基于SBAR沟通程序的反向交接班模式在新生儿监护室交接班中的应用

Application of handover pattern based on SBAR communication program in transitional class of critical patient in neonatology

目的探讨基于标准化沟通模式(SBAR)程序的反向交接班模式在新生儿重症监护病房(NICU)交接班中的应用效果。方法将2017年12月—2018年2月我院收治的55例危重症患儿作为对照组,采用传统交接班方式进行交接班;另将2018年3月—2018年5月我院收治的58例危重症患儿作为观察组,采用基于SBAR程序的反向交接班模式,通过相关专业理论调研与专家指导构建儿科重症监护病房SBAR反向交接班指引单,并对全科护士进行系统培训,考核合格后实施。比较两组护理交接不良事件发生率、护士交接问题发生率、护士临床思维能力、护士交接满意度和护士交接班时间的差异。结果观察组护理交接不良事件发生率为3.45%(2例),低于对照组的16.36%(9例);观察组护理交接班信息的完整率为94.83%,高于对照组的81.82%;观察组的护士临床思维能力合格率为95%,高于对照组的82%;观察组护士满意度(95%)高于对照组护士满意度(82%),且差异均具有统计学意义(P均<0.05)。对照组平均交接班时间为(18.56±2.10) min,观察组平均交接班时间为(19.12±2.16) min,二者差异无统计学意义(P>0.05)。结论基于SBAR程序反向交接班模式可降低护理交接不良事件发生率,提高护士交接患儿信息完整率,同时也提高护士汇报病情的临床思维能力与满意度,让护士有依据有方向有条理的交接患儿信息,减少护理风险,因此这一模式值得临床推广。

Objective To investigate the application effects of the reverse handover mode based on standardized communication mode( SBAR) procedure in the NICU shift work. Methods Fifty-five critically ill children hospitalized in our hospital during December 1,2017 and February 28,2018 were set as control groups and traditional handover methods were used in the shift work. From March 1,2018 to May 31,2018,there were58 cases of critically ill children were set as observation group,reverse shift work mode based on the SBAR program was adopted in the shift work. Based on the previous theoretical evidence-based survey and expert guidance,they constructed the SBAR reverse shift guidance form and trained the general nurses to guide the implementation. The incidence of adverse events during the shift work,the incidence of nurse handover problems,clinical thinking ability of nurses,the satisfaction of nurses,and the time of shifts of the two groups were compared.Results The incidence of nursing adverse events in the observation group was 3. 45%( 2 cases),which was statistically lower than 16.36%( 9 cases) of the control group. The rate of complete information during the shift work in the observation group was 94.83%,it was significantly higher than 81.82% of the control group.The qualified rate of clinical thinking ability in the observation group( 95%) was higher than that( 82%) of the control group,and the satisfaction degree of nurse in the observation group( 95%) was higher than that( 82%)in the control group. All the differences were statistically significant,P<0.05. The average shift time in the control group was 18.56±2.10 min,and the average shift time in the observation group was 19.12±2.16 min. There was no significant difference between the two groups( P >0.05).Conclusions The reverse shift work mode based on the SBAR program could reduce the incidence of adverse events and the incidence of unclear handover,and improve the clinical thinking ability and satisfaction of nurses,so that nurses have a complete direction for the transfer of children with information,so this model is worth of clinical promotion.