Contenuto dell'articolo principale
Abstract
INTRODUZIONE: Il passaggio delle consegne tra il personale del servizio di emergenza 118 e il personale di Medicina e Chirurgia d'Urgenza (MeCHAU) è fondamentale per la continuití delle cure per il paziente. Lo studio si pone l'obiettivo di indagare le modalití di passaggio di consegne dall'èquipe sanitaria dall'ambulanza agli infermieri del MeCHAU del Policlinico di Bari per verificare se è stato applicato e, se si, in quale misura sia stato utilizzato il metodo SBAR ("Situation", "Background", "Assessment", "Recommendation") raccomandato sia in letteratura sia dall' Organizzazione Mondiale della Sanití (OMS).
METODO: E' stata creata una scheda riferita al metodo SBAR ed è stata applicata in tutti i casi di trauma e di malore accettati dal MeCHAU nel periodo compreso tra Luglio-Agosto 2017.
Per ogni caso sono stati valutati: orario d'inizio e di fine consegna, tempo totale, codice-colore assegnato dal 118, codice-colore assegnato dal MeCHAU, tipo di ambulanza assegnata.
RISULTATI: In totale sono stati considerati 140 passaggi di consegne. Di queste è stato valutato il tempo medio in relazione al codice-colore (in minuti), il numero di informazioni ricevute in base al codice-colore, se è stato oppure no rispettato l'ordine SBAR e la completezza delle consegne in base al tipo di ambulanza assegnata dal 118.
CONCLUSIONI: Dai risultati ottenuti si è dimostrato la trasmissione delle consegne non avviene in maniera efficace, determinando tempi prolungati e bassa percentuale di informazioni fornite per tutti i codici-colore. Ne deriva che l'utilizzo della metodica SBAR nel passaggio delle consegne potrebbe migliorare l'efficacia dell'intervento e rendere la consegna completa, sintetica e ordinata.
Parole chiave: Sistema Emergenza 118; Consegne; Metodo SBAR; Pronto Soccorso.
Observational study of the handover with the SBAR method at Bari Polyclinic complex
INTRODUCTION: The handing over of deliveries between the emergency service personnel 118 and the Emergency Medicine and Surgery staff (MeCHAU) is fundamental for the continuity of care for the patient. The study aims to investigate the methods of handing over medical staff from the ambulance to the MeCHAU nurses of the Policlinico di Bari to verify if it has been applied and, if so, to what extent the SBAR method has been used ("Situation", "Background", "Assessment", "Recommendation") recommended both in literature and by the World Health Organization (WHO).
METHOD: A card was created referring to the SBAR method and was applied in all cases of trauma and illness accepted by the MeCHAU in the period between July-August 2017.
For each case, the following were evaluated: start and end delivery times, total time, color code assigned by 118, color code assigned by MeCHAU, type of ambulance assigned.
RESULTS: A total of 140 deliveries were considered. Of these, the average time in relation to the color code (in minutes), the number of information received based on the color code, whether or not the SBAR order was complied with and the completeness of deliveries based on the type was evaluated. of ambulance assigned from 118.
CONCLUSIONS: From the results obtained, the transmission of deliveries has not been shown to be effective, resulting in prolonged times and a low percentage of information provided for all color codes. It follows that the use of the SBAR method in the handing over of deliveries could improve the effectiveness of the intervention and make the delivery.
KEYWORDS: Deliveries; Emergency System118; First Aid; SBAR method.
Dettagli dell'articolo
Riferimenti
- Agency for Healthcare Research and Quality: Hospital survey on patient safety culture: 2009 comparative database report, Rockville (MD), 2009.
- Arizona Hospital and Healthcare Association. SBAR Communication Standardization in Arizona. Implementation Tool Kit. 2007. http://finance.azhha.org/patient_safety/ documents/SBARtoolkit_001.pdf
- Catchpole K, Sellers R, Goldman A et al. (2010). Patient handovers within the hospital: translating knowledge from motor racing to healthcare. Qual Saf Health Care,19, 318-322.
- Jeffcott, SA, Evans, SM, Cameron, PA et al. (2009). Improving measurement in clinical handover. Qual Saf Health Care, 18, 272-276. doi: 10.1136/qshc.2007.024570.
- Joint Commission. (2008). Joint Commission Resoucers: Handoff communications: Toolkit for implementing the National Patient Safety Goal. Visionato il 10 agosto 2017.
- Lally, S. (1999). An investigation into the functions of nurses' communication at the inter-shift handover. Journal of Nursing Management, 7(1), 29-36.
- Leape, L. L. (2002). Reporting of adverse events. The New England Journal of Medicine, 347(20), 1633-1638.
- Patterson, E. S., & Wears, R. L. (2010). Patient handoffs: Standardized and reliable measurement tools remain elusive. Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources, 36(2), 52-61.
- Pezzolesi, C., Schifano, F., Pickles, J., Randell, W., Hussain, Z., Muir, H., et al. (2010). Clinical handover incident reporting in one UK general hospital. International Journal for Quality in Health Care. Journal of the International Society for Quality in Health Care, 22(5), 396-401. doi: 10.1093/intqhc/mzq048.
- Philibert I, Supervision, preoccupation with failure, and the cultural shift in patient handover, J Grad Med Educ 2010; 2 (1): 144-145. doi: 10.4300/JGME-D-10-00015.1.
