Contenuto dell'articolo principale
Abstract
SCOPO: obiettivo di questo studio è quello di indagare le interruzioni che si verificano durante il passaggio di consegna infermieristica in una Terapia Intensiva Italiana. METODO: studio osservazionale prospettico svolto all'interno del reparto di Anestesia e Rianimazione dell'Azienda Socio Sanitaria Territoriale (ASST) di Lecco tra il 15 luglio 2016 e il 30 Dicembre 2016. Per catturare ed esplorare le interruzioni, i dati sono stati raccolti attraverso l'osservazione partecipante.
RISULTATI: la durata media di ogni consegna è stata di 7.31 minuti (deviazione stan- dard [DS] ±3.27) con un range di 3-25 min. Sono state raccolte 422 consegne e 352 interruzioni con una media di interruzioni per consegna di 0.83 (deviazione standard [DS] =+0.66). Il principale autore di interruzioni è stato il personale infermieristico di reparto (p<.001). Le interruzioni sono state osservate indipendentemente dal luogo dove è stata svolta la consegna.
CONCLUSIONI: gli infermieri interrompono e si lasciano interrompere da una vasta gamma di collaboratori, ma soprattutto dai loro stessi colleghi infermieri e la frequenza delle interruzioni è particolarmente preoccupante. Alla luce dei risultati, sono necessari ulteriori studi per raccogliere informazioni e dati in setting piuÌ€ etero- genei.
PAROLE CHIAVE: consegna infermieristica, terapia intensiva, interruzioni, patient safety
ABSTRACT
AIM: the purpose of this study is to investigate interruptions as they occur during the nursing handover in an Italian Intensive Care Unit.
METHOD: prospective observational study carried out in the Lecco hospital's Department of Anaesthesiology and Critical Care Service (formerly A. Manzoni Hospital) from 15th July 2016 to 30th December 2016. To capture and understand the causes and occurences of interruptions, data were collected through participating observation.
RESULTS: the mean handover time was 7.31 (standard deviation [SD] ±3.27) min with a range of 3–25 min. A total of 422 nursing handovers and 352 interruptions were collected with a mean of interruptions for handover of 0.83 (standard deviation [SD] =+0.66). The first author of the interruptions was detected to be the nursing department staff (p<.001). The interruptions were observed indepentenly of the place of handover.
CONCLUSION: Nurses interrupt and allow themselves to be interrupted by collabora- tors, primarily by their nurse collegues and the frequency of interruptions are particu- rarly worrying. After our results, further studies are needed to gather information and data in setting more heterogeneous.
KEYWORDS: nursing handover, intensive care, interruptions, patient safety
Dettagli dell'articolo
Riferimenti
- Anderson, C.D., & Mangino, R.R. (2006) Nurse shift report: who says you can't talk in front of the patient? Nurs Adm Q, Apr-Jun;30(2):112-22.
- Australian Council for Safety and Quality in Health Care: Clinical handover and patient safety literature. (2005) da https://safetyandquality. gov.au/search/clinical+handover+literature+ review
- Berg, L.M., Källberg, A.S., Göransson, K.E., Östergren, J,, Florin, J., Ehrenberg, A. (2013) Interruptions in emergency department work: an observational and interview study. BMJ Qual Saf, Aug; 22(8):656-63. doi: 10.1136/bmjqs-2013- 001967. Epub 2013 Apr 12.
- Biron, A.D., Loiselle, C.G., Lavoie-Tremblay, M. (2009) Work interruptions and their contribution to medication administration errors: an evidence review. Worldviews Evid Based Nurs, 6(2):70-86. doi: 10.1111/j.1741-6787.2009.00151.x. Epub 2009 Apr 29.
- Bjornssson, K. (2001) Udbraendthedd eller sygeliggorelse [Burnout or pathologized]. Sygeplejersken, 29, 12-14.
- Borowitz, S.M., Waggoner-Fountain, L.A., Bass, E.J., Sledd, R.M. (2008) Adequacy of information transferred at resident sign-out (inhospital handover of care): a prospective survey. Qual Saf Health Care, 17: 6-10.
