
科学领域:
- 医疗保健管理的管理
- 儿科重症监护 儿科重症监护
- 解决冲突 解决冲突
背景情况:
- 儿科重症监护室 (PICU) 经常发生决策冲突,导致患者,家庭和医疗团队的不良结果.
- 现有的研究强调了冲突结果的差异,但缺乏探索冲突管理策略.
研究的目的:
- 调查PICU设置中的冲突调解和升级的当前方法.
- 确定影响冲突管理策略及其有效性的因素.
主要方法:
- 一个全国性的,多中心的,前性的,混合方法调查与PICU医生和护士主任进行.
- 数据收集涉及有关医院政策,一般冲突方法和特定场景反应的封闭式和开放式问题.
主要成果:
- 只有23%的机构跟踪冲突及其结果,而65%的机构有冲突管理政策.
- 追踪行为合同的机构更有可能使用伦理咨询并客观地执行合同.
- 各机构都注意到冲突策略的变化和人员缺乏冲突管理培训.
结论:
- 追踪冲突和结果与PICU中更客观的干预策略相关.
- 需要标准化,基于证据的冲突管理流程来提高效率并减少结果差异.
- 开发和测试基于现有方法的标准化干预措施可以减少冲突和主观性.
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