首页|早期预警评分联合SBAR沟通模式在高危新生儿中的应用

早期预警评分联合SBAR沟通模式在高危新生儿中的应用

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目的 探讨改良早期预警评分(modified early warning score,MEWS)联合SBAR[现状(situation)、背景(backgro-und)、评估(assessment)、建议(recommendation)]沟通模式在高危新生儿中的应用效果,为临床提供一种有效评估患儿病情变化的沟通方法.方法 采用前-后对照研究方法,选取2022年8月至9月入住本院新生儿科病房的高危新生儿270例作为研究对象.以 8 月入院的高危新生儿为对照组,9 月入院的高危新生儿作为试验组,每组分别纳入 135 例患儿.对照组患儿按照常规护理实施病情观察,试验组患儿在对照组基础采用MEWS联合SBAR沟通模式实施病情观察.比较两组高危新生儿预警事件发生情况,护士预警事件与医生处理事件的一致率,医生对护士工作的满意率.结果 两组均完成研究.对照组中 63.6%的预警事件是由护士发现,试验组中 92.6%的预警事件是由护士发现,两组比较,差异具有统计学意义(χ 2=16.622,P<0.001).试验组护士预警事件与医生处理事件的一致性(Kappa系数=0.926)高于对照组(Kappa系数=0.641);试验组医生对护士在专科知识、抢救应急能力、掌握病情情况、及时观察病情变化、医护配合、工作积极性、沟通能力、心理素质方面的满意率均高于对照组(80.0%~95.0%v30.0%~55.0%),两组比较,差异具有统计学意义(均P<0.05).结论 MEWS与SBAR沟通模式联合应用,有助于护士准确评估患儿病情变化,及时有效完成医护沟通,提高护士观察、沟通和处理能力,也提高了医生对护士工作的满意度.
Effect of early warning score combined with SBAR communication model on early warning of high-risk neonates
Objective To investigate the effect of early warning score system combined with(situation,background,ssessment,recommendation,SBAR)communication model in early warning of high-risk neonates,therefore to provide an effective communication method for an effective communication method to assess the changes of condition in neonates.Methods A before-after study model was adopted in the study.A total of 270 high-risk neonates admitted to the ward of the Department of Neonatology in a tertiary hospital between August and September 2022 were selected as research subjects.The high-risk neonates admitted in hospital in August were assigned in a control group,and those admitted in September were assigned in an trial group,with 135 neonates per group.Routine care was carried out in the control group,while early warning scoring combined with SBAR communication model were applied in the trial group on top of the cares offered to the control group.The occurrence of early warning events,concordance rate of nurse warning event and doctor handling events,and the satisfaction rate of doctors with the nursing performance were compared between the two groups.Results A total of 63.6%of early warning events were triggered by nurses in the control group,while it was 92.6%in the trial group,with a statistically significant difference between the groups(χ2=16.622,P<0.001).The consistency of handling of early warning events between the nurses and doctors in the trial group(Kappa coefficient=0.926)was higher than that in the control group(Kappa coefficient=0.641).The satisfaction rates of the doctors with the nurses about specialist knowledge,ability in emergency events,mastery of disease,timely observation of disease progress,collaboration between doctors and nurses,working enthusiasm,communication capability and the psychological quality in the trial group were all significantly higher than those in the control group[80.0%-95.0%vs.30.0%-55.0%,all P<0.01].Conclusions The Early Warning Score system combined with SBAR communication model can help nurses to accurately evaluate the changes of disease in neonates,complete the communication with doctors timely and effectively.It improves the observation,communication and handling capability among the nurses as well as the satisfaction rate of doctors with nursing work.

high-risk neonatesearly warning scoreSBAR communication modebefore-after study

赵丽、印娟、贾贝贝、黄永梅、杭美芳、董丽敏

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江苏省无锡市妇幼保健院,江苏无锡,214002

高危新生儿 早期预警评分 SBAR沟通模式 前-后对照研究

无锡市卫生健康委科研项目江苏省妇幼健康重点学科建设项目

Q201933SFY3-EK2021

2024

现代临床护理
中山大学

现代临床护理

CSTPCD
影响因子:1.317
ISSN:1671-8283
年,卷(期):2024.23(2)
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