- Bower, R., Jackson, C., Manning, J.C. (2015) Interruptions and medication administration in critical care. Nurs Crit Care, Jul;20(4):183-95. doi: 10.1111/nicc.12185.
- Brixey, J.J., Robinson, D.J., Turley, J.P., Zhang, J. (2007) Initiators of interruption in workflow: the role of MDs and RNs. Stud Health Technol Inform, 130:103-9.
- Brown, G. (2006) Wound documentation: managing risk. Advanced Skin Wound Care, 19: 155-65.
- Cheevakasemsook, A., Chapman, Y., Francis, K., Davies, C. (2006) The study of nursing documentation complexities. International
- Journal of Nursing Practice, 12: 366-74. Compton, J., Copeland, K., Flanders, S., Cassity, C., Spetman, M., Xiao, Y., Kennerly, D. (2012) Implementing SBAR across a large multihospital health system. Jt Comm J Qual Patient Saf, Jun,
- (6):261-8.
- D'Antonio, S., Bagnasco, A., Bonetti, L., Sasso, L.
- (2014) Observational study on interruptions during nurses work in two surgical wards of a hospital in Liguria. Prof Inferm, Oct- Dec;67(4):211-8. doi: 10.7429/pi.2014.674211.
- De Meester, K., Verspuy, M., Monsieurs, K.G., Van Bogaert, P. (2013) SBAR improves nurse- physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation, Sep;84(9):1192-6. doi: 10.1016/j.resuscitation.2013. 03.016. Epub 2013 Mar 26.
- De Oliveira Prates, D., Bauer, A.L., Silva, C. (2016) Interruptions of activities experienced by nursing professionals in an intensive care unit. Rev Lat Am Enfermagem, 24: e2802.
- Dimond, B. (2005) Legal aspects of documentation. Abbreviations: the need for legibility and accuracy in documentation. British Journal of Nursing, 14: 665-6
- Fox, N.S., Brennan, J.S., Chasen, S.T., Brennan, Chasen. (2008) Clinical estimation of fetal weight and the Hawthorne effect. Eur. J. Obstet. Gynecol. Reprod. Biol., 141 (2): 111–4. doi:10.1016/j.ejogrb.2008.07.023. PMID 18771841.
- Giannini, A., Miccinesi, G., Prandi, E. (2012) "˜Opening' ICU: views of ICU doctors and nurses before and after liberalization of visiting policies. Critical Care, 16(Suppl 1):P492
- Gordon, M. (2013) Training on handover of patient care within UK medical schools. Medical Education Online, 11;18:1-5.
- Hoban, V. (2003) How to. handle a handover. Nursing Times, 99(9): 54-55.
- Jeffs, L., Acott, A., Simpson, E., Campbell, H., Irwin, T., Lo, J., Beswick, S., Cardoso, R. (2013) The value of bedside shift reporting enhancing nurse surveillance, accountability, and patient safety. J Nurs Care Qual, Jul-Sep;28(3):226-32. doi: 10.1097/NCQ.0b013e3182852f46.
- Kirkeby, O.F. (2004) Det nye lederskabè[The new Leadership]. Bí¸rsens Forlag A/S, Copenhagen. [in Danish]
- Kreckler, S., Catchpole, K., Bottomley, M., Handa, A., McCulloch, P. (2008) Interruptions during drug
- rounds: an observational study. British Journal of
- Nursing, Nov 27-Dec 10;17(21):1326-30. McCarney, R., Warner, J., Iliffe, S., Van Haselen, R., Griffin, M., Fisher, Warner, P. Iliffe, Van Haselen, Griffin, Fisher. (2007) The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol, 7: 30. doi:10.1186/1471-2288-7-30.
- PMC 1936999. PMID 17608932.
- McGillis, L., Hubley, P., Watson, C. (2010)
- Interruption and Pediatric Patient Safety. Jounal
- of Pediatric Nursing, 25: 167-175
- MeiíŸner, A., Hasselhorn, H.M., Estryn-Behar, M.,
- NeÌzet, O., Pokorski, J., Gould, D. (2007) Nurses' perception of shift handovers in Europe: results from the European Nurses' Early Exit Study. Journal of Advanced Nursing, 57(5): 535-42.
