Inter‐shift handoff: Changes over a 6‐year interval
Inter‐shift handoff: Changes over a 6‐year interval
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轮班交接：6 年间隔内的变化
DOI：
10.1111/jan.14537
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发表时间：
2020
影响因子：
3.8
通讯作者：
Itoh Kenji
中科院分区：
文献类型：
--
作者：
Gu Xiuzhu;Itoh Kenji
目的捕获 6 年间隔内的班间交接变化，并验证交接支持系统和辅助工具（例如指南、培训和协议）以及环境是否确实影响交接性能。设计一种非实验性横断面研究设计。采用2017年和2011年的调查数据进行比较。方法2017年对31家综合性医院的护理人员进行问卷调查，收集内科、外科、重症监护室、急诊科、手术室等住院病区4282名护理人员的答复。将这些结果与 2011 年上次调查中收集的 1,182 份回复进行比较。结果 6 年间隔的变化包括引入交接指南和增加培训。切换方法发生了显着变化，并且更加依赖电子系统，尤其是在住院病房。然而，中断情况并没有显着改善。信息传输的改善有限，并且仅在外科病房中观察到。显着相关性证实，在护理人员对指南有效性评价较为积极、面临的干扰较少且时间较多的医院，交接表现总体较好，充分信息传递的频率较高。结论虽然轮班间交接支持系统发生了很大变化，但信息传递的改善仅发生在手术病房且有限。事实证明，更有效的切换指南和更好的切换环境对于提高班间切换性能有显着贡献。影响本研究解决了班间切换是否真正得到改善的问题。答案是肯定的，但方式有限。根据调查结果和日本医院的交接实践，建议采用混合方法（口头、书面、技术）进行轮班交接。此外，改进当前的移交程序、指南和培训也很重要。
AimsTo capture inter‐shift handoff changes over a 6‐year interval and to verify whether the handoff supporting system and aids (e.g., guidelines, training, and protocols) and environment really affect handoff performance.DesignA non‐experimental cross‐sectional research design. Data from the 2017 and 2011 surveys were used for comparisons.MethodsA questionnaire survey was conducted among nursing staff in 31 general hospitals in 2017 and 4,282 staff responses were collected from inpatient wards such as internal medicine and surgery, the intensive care unit, emergency department and operating room. These were compared with the 1,182 responses collected in the previous 2011 survey.ResultsChanges in the 6‐year interval included the introduction of handoff guidelines and increased provision of training. The handoff approach changed significantly and relied more on electronic systems, especially in inpatient wards. However, there was no significant improvement in interruptions. Information transfer improvement was limited and only observed in the surgery wards. Significant correlations verified that in hospitals where nursing staff more positively evaluated the effectiveness of the guidelines, faced fewer interruptions and had more time, handoff performance was better overall, and a higher frequency of sufficient information transfer was evident.ConclusionAlthough the inter‐shift handoff supporting system had great changes, improvement of information transfer occurred only in the surgery wards and was limited. It was verified that more effective handoff guidelines and a better handoff environment contributed significantly to improving inter‐shift handoff performance.ImpactThis study addressed the question as to whether inter‐shift handoffs have really improved. The answer is yes, but in a limited way. Based on the survey results and handoff practices in Japanese hospitals, a mixed approach (verbal, written, technological) is suggested for inter‐shift handoffs. In addition, it is important to improve the current handoff procedures, guidelines and training.