運用ISBAR架構提升護理人員交班完整率

Application of ISBAR architecture to enhance the rate of nurse-handover integrity

呂麗戎(Li-Jung Lu) ； 李淑滿(Shu-Man Lee) ； 魏秀雲(Hsiu-Yun Wei) ； 張秋燕(Chiu-Yen Chang) ； 劉洪香水(Siang-Shuei Liou Hong)

《醫務管理期刊》 18卷1期 (2017/03) Pp. 56-72

https://doi.org/10.6174/JHM2017.18(1).56

摘要

目的：護理人員交班乃提供病人連續性照護之重要工作，傳統紙本交班模式欠缺交班規範與結構性，導致交班過程容易發生疏失或遺漏情形。因此本研究藉由運用ISBAR（Introduction，Situation，Background，Assessment，Recommendation）交班概念，提升交班完整率，以利確保服務品質與病人安全。方法：現況交班完整率僅66.5％，問卷調查交班滿意度僅22％。本研究透過ISBAR交班概念發展結構性護理交班規範規劃改善，執行期間從2013年2月至6月，改善後以實際稽核、人員訪談與交班滿意度調查確認改善結果。結果：改善後，交班完整率提升至85％，交班滿意度提升至94.2％。結論：具有結構性的交班規範，不僅可落實交班資訊傳遞之完整性、正確性與即時性，並可提升護理人員工作滿意度，進而確保照護服務品質與病人安全。

關鍵字

ISBAR ； 護理交班 ； 交班完整率

並列摘要

Objectives: A good nursing shift handover is important in providing continuity of patient care. The traditional ＂paper mode of nursing handover＂ lacked standards and structure, and was unable to provide updated information which may subsequently have caused negligence or omissions in nursing care. In order to improve patient care and the quality of the nursing shift handover, we developed an application of the ISBAR (Introduction, Situation, Background, Assessment, Recommendations) concept. Methods: Through a nurse-handover integrity survey, we found that the handover integrity rate was 66.5% and the satisfaction rate was 22%; this may have had a great impact on the quality of care and patient safety. To improve the integrity, accuracy and timeliness of nursing shift handover, structured nursing shift practice regulations using the ISBAR concept were implemented from February through June 2013. The results were confirmed by audits, interviews and satisfaction surveys. Results: After using the ISBAR shift transfer concept combined with the use of information technology, the nurse-handover integrity rate improved from 66.5% to 85 % and the shift satisfaction rate increased from 22% to 94.2%. Conclusions: The development of a structured shift handover not only improved nursing care satisfaction thereby enhancing communication among health care personnel but also promoted patient safety and quality of care.

並列關鍵字

ISBAR ； nursing shift handover ； handover integrity rate

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