- Paxton, F., Heaney, D., Howie, J., Porter, B.A. (1996) A study of interruption rates for practice nurses and GPs. Nurs Stand, Jul 17;10(43):33-6.
- Raduma-Toma, M., Flin, R., Yule, S., Williams, D. (2011) Doctors' handovers in hospitals: a literature review. BMJ Qual Saf, 20: 128-133.
- Riesenberg, L.A., Leitzsch, J., Massucci, J.L. (2009) Residents' and attending physicians' handoffs: a systematic review of the literature. Acad Med, 84: 1775-1787.
- Sand-Jecklin, K., & Sherman, J. (2014) A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. J Clin Nurs, Oct;23(19-20):2854-63. doi: 10.1111/jocn.12575. Epub 2014 Mar 8.
- Sasangohar, F., Donmez, B., Easty, A.C., Trbovich, P.L. (2015) The relationship between interruption content and interrupted task severity in intensive care nursing: an observational study. Int J Nurs Stud., Oct;52(10):1573-81. doi: 10.1016/j.ijnurstu.2015.06.002. Epub 2015 Jun 17.
- Speier, C., Valacich, J.S., Vessey, I. (1999) The influence of task interruption on individual decision making: An information overload perspective. Decision Sciences, March 30,2.
- Spooner, A.J., Corley, A., Chaboyer, W., Hammond, N.E., Fraser, J.F. (2015) Measurement of the frequency and source of interruptions occurring during bedside nursing handover in the intensive care unit: An observational study. Australian Critical Care, 28, 19–23
- Sí¸rensen, E.E., & Brahe, L. (2014) Interruptions in clinical nursing practice. J Clin Nurs, May;23(9- 10):1274-82. doi: 10.1111/jocn.12329. Epub 2013 Sep 5.
- Sí¸rensen, E.E., Delmar, C., Pedersen, B.D. (2011) Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles. J Nurs Manag, May;19(4):421-30. doi: 10.1111/j.1365- 2834.2011.01212.x. Epub 2011 Mar 29.
- Toccafondi, G., Albolino, S., Tartaglia, R., Guidi, S., Molisso, A., Venneri, F., Peris, A., Pieralli, F., Magnelli, E., Librenti, M., Morelli, M., Barach, P. (2012) The collaborative communication model for patient handover at the interface between high- acuity and low-acuity care. British Medical Journal, Quality and Safety, 21: 58-66
- Tucker, A.L., & Spear, S.J. (2006) Operational failures and interruptions in hospital nursing. Health Serv Res,
- Jun;41(3 Pt 1):643-62.
- Westbrook, J.I., Woods, A., Rob, M.I., Dunsmuir, W.T.,
- Day, R.O. (2010) Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med, Apr 26;170(8):683-90. doi: 10.1001/archinternmed. 2010.65.
- Wildner, J., & Ferri, P. (2012) The Implementation of the Bedside Handover for the Improvement of Nursing Quality in an Italian Hospice. Journal of Hospice & Palliative Nursing, 14(3): 216-224.
- Wilkinson, J., & Lardner, R. (2013) Shift handover after buncefield. Chemical Engineering Transactions, 31: 295-300. DOI: 10.3303/CET1331050
Riferimenti
Anderson, C.D., & Mangino, R.R. (2006) Nurse shift report: who says you can't talk in front of the patient? Nurs Adm Q, Apr-Jun;30(2):112-22.
Australian Council for Safety and Quality in Health Care: Clinical handover and patient safety literature. (2005) da https://safetyandquality. gov.au/search/clinical+handover+literature+ review
Berg, L.M., Källberg, A.S., Göransson, K.E., Östergren, J,, Florin, J., Ehrenberg, A. (2013) Interruptions in emergency department work: an observational and interview study. BMJ Qual Saf, Aug; 22(8):656-63. doi: 10.1136/bmjqs-2013- 001967. Epub 2013 Apr 12.
