Team STEPPS模型在“ICU-病房”肺部延伸护理中的应用效果评价
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摘要
目的:评价基于提高医疗质量和患者安全的团队策略和工具包(Team Strategies and Tools to Enhance Performance and Patient Safety,Team STEPPS)构建的"ICU-病房"肺部延伸护理模式的应用效果。方法:回顾性选取2016年1-12月符合纳入标准的术后患者为对照组(98例),给予常规护理。纳入2017年1-12月符合纳入标准的术后患者为实验组(135例),运用基于Team STEPPS模型构建的"ICU-病房"肺部延伸护理模式。结果:实验组患者非计划重返ICU率、因肺部原因重返ICU率均低于对照组,患者对护理工作满意度评分高于对照组,差异均有统计学意义(P<0.05)。结论:运用基于Team STEPPS模型构建的"ICU-病房"肺部延伸护理模式可降低患者重返ICU率,提高患者满意度。
Objective: To evaluate the effects of "ICU-ward" extended lung nursing care based on Team Strategies & Tools to Enhance Performance & Patient Safety(Team STEPPS) on reducing ICU readmission rate caused by pulmonary infection. Methods: The control group included the patients met inclusion criteria from January to December 2016(n=98).The experimental group included the patients met inclusion criteria from January to December 2017(n=135). Patients in the control group received routine nursing care, while patients in the experimental group received "ICU-ward" extended lung nursing care based on Team STEPPS model. Results: The rates of unplanned ICU readmission and ICU readmission caused by lung of the experimental group were lower than the control group, and the patients' satisfaction with nursing work was higher than the control group(P<0.05). Conclusion: The "ICU-ward" extended lung nursing care based on Team STEPPS model can significantly reduce ICU readmission rate and improve patients' satisfaction.
Objective: To evaluate the effects of "ICU-ward" extended lung nursing care based on Team Strategies & Tools to Enhance Performance & Patient Safety(Team STEPPS) on reducing ICU readmission rate caused by pulmonary infection. Methods: The control group included the patients met inclusion criteria from January to December 2016(n=98).The experimental group included the patients met inclusion criteria from January to December 2017(n=135). Patients in the control group received routine nursing care, while patients in the experimental group received "ICU-ward" extended lung nursing care based on Team STEPPS model. Results: The rates of unplanned ICU readmission and ICU readmission caused by lung of the experimental group were lower than the control group, and the patients' satisfaction with nursing work was higher than the control group(P<0.05). Conclusion: The "ICU-ward" extended lung nursing care based on Team STEPPS model can significantly reduce ICU readmission rate and improve patients' satisfaction.
引文
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[9]许美丽,王申.国内外延续性护理的发展现状及对策.解放军护理杂志,2014,31(19):28-33.Xu ML,Wang S.Development status and countermeasures of transitional care model at home and abroad.Nursing Journal of Chinese People's Liberation Army,2014,31(19):28-33.
[10]张晓雪,王欣然.ICU过渡期患者安全影响因素及管理对策.中国护理管理,2018,18(4):526-529.Zhang XX,Wang XR.Influencing factors of patient safety during the ICU transition period and management countermeasures.Chinese Nursing Management,2018,18(4):526-529.
[11]刘永宁,张卫国.医疗模式转型中团队医疗的理念和实践.医学与哲学,2016,37(5B):90-93.Liu YN,Zhang WG.Idea and practice of team cooperation medical treatment in the transformation of medical model.Medicine&Philosophy,2016,37(5B):90-93.
[12]Castner J.Validity and reliability of the Brief Team STEPPS Teamwork Perceptions Questionnaire.J Nurs Meas,2012,20(3):186-198.
[13]孙晓靓,罗茜,康宝丽,等.某医院引入“加强临床表现和医疗安全的团队策略与工具”课程的探索.中国卫生资源,2016,19(3):221-225.Sun XL,Luo Q,Kang BL,et al.The introduction and practice of Team Strategies&Tools to Enhance Performance&Patient Safety in a hospital.Chinese Health Resources,2016,19(3):221-225.
[14]Weld LR,Stringer MT,Ebertowski JS,et al.TeamSTEPPS improves operating room efficiency and patient safety.American Journal of Medical Quallity,2016,31(5):408-414.
[15]Low XM,Horrigan D,Brewster DJ.The effects of team-training in intensive care medicine:a narrative review.J Crit Care,2018(48):283-289.
[16]Obenrader C,Broome ME,Yap TL,et al.Changi ng team member perceptions by implementing TeamSTEPPS in an emergency department.J Emerg Nurs,2018,1767(17):30223-30224.
[17]徐敏,王小芳.Team STEPPS在团队培训课程与不良事件分析中的临床应用进展.中国护理管理,2018,18(5):661-664.Xu M,Wang XF.Progress and status of TeamSTEPPS group training course in clinical practice.Chinese Nursing Management,2018,18(5):661-664.
[18]Clancy CM,Tornberg DN.TeamSTEPPS:assuring optimal teamwork in clinical settings.Am J Med Qual,2007,22(3):214-217.
[19]Sheppard F,Williams M,Klein VR.Team STEPPS and patient safety in healthcare.J Healthc Risk Manag,2013,32(3):5-10.
[20]秦春香,毛平,向亚利,等.团队培训模式在护理安全管理中的应用及效果评价.护理学报,2015,22(5):25-28.Qin CX,Mao P,Xiang YL,et al.Application and effect evaluation of TeamSTEPPS in nursing safety management.Journal of Nursing(China),2015,22(5):25-28.
