基于预警分级管理的SBAR沟通模式在急诊观察室交接班中的应用

Application of SBAR communication mode based on early warning hierarchical management in emergency observation room

目的:探讨基于预警分级管理的SBAR沟通模式在急诊观察室交接班中的应用效果。方法:制订基于预警分级管理的SBAR沟通模式的交接方案,对观察室护士进行系统培训并落实方案。将2018年11-12月观察室18名护士交接的455例患者列为对照组,实施传统的SBAR沟通模式进行交接班。将2019年11-12月以上护士交接的443例患者列为观察组,实施基于预警分级管理的SBAR沟通模式的交接班。比较2组患者护理不良事件的发生率、护理交接班质量、医护对交接班满意度的情况。结果:观察组患者不良事件发生率为1.81%(8/443),对照组为7.91%(36/455),2组比较差异有统计学意义(χ^2值为17.96,P<0.05);观察组护士的交接班护理质量和护士对病情知晓率分别为(91.37±2.73)分、96.7%(58/60),对照组分别为(89.07±2.76)分、81.7%(49/60),2组比较差异有统计学意义(t值为-2.38、χ^2值为6.99,P<0.05);观察组医生、护士对护理交接班满意度分别为95.0%(57/60)、95.0%(57/60),对照组分别为83.3%(50/60)、81.7%(49/60),2组比较差异有统计学意义(χ^2值为4.23、5.18,P<0.05)。结论:基于预警分级的SBAR沟通模式能显著提高急诊观察室护士交接班中的预警能力,减少护理不良事件的发生,提高护理交接班的质量,提升医护双方的满意度。

Objective To explore the application effect of SBAR communication mode based on early warning hierarchical management in emergency observation room.Methods Formulating the handover program of SBAR communication mode based on the early warning hierarchical management,systematically training the nurses of the observation room and put into effect.The 455 patients transferred by 18 nurses in the observation room from November to December 2018 were listed as the control group,and the traditional SBAR communication mode was implemented for the handover.A total of 443 patients with nurse handover from November to December 2019 were included in the observation group,and the SBAR communication mode based on early warning hierarchical management was implemented.The incidence of adverse nursing events,quality of nursing handover,doctors'and nurses'satisfaction with the handover were compared between the two groups.Results The incidence of adverse events was 1.81%(8/443)in the observation group and 7.91%(36/455)in the control group,the difference between the two groups was statistically significant(χ^2 value was 17.96,P<0.05).In the observation group,the nursing handover quality and nurse's knowledge of the patients’condition were(91.37±2.73)points and(96.7%,58/60)respectively,while those in the control group were(89.07±2.76)points and(81.7%,49/60).The difference between the two groups was statistically significant(t value was-2.38,χ^2 value was 6.99,all P<0.05).The satisfaction of doctors and nurses on nursing handover was 95.0%(57/60)and 95.0%(57/60)in the observation group respectively,and that in the control group was 83.3%(50/60)and 81.7%(49/60)respectively.The difference between the two groups was statistically significant(χ2 values were 4.23,5.18,P<0.05).Conclusions SBAR communication mode based on early warning classification can significantly improve the early warning ability of nurses in emergency observation room during the shift,reduce the occurrence of adverse nursing events,improve the quality of nursing shift,and improve the satisfaction of doctors and nurses.