沟通障碍是临床常规不良事件的主要原因之一,特别是在交接情况下。通信工具SBAR(情况,背景,评估和建议)是为了提高移交质量而开发的,并被广泛认为可以提高患者安全性。本综述的目的是总结实施SBAR对患者安全的影响。
对发表在SBAR上的文章进行了系统评价,EMBASE,CINAHL,Cochrane图书馆和PsycINFO于2017年1月发布。纳入所有符合以下资格标准的SBAR的原始研究文章:(1)将SBAR纳入临床常规,(2)SBAR的调查是主要目标,(3)至少报告了一名患者的预后。
初级和二级保健和疗养院内的各种设置。
各种健康专业人员,包括护士和医生。
患者安全方面(患者结果)定义为不良事件的发生或发生率。
在不同临床环境中进行的8项前后设计研究和3项对照临床试验符合纳入标准。这些研究的目标是改善团队沟通,从护士到医生的电话中的病人移交和通信。这些研究在研究特征方面是异质的,尤其是患者的结果。总的来说,测量了26个不同的患者结果,据报道,其中8个得到了显着改善。11人被描述为改善,但没有进一步的统计检验报告,6个结局没有显著变化.只有一项研究报告了患者预后的描述性降低。
这篇综述发现了通过实施SBAR改善患者安全性的适度证据。特别是当用于通过电话构建通信时。然而,缺乏对这种广泛使用的通信工具的高质量研究。
无。
Communication breakdown is one of the main causes of adverse events in clinical routine, particularly in handover situations. The communication tool SBAR (situation, background, assessment and recommendation) was developed to increase handover quality and is widely assumed to increase patient safety. The objective of this
review is to summarise the impact of the implementation of
SBAR on patient safety.
A systematic
review of articles published on
SBAR was performed in PUBMED, EMBASE, CINAHL, Cochrane Library and PsycINFO in January 2017. All original research articles on
SBAR fulfilling the following eligibility criteria were included: (1)
SBAR was implemented into clinical routine, (2) the investigation of
SBAR was the primary objective and (3) at least one patient outcome was reported.
A wide range of settings within primary and secondary care and nursing homes.
A variety of heath professionals including nurses and physicians.
Aspects of patient safety (patient outcomes) defined as the occurrence or incidence of adverse events.
Eight studies with a before-after design and three controlled clinical trials performed in different clinical settings met the inclusion criteria. The objectives of the studies were to improve team communication, patient hand-offs and communication in telephone calls from nurses to physicians. The studies were heterogeneous with regard to study characteristics, especially patient outcomes. In total, 26 different patient outcomes were measured, of which eight were reported to be significantly improved. Eleven were described as improved but no further statistical tests were reported, and six outcomes did not change significantly. Only one study reported a descriptive reduction in patient outcomes.
This
review found moderate evidence for improved patient safety through
SBAR implementation, especially when used to structure communication over the phone. However, there is a lack of high-quality research on this widely used communication tool.
none.