Biron, A.D., Loiselle, C.G., Lavoie-Tremblay, M. (2009) Work interruptions and their contribution to medication administration errors: an evidence review. Worldviews Evid Based Nurs, 6(2):70-86. doi: 10.1111/j.1741-6787.2009.00151.x. Epub 2009 Apr 29.
Bjornssson, K. (2001) Udbraendthedd eller sygeliggorelse [Burnout or pathologized]. Sygeplejersken, 29, 12-14.
Borowitz, S.M., Waggoner-Fountain, L.A., Bass, E.J., Sledd, R.M. (2008) Adequacy of information transferred at resident sign-out (inhospital handover of care): a prospective survey. Qual Saf Health Care, 17: 6-10.
Bower, R., Jackson, C., Manning, J.C. (2015) Interruptions and medication administration in critical care. Nurs Crit Care, Jul;20(4):183-95. doi: 10.1111/nicc.12185.
Brixey, J.J., Robinson, D.J., Turley, J.P., Zhang, J. (2007) Initiators of interruption in workflow: the role of MDs and RNs. Stud Health Technol Inform, 130:103-9.
Brown, G. (2006) Wound documentation: managing risk. Advanced Skin Wound Care, 19: 155-65.
Cheevakasemsook, A., Chapman, Y., Francis, K., Davies, C. (2006) The study of nursing documentation complexities. International
Journal of Nursing Practice, 12: 366-74. Compton, J., Copeland, K., Flanders, S., Cassity, C., Spetman, M., Xiao, Y., Kennerly, D. (2012) Implementing SBAR across a large multihospital health system. Jt Comm J Qual Patient Saf, Jun,
(6):261-8.
D'Antonio, S., Bagnasco, A., Bonetti, L., Sasso, L.
(2014) Observational study on interruptions during nurses work in two surgical wards of a hospital in Liguria. Prof Inferm, Oct- Dec;67(4):211-8. doi: 10.7429/pi.2014.674211.
De Meester, K., Verspuy, M., Monsieurs, K.G., Van Bogaert, P. (2013) SBAR improves nurse- physician communication and reduces unexpected death: a pre and post intervention study. Resuscitation, Sep;84(9):1192-6. doi: 10.1016/j.resuscitation.2013. 03.016. Epub 2013 Mar 26.
De Oliveira Prates, D., Bauer, A.L., Silva, C. (2016) Interruptions of activities experienced by nursing professionals in an intensive care unit. Rev Lat Am Enfermagem, 24: e2802.
Dimond, B. (2005) Legal aspects of documentation. Abbreviations: the need for legibility and accuracy in documentation. British Journal of Nursing, 14: 665-6
Fox, N.S., Brennan, J.S., Chasen, S.T., Brennan, Chasen. (2008) Clinical estimation of fetal weight and the Hawthorne effect. Eur. J. Obstet. Gynecol. Reprod. Biol., 141 (2): 111–4. doi:10.1016/j.ejogrb.2008.07.023. PMID 18771841.
Giannini, A., Miccinesi, G., Prandi, E. (2012) "˜Opening' ICU: views of ICU doctors and nurses before and after liberalization of visiting policies. Critical Care, 16(Suppl 1):P492
Gordon, M. (2013) Training on handover of patient care within UK medical schools. Medical Education Online, 11;18:1-5.
Hoban, V. (2003) How to. handle a handover. Nursing Times, 99(9): 54-55.
Jeffs, L., Acott, A., Simpson, E., Campbell, H., Irwin, T., Lo, J., Beswick, S., Cardoso, R. (2013) The value of bedside shift reporting enhancing nurse surveillance, accountability, and patient safety. J Nurs Care Qual, Jul-Sep;28(3):226-32. doi: 10.1097/NCQ.0b013e3182852f46.
Kirkeby, O.F. (2004) Det nye lederskabè[The new Leadership]. Bí¸rsens Forlag A/S, Copenhagen. [in Danish]
Kreckler, S., Catchpole, K., Bottomley, M., Handa, A., McCulloch, P. (2008) Interruptions during drug
rounds: an observational study. British Journal of
Nursing, Nov 27-Dec 10;17(21):1326-30. McCarney, R., Warner, J., Iliffe, S., Van Haselen, R., Griffin, M., Fisher, Warner, P. Iliffe, Van Haselen, Griffin, Fisher. (2007) The Hawthorne Effect: a randomised, controlled trial. BMC Med Res Methodol, 7: 30. doi:10.1186/1471-2288-7-30.
