冠状动脉旁路移植术后患者基于多学科合作的ISBAR标准化交接单的构建和初步应用

Construction of a standardized ISBAR handover sheet based on multidisciplinary cooperation forpost-CABG patientsand its initial application

目的 编制“冠状动脉旁路移植(coronary artery bypass grafting, CABG)术后患者基于多学科合作的ISBAR标准化交接单”,并探索其临床应用效果。方法 运用德尔菲法对20名多学科专家进行2轮专家咨询,最终形成“CABG术后患者基于多学科合作的ISBAR标准化交接单”,并初步运用于临床。选取2022年1-12月,合肥京东方医院心脏大血管外科CABG术后转入ICU的90例患者为研究对象,根据时间先后分为对照组(2022年1-6月)45例和观察组(2022年7-12月)45例,评价该交接单对交接质量和交接者满意度的影响。结果 2轮专家函询问卷回收率均为100%,专家权威系数为(0.88±0.04);第2轮函询后最终形成5个一级指标、57个二级指标、133个三级指标、9个四级指标的交接单。对照组填写标准化交接单耗时(11.18±1.49)min,观察组耗时(11.91±1.90)min,差异有统计学意义(P<0.05);观察组交接情况和交接者满意度均高于对照组,差异有统计学意义(P<0.001)。结论 本研究初步构建的“CABG术后患者基于多学科合作的ISBAR标准化交接单”,可提高交接人员满意度和交接质量,值得临床推广应用。

Objective To compile the"ISBAR standardized handover form based on multidisciplinary cooperation for patients after coronary artery bypass grafting(CABG)surgery"and explore its clinical application effect.Methods The Delphi method was used to conduct 2 rounds of expert consultation with 20 multidisciplinary experts,and the"ISBAR standardized handover form based on multidisciplinary cooperation for patients after CABGsurgery"was finallyformed,and was initially applied to clinical practice.Patients transferred to ICU after CABG surgery in Hefei BOE Hospital from January to December 2022 were selected as the study objects,and divided into the control group(from January to June 2022)and the observation group(from July to December 2022)according to the time sequence,so as to evaluate the impact of the handover form on the handover quality and the satisfaction of the recipients.Results The recovery rate of 2 rounds of expert inquiry questionnaires was 100%,and the expert authority coefficient was(0.881±0.041);After the second round of inquiry,5 first-level indicators,57 second-level indicators,133 third-level indicators,and 9 fourth-level indicators were ultimately formed.The consuming time filling in the standardized handover sheetin the control group was(11.18±1.49)min,and that in the observation group was(11.91±1.90)min,and the difference was statistically significant(P<0.05).The handover situation and handover satisfaction of the observation group were higher than those of the control group,with statistically significant differences(P<0.001).Conclusion This study has preliminarily constructed the"ISBAR standardized handover form for postoperative CABG patients based on multidisciplinary cooperation",which can improve the satisfaction and quality of handover personnel and is worthy of clinical promotion and application.