Quiet Time Improves the Patient Experience
Quiet Time Improves the Patient Experience
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DOI：
10.1097/ncq.0000000000000363
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发表时间：
2019-07-01
影响因子：
1.2
通讯作者：
Ball, Pamela
中科院分区：
文献类型：
--
作者：
Hedges, Christine;Hunt, Candice;Ball, Pamela
背景：安静的环境有助于休息和康复，但在忙碌的急性护理环境中提供安静的环境往往具有挑战性。在指定的时间内改善医院的安静状况可以提高患者的满意度。这些工作通常是护理人员的主要责任。本地问题：两个医疗单位与一贯低医院消费者评估的卫生保健提供者和系统（HCAHPS）的“总是安静”的分数被选为这项研究。研究方法：一个多学科团队使用精益方法和改进模型来测试安静时间（QT）的干预措施，并使用HCAHPS“始终安静”评分作为主要结果指标。干预措施：该团队制定了夜间和下午的QT，通过舍入和脚本，调暗灯光，降低工作人员的声音，在晚上提供睡眠菜单，并更换嘈杂的车轮。结果：11个月后，两个单位的安静评分均有所改善。结论：医院中的噪音通常超出了护士驱动的改善范围;然而，由护士领导的QT协议，由多个利益相关者开发，并专注于改变对安静的期望，可以导致患者对安静的感知的可测量的改善。
Background: A quiet environment promotes rest and healing but is often challenging to provide in a busy acute care setting. Improving quiet in the hospital for designated hours improves patient satisfaction. Such efforts have typically been the primary responsibility of the nursing staff. Local Problem: Two medical units with consistently low Hospital Consumer Assessment of Health Care Providers and Systems (HCAHPS) "always quiet" scores were chosen for this study. Methods: A multidisciplinary team used Lean methods and the Model for Improvement to test interventions for quiet time (QT) and used HCAHPS "always quiet" scores as the primary outcome measure. Interventions: The team instituted nighttime and afternoon QT supported by rounding and scripting, dimming lights, lowering staff voices, offering a sleep menu at night, and replacing noisy wheels. Results: Quiet scores improved on both units after 11 months. Conclusions: Noise in hospitals is often beyond the scope of nurse-driven improvement; however, a QT protocol led by nurses, developed by multiple stakeholders, and focused on changing expectations for quiet can lead to measurable improvements in patient perception of quiet.