SBAR标准沟通模式在我国护理工作中应用效果的Meta分析

Application effect of SBAR standard communication mode in nursing work in China:a meta-analysis

[目的]系统评价在我国护理工作中实施SBAR标准沟通模式前后的不良事件发生率、交接平均耗时、病人及医务人员满意度,评价其应用效果,为进一步广泛开展提供科学依据。[方法]计算机检索PubMed、EMbase、The Cochrane Library、Science Direct、Springer Link、Wiley Interscience、OVID、MEDLINE、中国知网、万方数据资源系统、维普中文科技期刊全文数据库等,同时通过参考文献追溯和手工检索方法补充文献,查找对国内医院应用SBAR标准沟通模式后进行效果评价的研究文献(干预时间≥6个月),检索时限至2016年11月。[结果]最终纳入22篇文献,Meta分析结果显示:在交接过程中应用SBAR标准沟通模式后,不良事件发生率降低[OR=0.24,95%CI(0.22,0.27),P<0.000 01];亚组分析显示,在护理转运交接中应用SBAR效果尤为显著[OR=0.22,95%CI(0.17,0.27),P<0.000 01];交接平均耗时降低[MD=-7.18,95%CI(-8.77,-5.60),P<0.000 01];病人满意度提高[OR=5.08,95%CI(4.07,6.33),P<0.000 01],医务人员满意度提高[OR=4.30,95%CI(3.39,5.45),P<0.000 01]。[结论]SBAR标准沟通模式较普通沟通模式相比存在优势,可有效降低不良事件发生率,缩短交接耗时,提高病人及医务人员满意度。

Objective： To systematically review the application effect of Situation Background Assessment Recommendation （SBAR） standard communication mode in nursing work in China,including the incidence of adverse events,average transition period,and satisfaction of patients and medical staff,and evaluate its application effect,in order to provide a scientific evidence for its further development. Methods： Literature reviewing the application effect of SBAR investigated over 6 months in the hospital of China were retrieved from PubMed,EMbase,The Cochrane Library, Elsevier,Science Direct,Springer Link,Wiley Interscience,OVID,MEDLINE, CNKI,WanFang Data and VIP database under the time limit November 2016. Results： A total of 22 papers were included in this study. Meta analysis results showed that when using SBAR in the handover process,the incidence of adverse events reduced[ OR =0.24,95% CI （0.22,0.27）, P 〈0.000 01];subgroup analysis showed an especially significant effect in nursing handover[ OR =0.22,95% CI （0.20,0.30）, P 〈0.000 01];the average handover time shortened[MD=-7.18 min,95% CI （-8.77,-5.60）, P 〈0.000 01];patients′ satisfaction increased[ OR =5.08,95% CI （4.07,6.33）, P 〈0.000 01]; and the satisfaction of medical staff increased[ OR =4.30, 95% CI （3.39,5.45）, P 〈0.000 01]. Conclusion： SBAR had advantages than the common communication mode. SBAR could effectively reduce the incidence of adverse events,shorten the handover time,and improve the satisfaction of patients and medical staff,which was worth to put efforts to promote.