[21]黄群,李娜,张月莉,等.食管癌根治术后患者由ICU转出过渡期护理模式的应用.上海护理,2017,17(6):69-72.Huang Q,Li N,Zhang YL,et al.The application of transitional care model in patients after radical resection of esophageal cancer.Shanghai Nursing,2017,17(6):69-72.
[2]Centers for Medicare and Medicaid Services(CMS),HHS.Medicare program:changes to the hospital inpatient prospective payment systems and fiscal year 2009 rates;payments for graduate medical education in certain emergency situations;changes to disclosure of physician ownership in hospitals and physician self-referral rules;updates to the long-term care prospective payment system;updates to certain IPPS-excluded hospitals;and collection of information regarding financial relationships between hospitals.Final rules.Fed Regist,2008,73(161):48433-49084.
[3]肖乐乐,徐玲芬,吴巍,等.ICU联络护士在过渡期护理中的作用研究.护士进修杂志,2018,33(8):716-719.Xiao LL,Xu LF,Wu W,et al.Study on the role of intensive care unit liaison nurse in transitional care.Journal of Nurses Training,2018,33(8):716-719.
[4]代蕊,卢婉娴.42例患者重回ICU原因分析及护理对策.护理学报,2012,19(4B):52-53.Dai R,Lu WX.Cause analysis and nursing countermeasures of 42 patients returning to ICU.Journal of Nursing(China),2012,19(4B):52-53.
[5]韩芳,梅秀芳,朱胜春.24小时内重回ICU患者的原因分析和护理防范对策.中国农村卫生事业管理,2013,33(2):218-220.Han F,Mei XF,Zhu SC.Cause analysis and nursing countermeasures of patients returning to ICU within 24 hours.Chinese Rural Health Service Administration,2013,33(2):218-220.
[6]Brown SE,Ratcliffe SJ,Kahn JM,et al.The epidemiology of intensive care unit readmissions in the United States.Am J Respir Crit Care Med,2012,185(9):955-964.
[7]李玉萍,谢冬,杨健,等.普胸外科重返重症监护室患者术后并发症分析.中华胸心血管外科杂志,2015,31(9):545-548.Li YP,Xie D,Yang J,et al.Analysis of readmissions to the thoracic surgical intensive care unit.Chinese Journal of Thoracic and Cardiovascular Surgery,2015,31(9):545-548.
[8]付伟,李萍,钟银燕.延续性护理研究综述.中国实用护理杂志,2010,26(4):27.Fu W,Li P,Zhong YY.An overview of transitional care model.Chinese Journal of Practice Nursing,2010,26(4):27.
[9]许美丽,王申.国内外延续性护理的发展现状及对策.解放军护理杂志,2014,31(19):28-33.Xu ML,Wang S.Development status and countermeasures of transitional care model at home and abroad.Nursing Journal of Chinese People's Liberation Army,2014,31(19):28-33.
[10]张晓雪,王欣然.ICU过渡期患者安全影响因素及管理对策.中国护理管理,2018,18(4):526-529.Zhang XX,Wang XR.Influencing factors of patient safety during the ICU transition period and management countermeasures.Chinese Nursing Management,2018,18(4):526-529.
[11]刘永宁,张卫国.医疗模式转型中团队医疗的理念和实践.医学与哲学,2016,37(5B):90-93.Liu YN,Zhang WG.Idea and practice of team cooperation medical treatment in the transformation of medical model.Medicine&Philosophy,2016,37(5B):90-93.
[12]Castner J.Validity and reliability of the Brief Team STEPPS Teamwork Perceptions Questionnaire.J Nurs Meas,2012,20(3):186-198.
[13]孙晓靓,罗茜,康宝丽,等.某医院引入“加强临床表现和医疗安全的团队策略与工具”课程的探索.中国卫生资源,2016,19(3):221-225.Sun XL,Luo Q,Kang BL,et al.The introduction and practice of Team Strategies&Tools to Enhance Performance&Patient Safety in a hospital.Chinese Health Resources,2016,19(3):221-225.
[14]Weld LR,Stringer MT,Ebertowski JS,et al.TeamSTEPPS improves operating room efficiency and patient safety.American Journal of Medical Quallity,2016,31(5):408-414.
[15]Low XM,Horrigan D,Brewster DJ.The effects of team-training in intensive care medicine:a narrative review.J Crit Care,2018(48):283-289.
[16]Obenrader C,Broome ME,Yap TL,et al.Changi ng team member perceptions by implementing TeamSTEPPS in an emergency department.J Emerg Nurs,2018,1767(17):30223-30224.
[17]徐敏,王小芳.Team STEPPS在团队培训课程与不良事件分析中的临床应用进展.中国护理管理,2018,18(5):661-664.Xu M,Wang XF.Progress and status of TeamSTEPPS group training course in clinical practice.Chinese Nursing Management,2018,18(5):661-664.
[18]Clancy CM,Tornberg DN.TeamSTEPPS:assuring optimal teamwork in clinical settings.Am J Med Qual,2007,22(3):214-217.
[19]Sheppard F,Williams M,Klein VR.Team STEPPS and patient safety in healthcare.J Healthc Risk Manag,2013,32(3):5-10.
[20]秦春香,毛平,向亚利,等.团队培训模式在护理安全管理中的应用及效果评价.护理学报,2015,22(5):25-28.Qin CX,Mao P,Xiang YL,et al.Application and effect evaluation of TeamSTEPPS in nursing safety management.Journal of Nursing(China),2015,22(5):25-28.
[21]黄群,李娜,张月莉,等.食管癌根治术后患者由ICU转出过渡期护理模式的应用.上海护理,2017,17(6):69-72.Huang Q,Li N,Zhang YL,et al.The application of transitional care model in patients after radical resection of esophageal cancer.Shanghai Nursing,2017,17(6):69-72.
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