从手术室到麻醉后护理单位的白色快速传递标准化的作用:质量改进项目
Naomi Lyle1, Rémi Hueckel1, Brittany Fry2
1Duke University School of Nursing, Durham, NC; Duke University Health System, Durham, NC.
概括
一个经过修订的白色快速跟踪评分 (WFTS) 工具提高了手术室 (OR) 到麻醉后护理单位 (PACU) 的交付合规性37%. 然而,这种增强的沟通导致工作流程的效率低下和员工的冗余.
科学领域:
- 改善医疗保健质量 改善医疗保健质量
- 患者安全 患者安全
- 护理传播 护理传播
背景情况:
- 有效的患者移交对于减少医疗错误和确保高质量的护理至关重要.
- 标准化工具可以提高患者移交期间信息传输的一致性和完整性.
研究的目的:
- 将手术室 (OR) 与麻醉后护理单位 (PACU) 的交接标准化,使用修订后的白色快速跟踪得分 (WFTS) 工具.
- 评估修订后的WFTS工具对移交合规性和护理满意度的影响.
主要方法:
- 利用了三个计划-做-研究-行动 (PDSA) 周期来完善WFTS工具及其实施.
- 整合了反来增强该工具的记忆辅助,关键字提示和培训.
- 通过调查来衡量交付过程的忠实性和评估护理满意度.
主要成果:
- 符合WFTS交付元素的遵守率从PDSA周期2的48%显著增加到PDSA周期3的85% (P<.001).
- 关键元素的记录,如麻醉细节,意识和稳定性显著改善.
- PACU护士对信息传输质量表示更高的满意度,而OR护士保持中立;定性反指出工作流程效率低下.
结论:
- 修订后的WFTS工具增强了交付合规性,但引入了工作流失效率和冗余性.
- 建议包括根据病例复杂性量身定制元素,减少冗余,解决工作流程障碍,增加护士参与.
- 平衡标准化与效率是优化术后移交通信的关键.
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