การพัฒนาคุณภาพการสื่อสารสำหรับการเคลื่อนย้ายผู้ป่วยระหว่าง หน่วยวิสัญญีและห้องพักฟื้น โรงพยาบาลมหาราชนครเชียงใหม่

Abstract

Continuity of care and patient safety are enhanced with effective communication between nurses in the anesthesia unit and recovery room. The purpose of this study was to improve communication at the time of handoff between nurses in the anesthesia unit and recovery room at Maharaj Nakorn Chiang Mai Hospital. Study methodology was guided by the FOCUS PDCA quality improvement process (Deming, 1993) which consisted of nine steps: find a process to improve; organize a team that knows the process; clarify current knowledge of the process; understand causes of process variation; select the processes improvement; plan the improvement; do the improvement; check the result, data collection and analysis; and act to hold the gain and continue improvement. The study sample included 10 registered nurses in the anesthesia unit. The research instruments included interview guidelines and the handoff communication observation checklist. Data were analyzed by descriptive statistics. The researcher used the FOCUS PDCA process to guide development a handoff protocol between nurses in the anesthesia unit and the recovery room as well as a handoff form. The anesthesia nurses were trained in the handoff protocol and all were encouraged to comply with the protocol. Following training, 99% of anesthesia nurses were compliant with the protocol. While the quality of communication at handoff times between nurses in the two units improved, some problems occurred between the senders and receivers during the handoff process. Sending nurses did not have sufficient time to complete all items in the handoff form and failed to provide essential patient data to receiving nurses. Problems identified with the receiving nurses included lack of time to have a handoff discussion and not paying attention during the discussion as sending nurses explained patient status.

This study demonstrates an improvement in handoff communication between nurses in anesthesia unit and recovery room through FOCUS PDCA, handoff communication protocol and handoff communication form. Nursing administrators can apply this improvement methodology to improve communication between departments within and outside the hospital.