接近失误管理联合标准化沟通模式在肾内科危重患者院内转运中的应用

Application of near miss management combined with standardized communication model in hospital transportation of critical patients in nephrology department

目的评价接近失误管理联合现状-背景-评估-建议标准化沟通模式(SBAR)在肾内科危重患者院内转运中的应用效果。方法便利选取某三级甲等综合医院肾内科需院内转运至ICU的危重患者为研究对象,将2022年1月—6月收治的112例患者作为试验组,采用接近失误管理联合SBAR沟通模式进行院内转运,2021年6月—12月收治的103例患者作为对照组,采用常规院内转运方法。比较两组转运中护理接近失误事件发生率、转运用时、护士危急重症患者院内转运知信行得分。结果试验组转运接近失误事件发生率(18.75%)较对照组(38.83%)低(χ2=10.651,P<0.05),试验组转运准备时间、转运后交接时间、转运总时长均低于对照组(P<0.001),但转运时间差异无统计学意义(P=0.537);经培训及临床实践后,护士危重症患者院内转运知信行得分(154.32±5.00)分较培训前(120.56±6.25)分显著提高(t=10.734,P<0.05)。结论在肾内科危重患者院内转运中实施接近失误管理,并联合SBAR沟通模式进行交接,有助于降低接近失误事件发生率,缩短转运准备和交接时间、转运总时长,提高转运效率和质量。

Objective To evaluate the application effect of near miss management combined with situation-background-assessment-recommendation(SBAR)standardized communication model in hospital transportation of critical patients in nephrology department.Methods We selected the critically ill patients who need to be transferred to ICU in the department of nephrology of a tertiary class A general hospital as the research object by convenient sampling.112 patients from January to June 2022 were selected as the test group and received near miss management combined with SBAR communication mode for in-hospital transfer.103 patients from June to December 2021 were selected as the control group and received the conventional in-hospital transfer method.Compare the incidence of nursing near miss events,transfer time,and the score of nurses'knowledge,belief and practice on hospital transfer of critical patients between the two groups.Results The incidence of transport near miss events in the test group(18.75%)was lower than that in the control group(38.83%)(χ^(2)=10.651,P<0.05).The length of transport preparation,handover time after transfer and total handover time of transportation in the test group were lower than those in the control group(P<0.001).But there was no significant difference in transport time(P=0.537).After training and clinical practice,the score of knowledge,belief and practice of nurses on hospital transfer of critical patients was(154.32±5.00),which was significantly higher than that before training(120.56±6.25)(t=10.734,P<0.05).Conclusion The implementation of near miss management in the transport of critically ill patients in the department of nephrology and the use of SBAR communication mode for the transfer will reduce the incidence of near miss events,shorten the transport and handover time,improve the efficiency and quality of transport.