การพัฒนาคุณภาพการสื่อสารสำหรับการเคลื่อนย้ายผู้ป่วย จากหน่วยอุบัติเหตุและฉุกเฉินไปหอผู้ป่วยใน โรงพยาบาลปาย จังหวัดแม่ฮ่องสอน

Abstract

Ineffective handoff communication between units will lead to medical errors and adverse events in an emergency unit. Thus, it is imperative for enhancing the quality of the handoff process between emergency units. This developmental study aimed to improve the communication process of the patient transfer from an emergency unit to an inpatient ward of Pai hospital, Mae Hong Son Province. Study methodology was guided by the FOCUS PDCA quality improvement process (Deming, 1993) which consisted of nine steps: identify a process that needs to be improved; organize a team that knows the process; clarify the current process; understand causes of variation in the process; select the processes that require improvement; plan for improvement; implement the plan; check for practice process; and act to maintain and continue the improvement. The study sample included 7 registered nurses. The research instruments included interview guidelines and the handoff communication observation checklist. Data were analyzed by using descriptive statistics. Results showed that after using the FOCUS-PDCA process, mnemonic SBAR (Situation, Background, Assessment, Recommendation) to improve the quality of communication between units, all registered nurses could comply with the handoff protocol and send patients’ information completely and correctly. As a result, the quality of the handoff process from the Emergency Unit to the Inpatient Ward improved. Nurses were satisfied with the improvement of the nursing handoff process and required to improve some problems that were found in the process. The problems included: 1) information transfer between nurses within the Emergency Unit was not effective which resulted in handoff communication delay, and 2) the recipient did not pay attention during the sending nurse’s patient status report. The results of this study showed that the use of the FOCUS PDCA process and SBAR technique are effective and useful to improve the handoff process between units. Nursing administrators can use these methods to improve the quality of communication of units and departments within and outside of hospitals.