소아심장외과 중환자실에서의 실무의사소통 프로토콜이 수술 후 성과에 미치는 영향

• Published in: Kanho Haengjŏng Hakhoe chi = The journal of Korean Nursing Administration Academic Society Vol. 21; no. 3; pp. 243 - 253
• Main Authors: 엄주연(Ju Yeon Uhm), 이월숙(Worl Sook Lee)
• Format: Journal Article
• Language: Korean
• Published: 한국간호행정학회 2015
• Subjects: Heart defects; Intensive Care Units; Health Care; 성과연구; Congenital; 선천성 심질환; Patient handoff; 중환자실; 환자인수인계; Outcome Assessment
• ISSN: 1225-9330; 2288-4955

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.