- Raduma-Toma, M, Flin R, Yule S, Williams D. (2011). Doctors' handovers in hospitals: a literature review. BMJ Qual Saf, 20, 128-133. doi: 10.1136/bmjqs.2009.034389.
- Riesenberg, LA, Leitzsch, J, Massucci, JL et al. (2009). Residents' and attending physicians' handoffs: a systematic review of the literature. Acad Med, 84, 1775-1787. doi: 10.1097/ACM.0b013e3181bf51a6.
- Riesenberg, LA, Leisch, J, Cunningham, JM. (2010) Nursing handoffs: a systematic review of the literature. American Journal of Nursing, 110, 24-34. doi: 10.1097/01.NAJ.0000370154.79857.09.
- Safe handover: safe patients' guideline (AMA, 2006), United Kingdom National Patient Safety Agency (2004), The ossie guide to clinical handover improvement – Australian commission on safety and quality inhealth care (2009)
- Trentham, B, Andreoli, A, Boaro, N, Velji, K, Fancott, C. (2010). SBAR: a shared structure for effective team communication. An implementation toolkit 2nd Edition. The Toronto Rehabilitation Institute and the Canadian Patient Safety Institute 2010.
- Vitale, E. (2014). Clinical teaching models for nursing practice: a review of literature. Professioni Infermieristiche 67(2), 117-25. doi: 10.7429/pi.2014.672117.
- Vitale, E., Germini, F., Massaro, M., Fortunato, R.S.. (2019). Nursing perception on patient safety culture: the latest methodological approaches. Journal of Health Medicine and Nursing 62, 90-100. doi: 10.7176/JHMN
- World Health Organization. Patient Safety 1. 2007. http://www.who.int/patientsafety. Ultimo accesso 10 agosto 2017
Riferimenti
Agency for Healthcare Research and Quality: Hospital survey on patient safety culture: 2009 comparative database report, Rockville (MD), 2009.
Arizona Hospital and Healthcare Association. SBAR Communication Standardization in Arizona. Implementation Tool Kit. 2007. http://finance.azhha.org/patient_safety/ documents/SBARtoolkit_001.pdf
Catchpole K, Sellers R, Goldman A et al. (2010). Patient handovers within the hospital: translating knowledge from motor racing to healthcare. Qual Saf Health Care,19, 318-322.
Jeffcott, SA, Evans, SM, Cameron, PA et al. (2009). Improving measurement in clinical handover. Qual Saf Health Care, 18, 272-276. doi: 10.1136/qshc.2007.024570.
Joint Commission. (2008). Joint Commission Resoucers: Handoff communications: Toolkit for implementing the National Patient Safety Goal. Visionato il 10 agosto 2017.
Lally, S. (1999). An investigation into the functions of nurses' communication at the inter-shift handover. Journal of Nursing Management, 7(1), 29-36.
Leape, L. L. (2002). Reporting of adverse events. The New England Journal of Medicine, 347(20), 1633-1638.
Patterson, E. S., & Wears, R. L. (2010). Patient handoffs: Standardized and reliable measurement tools remain elusive. Joint Commission Journal on Quality and Patient Safety / Joint Commission Resources, 36(2), 52-61.
Pezzolesi, C., Schifano, F., Pickles, J., Randell, W., Hussain, Z., Muir, H., et al. (2010). Clinical handover incident reporting in one UK general hospital. International Journal for Quality in Health Care. Journal of the International Society for Quality in Health Care, 22(5), 396-401. doi: 10.1093/intqhc/mzq048.
Philibert I, Supervision, preoccupation with failure, and the cultural shift in patient handover, J Grad Med Educ 2010; 2 (1): 144-145. doi: 10.4300/JGME-D-10-00015.1.
Raduma-Toma, M, Flin R, Yule S, Williams D. (2011). Doctors' handovers in hospitals: a literature review. BMJ Qual Saf, 20, 128-133. doi: 10.1136/bmjqs.2009.034389.
Riesenberg, LA, Leitzsch, J, Massucci, JL et al. (2009). Residents' and attending physicians' handoffs: a systematic review of the literature. Acad Med, 84, 1775-1787. doi: 10.1097/ACM.0b013e3181bf51a6.
Riesenberg, LA, Leisch, J, Cunningham, JM. (2010) Nursing handoffs: a systematic review of the literature. American Journal of Nursing, 110, 24-34. doi: 10.1097/01.NAJ.0000370154.79857.09.
Safe handover: safe patients' guideline (AMA, 2006), United Kingdom National Patient Safety Agency (2004), The ossie guide to clinical handover improvement – Australian commission on safety and quality inhealth care (2009)
Trentham, B, Andreoli, A, Boaro, N, Velji, K, Fancott, C. (2010). SBAR: a shared structure for effective team communication. An implementation toolkit 2nd Edition. The Toronto Rehabilitation Institute and the Canadian Patient Safety Institute 2010.
Vitale, E. (2014). Clinical teaching models for nursing practice: a review of literature. Professioni Infermieristiche 67(2), 117-25. doi: 10.7429/pi.2014.672117.
Vitale, E., Germini, F., Massaro, M., Fortunato, R.S.. (2019). Nursing perception on patient safety culture: the latest methodological approaches. Journal of Health Medicine and Nursing 62, 90-100. doi: 10.7176/JHMN
World Health Organization. Patient Safety 1. 2007. http://www.who.int/patientsafety. Ultimo accesso 10 agosto 2017