The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: Pre-test post-test comparative study
The impact of Nursing Rounds on the practice environment and nurse satisfaction in intensive care: Pre-test post-test comparative study
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DOI：
10.1016/j.ijnurstu.2010.10.004
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发表时间：
2011-08-01
影响因子：
8.1
通讯作者：
Gardner, Glenn
中科院分区：
文献类型：
--
作者：
Aitken, Leanne M.;Burmeister, Elizabeth;Gardner, Glenn
背景：先前显示的影响患者护理的因素包括有效的决策、团队合作、循证实践、人员配备和工作满意度。临床查房有可能优化这些因素并影响患者的预后，目的：确定在重症监护环境中实施护理查房对病人护理计划、护士对实习环境和工作满意度的影响。设计：前测后测2组比较设计。地点：澳大利亚三级教学医院的两个重症监护病房。参与者：随机抽样244名注册护士(n=244)在参与的重症监护病房全职或兼职工作。方法：要求参与重症监护病房的护士完成实习环境量表-护理工作指数(PES-护理工作指数)在干预单元进行常规护理查房的12个月期间前后进行护理工作生活满意度评定量表(NWSS)。对护理查房中提出的问题进行了描述和分类。通过连续变量的t检验和分类变量的卡方检验，对样本和量表得分的特点进行了总结，并分析了前后得分的差异。结果：护理查房导致171名患者发生了577项变化：这些变化与护理的生理、心理-个人、心理-家庭或专业实践方面有关。在研究前后，两个参与单位的PES-NWI和NWSS总分是相似的。干预组护士之间的人际交往得分在研究期间有所改善(前4.85+/-0.93：后5.36+/-0.89，p=0.002)，对照组无明显增加。影响PES-NWI的独立因素包括干预地点和重症监护年限(p<；0.05)。结论：在重症监护环境中实施护理查房是可行的，是启动患者护理变革的有效策略。需要在其他环境中应用和测试这一战略，包括确定最适当的衡量影响的方法，以确定普遍性。(C)2010爱思唯尔有限公司。保留所有权利。
Background: Factors previously shown to influence patient care include effective decision making, team work, evidence based practice, staffing and job satisfaction. Clinical rounds have the potential to optimise these factors and impact on patient outcomes, but use of this strategy by intensive care nurses has not been reported.Objectives: To determine the effect of implementing Nursing Rounds in the intensive care environment on patient care planning and nurses' perceptions of the practice environment and work satisfaction.Design: Pre-test post-test 2 group comparative design.Settings: Two intensive care units in tertiary teaching hospitals in Australia.Participants: A convenience sample of registered nurses (n = 244) working full time or part time in the participating intensive care units.Methods: Nurses in participating intensive care units were asked to complete the Practice Environment Scale-Nursing Work Index (PES-NWI) and the Nursing Worklife Satisfaction Scale (NWSS) prior to and after a 12 month period during which regular Nursing Rounds were conducted in the intervention unit. Issues raised during Nursing Rounds were described and categorised. The characteristics of the sample and scale scores were summarised with differences between pre and post scores analysed using t-tests for continuous variables and chi-square tests for categorical variables. Independent predictors of the PES-NWI were determined using multivariate linear regression.Results: Nursing Rounds resulted in 577 changes being initiated for 171 patients reviewed: these changes related to the physical, psychological - individual, psychological - family, or professional practice aspects of care. Total PES-NWI and NWSS scores were similar before and after the study period in both participating units. The NWSS sub-scale of interaction between nurses improved in the intervention unit during the study period (pre - 4.85 +/- 0.93: post - 5.36 +/- 0.89, p = 0.002) with no significant increase in the control group. Factors independently related to higher PES-NWI included intervention site and less years in critical care (p < 0.05).Conclusions: Implementation of Nursing Rounds within the intensive care environment is feasible and is an effective strategy for initiating change to patient care. Application and testing of this strategy, including identification of the most appropriate methods of measuring impact, in other settings is needed to determine generalisability. (C) 2010 Elsevier Ltd. All rights reserved.