PMC 1936999. PMID 17608932.
McGillis, L., Hubley, P., Watson, C. (2010)
Interruption and Pediatric Patient Safety. Jounal
of Pediatric Nursing, 25: 167-175
MeiíŸner, A., Hasselhorn, H.M., Estryn-Behar, M.,
NeÌzet, O., Pokorski, J., Gould, D. (2007) Nurses' perception of shift handovers in Europe: results from the European Nurses' Early Exit Study. Journal of Advanced Nursing, 57(5): 535-42.
Paxton, F., Heaney, D., Howie, J., Porter, B.A. (1996) A study of interruption rates for practice nurses and GPs. Nurs Stand, Jul 17;10(43):33-6.
Raduma-Toma, M., Flin, R., Yule, S., Williams, D. (2011) Doctors' handovers in hospitals: a literature review. BMJ Qual Saf, 20: 128-133.
Riesenberg, L.A., Leitzsch, J., Massucci, J.L. (2009) Residents' and attending physicians' handoffs: a systematic review of the literature. Acad Med, 84: 1775-1787.
Sand-Jecklin, K., & Sherman, J. (2014) A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. J Clin Nurs, Oct;23(19-20):2854-63. doi: 10.1111/jocn.12575. Epub 2014 Mar 8.
Sasangohar, F., Donmez, B., Easty, A.C., Trbovich, P.L. (2015) The relationship between interruption content and interrupted task severity in intensive care nursing: an observational study. Int J Nurs Stud., Oct;52(10):1573-81. doi: 10.1016/j.ijnurstu.2015.06.002. Epub 2015 Jun 17.
Speier, C., Valacich, J.S., Vessey, I. (1999) The influence of task interruption on individual decision making: An information overload perspective. Decision Sciences, March 30,2.
Spooner, A.J., Corley, A., Chaboyer, W., Hammond, N.E., Fraser, J.F. (2015) Measurement of the frequency and source of interruptions occurring during bedside nursing handover in the intensive care unit: An observational study. Australian Critical Care, 28, 19–23
Sí¸rensen, E.E., & Brahe, L. (2014) Interruptions in clinical nursing practice. J Clin Nurs, May;23(9- 10):1274-82. doi: 10.1111/jocn.12329. Epub 2013 Sep 5.
Sí¸rensen, E.E., Delmar, C., Pedersen, B.D. (2011) Leading nurses in dire straits: head nurses' navigation between nursing and leadership roles. J Nurs Manag, May;19(4):421-30. doi: 10.1111/j.1365- 2834.2011.01212.x. Epub 2011 Mar 29.
Toccafondi, G., Albolino, S., Tartaglia, R., Guidi, S., Molisso, A., Venneri, F., Peris, A., Pieralli, F., Magnelli, E., Librenti, M., Morelli, M., Barach, P. (2012) The collaborative communication model for patient handover at the interface between high- acuity and low-acuity care. British Medical Journal, Quality and Safety, 21: 58-66
Tucker, A.L., & Spear, S.J. (2006) Operational failures and interruptions in hospital nursing. Health Serv Res,
Jun;41(3 Pt 1):643-62.
Westbrook, J.I., Woods, A., Rob, M.I., Dunsmuir, W.T.,
Day, R.O. (2010) Association of interruptions with an increased risk and severity of medication administration errors. Arch Intern Med, Apr 26;170(8):683-90. doi: 10.1001/archinternmed. 2010.65.
Wildner, J., & Ferri, P. (2012) The Implementation of the Bedside Handover for the Improvement of Nursing Quality in an Italian Hospice. Journal of Hospice & Palliative Nursing, 14(3): 216-224.
Wilkinson, J., & Lardner, R. (2013) Shift handover after buncefield. Chemical Engineering Transactions, 31: 295-300. DOI: 10.3303/CET1331050