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Clinical handover practices among healthcare practitioners in acute care services: A qualitative study

机译:急性护理服务中医疗保健从业者之间的临床切换实践:定性研究

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Aims and objectives To examine clinical handover practices in acute care services in Ireland. Objectives were to examine clinical handover practices between and within teams and between shifts, to identify resources and supports to enhance handover effectiveness and to identify barriers and facilitators of effective handover. Background Clinical handover is a high-risk activity, and ineffective handover practice constitutes a risk to patient safety. Evidence suggests that handover effectiveness is achieved through staff training and standardised handover protocols. Design The study design was qualitative-descriptive using inductive analysis. Methods The study involved a series of focus group discussions and interviews among a sample of healthcare practitioners recruited from 12 urban and regional acute hospitals in Ireland. A total of 116 healthcare professionals took part in 28 interviews and 13 focus group discussions. We analysed the data using the directed content analysis method. Results Data collection generated rich qualitative data, yielding five categories from which two broad themes emerged: "policy and practice" and "handover effectiveness." The themes and their associated categories indicate that there is limited organisational-level policy and limited explicit training in clinical handover, that medical and nursing handovers are separate activities with somewhat different purposes and different modes of execution, and that several factors in the acute care setting, including location, timing and documentation, act as either barriers or enablers to handover effectiveness. Conclusion The evidence in the current study suggests that clinical handover merits increased level of prominence in hospital policies or operating procedures. Medical and nursing handover practices represent distinct activities in their content and execution that may be related to cultural and organisational factors. Relevance to clinical practice Achieving multidisciplinary team handover requires a change in embedded traditional practices. Several aspects of the clinical handover activities of nursing and medical staff appear to diverge from best-practice evidence.
机译:旨在审查爱尔兰急性护理服务中的临床切换实践。目标是在团队之间以及转移之间进行临床切换实践,以确定资源,并支持提高切换效率,并确定有效移交的障碍和促进者。背景技术临床切换是一种高风险的活动,无效的切换实践构成患者安全的风险。证据表明,通过员工培训和标准化的切换协议实现了切换效率。设计研究设计使用归纳分析具有定性描述性。方法研究涉及从爱尔兰12个城市和区域急诊医院招募的医疗保健从业者样本中的一系列焦点小组讨论和访谈。共有116名医疗保健专业人员参加了28个访谈和13个焦点小组讨论。我们使用定向内容分析方法分析了数据。结果数据收集产生丰富的定性数据,产生了五类出现了两类:“政策和实践”和“切换效率”。主题及其相关类别表明,在临床切换中有有限的组织级政策和有限的明确培训,医疗和护理切换是具有稍微不同目的和不同的执行方式的单独活动,以及急性护理环境中的几个因素,包括位置,时序和文档,充当障碍或使能效果的障碍。结论本研究中的证据表明,临床切换优点增加了医院政策或操作程序的突出水平。医疗和护理切换实践代表了与文化和组织因素有关的内容和执行中的独特活动。达到多学科团队切换的临床实践的相关性需要改变嵌入式传统实践。护理和医务人员的临床切换活动的几个方面似乎与最佳实践证据分歧。

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