Before-After Study of a Checklist to Improve Acute Care to ICU Handoffs.
Before-After Study of a Checklist to Improve Acute Care to ICU Handoffs.
复制标题
改善急诊护理至 ICU 交接的清单的前后研究。
DOI：
10.1097/jmq.0000000000000091
复制
发表时间：
2023
期刊：
影响因子：
--
通讯作者：
Jennerich,AnnL
中科院分区：
文献类型：
--
作者：
Hicks,KatherineG;Downey,Lois;Elketami,Addy;Nielsen,ElizabethL;Engelberg,RuthA;Jennerich,AnnL
转移病人的护理是一个关键的过程。本研究的目的是评估一份清单，以规范从急症护理到重症监护病房（ICU）的移交。这是一项单中心、前后对照的检查表研究，以规范从急症护理到内科-心脏ICU的患者转移。临床医生在实施检查表之前和之后完成了关于交接的调查。研究期间与调查数据之间的关系采用多变量logistic回归与交叉分类多水平模型进行分析。179名临床医生完成了调查。实施检查表后，ICU更有可能发生交接（OR 17.23; 95% CI, 1.81-164.19），并涵盖患者的治疗偏好（OR 2.73; 95% CI, 1.12-6.66）。然而，检查表的使用是次优的（30%的回答表示使用检查表）。在急症护理到ICU的转移过程中实施核对表是具有挑战性的。提示流程改进的信号值得进一步研究。
Transferring care of a patient is a critical process. The objective of this study was to evaluate a checklist to standardize handoffs from acute care to the intensive care unit (ICU). This was a single-center, before-after study of a checklist to standardize transfers of patients from acute care to the medical-cardiac ICU. Clinicians completed surveys about handoffs before and after checklist implementation. The association between study period and survey data was analyzed using multivariable logistic regression with cross-classified multilevel models. Surveys were completed by 179 clinicians. After checklist implementation, handoffs were more likely to occur in the ICU (OR 17.23; 95% CI, 1.81-164.19) and cover patient treatment preferences (OR 2.73; 95% CI, 1.12-6.66). However, checklist uptake was suboptimal (30% of responses indicated checklist use). Implementation of a checklist during acute care to ICU transfers is challenging. Signals suggesting process improvement warrant additional study.