Abstract：
OBJECTIVE: The aim of this study was to explore and better understand the experiences of Hong Kong general ward nurses who care for post-intensive care patients.
METHODS: Inductive thematic analysis and focus groups interviews were used in this study.
METHODS: A purposive sample of 20 ward-based registered nurses were recruited, formed five focus groups and interviewed online using video-conferencing media.
RESULTS: The ward nurses in this study described the difficulties and challenges they experienced caring for the post-intensive care patient. Issues around workload and patient allocation figured highly along with a lack of education and training. Many felt scared and helpless when caring for these patients which significantly increased their anxiety. Some were compelled to spend more time with their other patients while others were so consumed with the post-ICU patient that they often neglected their other patients. The handover from the intensive care unit nurse was filled with trepidation and concern because of the level of information being handed-over was alien and complex to them so was the medications and the level of monitoring the intensive care unit nurse expected which was not often forthcoming on the ward simply because they didn\'t know what they were doing.
CONCLUSIONS: The findings of this study demonstrate that these ward-nurses found themselves in a difficult situation with trying to understand of the needs of the post-intensive care patient. A lack of support, a lack of education and an increased workload made this situation hard. One possible solution is the development and evaluation of a critical care outreach team to support ward-based decision-making. Combined with formal training and education around the acutely ill and /or the deteriorating patient would be a positive step forward.
CONCLUSIONS: The post-intensive care patient poses significant challenges to ward nurses unfamiliar with the level of care they require. Unlike intensive care unit nurses whose focus is on survival and preventing deterioration, the ward nurse\'s attention is meeting the activities of daily living and progressing the patient\'s rehabilitation. One of the major obstacle experienced was at handover and the transferring of responsibility where the information conveyed was overly complex and to the ward nurse mostly irrelevant. For this, critical nurses must improve their proficiency at handover so that information is tailored to the needs of the ward environment. One way would be the development of a intensive care unit/Ward handover tool developed collaboratively so as maximise the priorities of care and improve patient outcome.
METHODS: Inductive thematic analysis and focus groups interviews were used in this study.
METHODS: A purposive sample of 20 ward-based registered nurses were recruited, formed five focus groups and interviewed online using video-conferencing media.
RESULTS: The ward nurses in this study described the difficulties and challenges they experienced caring for the post-intensive care patient. Issues around workload and patient allocation figured highly along with a lack of education and training. Many felt scared and helpless when caring for these patients which significantly increased their anxiety. Some were compelled to spend more time with their other patients while others were so consumed with the post-ICU patient that they often neglected their other patients. The handover from the intensive care unit nurse was filled with trepidation and concern because of the level of information being handed-over was alien and complex to them so was the medications and the level of monitoring the intensive care unit nurse expected which was not often forthcoming on the ward simply because they didn\'t know what they were doing.
CONCLUSIONS: The findings of this study demonstrate that these ward-nurses found themselves in a difficult situation with trying to understand of the needs of the post-intensive care patient. A lack of support, a lack of education and an increased workload made this situation hard. One possible solution is the development and evaluation of a critical care outreach team to support ward-based decision-making. Combined with formal training and education around the acutely ill and /or the deteriorating patient would be a positive step forward.
CONCLUSIONS: The post-intensive care patient poses significant challenges to ward nurses unfamiliar with the level of care they require. Unlike intensive care unit nurses whose focus is on survival and preventing deterioration, the ward nurse\'s attention is meeting the activities of daily living and progressing the patient\'s rehabilitation. One of the major obstacle experienced was at handover and the transferring of responsibility where the information conveyed was overly complex and to the ward nurse mostly irrelevant. For this, critical nurses must improve their proficiency at handover so that information is tailored to the needs of the ward environment. One way would be the development of a intensive care unit/Ward handover tool developed collaboratively so as maximise the priorities of care and improve patient outcome.
摘要：
目的：这项研究的目的是探索和更好地了解香港普通病房护士照顾重症监护病人的经验。
方法：本研究采用归纳性主题分析和焦点小组访谈。
方法：招募了20名病房注册护士，成立了五个焦点小组，并使用视频会议媒体在线采访。
结果：本研究中的病房护士描述了他们在照顾重症监护后患者时遇到的困难和挑战。围绕工作量和患者分配的问题与缺乏教育和培训密切相关。许多人在照顾这些患者时感到害怕和无助，这大大增加了他们的焦虑。有些人被迫花更多的时间与其他患者在一起，而另一些人则与ICU后患者在一起，以至于他们经常忽略其他患者。重症监护病房护士的移交充满了恐惧和担忧，因为移交的信息水平对他们来说是陌生和复杂的，所以药物和重症监护病房护士预期的监测水平并不经常出现在病房，因为他们不知道自己在做什么。
结论：这项研究的结果表明，这些病房护士在试图了解重症监护后患者的需求时，发现自己处于困境。缺乏支持,缺乏教育和工作量的增加使这种情况变得困难。一种可能的解决方案是开发和评估重症监护外联团队，以支持基于病房的决策。结合对急病和/或恶化患者的正规培训和教育，将是向前迈出的积极一步。
结论：重症监护后患者对不熟悉其需要的护理水平的病房护士构成了重大挑战。与重症监护病房护士不同，他们的重点是生存和预防恶化，病房护士的注意力是满足日常生活活动和推进病人的康复。经历的主要障碍之一是移交和责任转移，其中传达的信息过于复杂，并且与病房护士几乎无关。为此，重症护士必须提高交接时的熟练程度，以便根据病房环境的需求量身定制信息。一种方法是合作开发重症监护病房/病房移交工具，以最大程度地提高护理优先级并改善患者预后。
方法：本研究采用归纳性主题分析和焦点小组访谈。
方法：招募了20名病房注册护士，成立了五个焦点小组，并使用视频会议媒体在线采访。
结果：本研究中的病房护士描述了他们在照顾重症监护后患者时遇到的困难和挑战。围绕工作量和患者分配的问题与缺乏教育和培训密切相关。许多人在照顾这些患者时感到害怕和无助，这大大增加了他们的焦虑。有些人被迫花更多的时间与其他患者在一起，而另一些人则与ICU后患者在一起，以至于他们经常忽略其他患者。重症监护病房护士的移交充满了恐惧和担忧，因为移交的信息水平对他们来说是陌生和复杂的，所以药物和重症监护病房护士预期的监测水平并不经常出现在病房，因为他们不知道自己在做什么。
结论：这项研究的结果表明，这些病房护士在试图了解重症监护后患者的需求时，发现自己处于困境。缺乏支持,缺乏教育和工作量的增加使这种情况变得困难。一种可能的解决方案是开发和评估重症监护外联团队，以支持基于病房的决策。结合对急病和/或恶化患者的正规培训和教育，将是向前迈出的积极一步。
结论：重症监护后患者对不熟悉其需要的护理水平的病房护士构成了重大挑战。与重症监护病房护士不同，他们的重点是生存和预防恶化，病房护士的注意力是满足日常生活活动和推进病人的康复。经历的主要障碍之一是移交和责任转移，其中传达的信息过于复杂，并且与病房护士几乎无关。为此，重症护士必须提高交接时的熟练程度，以便根据病房环境的需求量身定制信息。一种方法是合作开发重症监护病房/病房移交工具，以最大程度地提高护理优先级并改善患者预后。
