基于理论域框架的ICU患者转入普通病房结构化交接促进和障碍因素分析

Facilitators and barriers in structured handover from ICU to general ward based on theoretical domain framework

目的基于理论域框架探讨危重患者转入普通病房实施结构化交接的促进和障碍因素。方法方便选取某三级甲等医院的26名护士进行半结构访谈,基于理论域框架制订访谈提纲及内容分析。结果本研究总结了与理论域框架中7个领域有关的促进和障碍因素。促进因素涵盖:交接流程及交接单等工具的使用、固定转运员和护理组长的加入。障碍因素包括:新护士交接能力、跨学科护理知识及沟通技巧、患者参与程度、信息系统智能化5个方面有待完善。结论影响ICU患者转入普通病房结构化交接的因素多样,应加强证据实施者的知识与技能,鼓励患者参与,加强信息系统智能化建设,从而促进结构化交接的实施。

Objective To explore the facilitators and barriers in structured handover from ICU to general ward based on theoretical domain framework(TDF).Methods Twenty-six nurses from a tertiary grade-A hospital were selected conveniently for semi-structured interviews,and the interview outline and content analysis were formulated based on TDF.Results This study summarized the barriers and facilitators related to seven domains in TDF.Facilitators included the use of tools such as handover process and handover orders,and the participation of fixed transporters and nursing team leaders.Barriers included that handover ability of new nurses,interdisciplinary nursing knowledge and communication skills,patient participation and intelligent information system.Conclusion There are diverse factors affecting the structured handover of ICU patients transferred to general wards,and improved knowledge and skills of evidence implementers,more patient participation,and strengthened intelligent construction of information system are beneficial to promoting the implementation of structured handover.