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新生儿机械通气治疗协调中对可预测性的需求——一项定性研究。

The need for predictability in coordination of ventilator treatment of newborn infants--a qualitative study.

作者信息

Solberg Marianne Trygg, Hansen Thor Willy R, Bjørk Ida Torunn

机构信息

Lovisenberg Deaconal University College, Oslo, Norway; Department of Nursing Science, Faculty of Medicine, University of Oslo, Nedre Ullevål 9, Stjerneblokka, 0850 Oslo, Norway.

Department of Neonatal Intensive Care, Women's and Children's Division, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.

出版信息

Intensive Crit Care Nurs. 2015 Aug;31(4):205-12. doi: 10.1016/j.iccn.2014.12.003. Epub 2015 Jan 20.

Abstract

OBJECTIVE

New strategies for interprofessional collaboration are needed to achieve best practice in the care of ventilated newborns. This study explores what physicians and nurses believe to be important to improve collaboration during ventilator treatment.

METHODS

Qualitative data collected from one focus group were analysed using Gittell's theory of relational coordination.

RESULTS

To optimise communication about and coordination of ventilator treatment, six strategies were needed: (1) a pathway toward the goal for each newborn, (2) regular meetings, (3) accurate communication following an established pattern in the rounds conference, (4) collaboration to improve interprofessional level of knowledge, (5) courage to communicate one's own point of view, and (6) flexible responsibility in extubation situations.

CONCLUSION

By identifying weak areas in collaboration, nurses and physicians were inspired to suggest and discuss concrete improvements of work practices in the neonatal intensive care unit. Nurses and physicians can coordinate ventilator treatment by using a pathway and at the same time enhance nurses' involvement and responsibility in order to increase the flexibility of job boundaries, allowing the professions to cover for each other's work.

摘要

目的

为了在机械通气新生儿护理中实现最佳实践,需要新的跨专业协作策略。本研究探讨医生和护士认为在机械通气治疗期间改善协作的重要因素。

方法

使用吉特尔的关系协调理论对从一个焦点小组收集的定性数据进行分析。

结果

为了优化机械通气治疗的沟通与协调,需要六种策略:(1)针对每个新生儿的目标路径;(2)定期会议;(3)在查房会议中按照既定模式进行准确沟通;(4)协作以提高跨专业知识水平;(5)勇于表达自己的观点;(6)在拔管情况下灵活承担责任。

结论

通过识别协作中的薄弱环节,护士和医生受到启发,提出并讨论了新生儿重症监护病房工作实践的具体改进措施。护士和医生可以通过使用路径来协调机械通气治疗,同时提高护士的参与度和责任感,以增加工作界限的灵活性,使各专业能够相互支持工作。

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