基于SBAR的质量改进方案在产科床边交接班中的应用研究

Application of SBAR-Based Quality Improvement Plan in Bedside Shift Handover in Obstetrics

摘要: 目的：探讨基于SBAR (情境–背景–评估–建议)质量改进方案在产科床边交接班中的应用效果，提高交接班质量和患者满意度。方法：选取2023年4月至2024年9月在我院产科分娩的产妇共240例，分为对照组(120例)和试验组(120例)。对照组实施常规交接班方式，试验组采用基于SBAR的改进方案。观察指标包括护士交接班评分表得分、交接班不合格率、护士满意度量表得分及患者满意度量表得分，统计学分析采用独立样本t检验和卡方检验。结果：干预后试验组护士交接班评分显著高于对照组(94.87 ± 2.34 vs. 81.45 ± 3.67, t = 26.32, P < 0.001)，交接班不合格率显著降低(2.5% vs. 18.3%, χ² = 15.87, P < 0.001)。护士满意度量表得分(79.56 ± 4.12 vs. 64.89 ± 5.14, t = 20.45, P < 0.001)和患者满意度量表得分(81.32 ± 3.76 vs. 66.43 ± 5.31, t = 21.56, P < 0.001)均显著提升。结论：基于SBAR的质量改进方案有效提高了产科床边交接班质量和满意度，具有临床推广价值。

Abstract: Objective: To explore the application effect of SBAR (context-context-assessment-recommendation) quality improvement plan in bedside shift handover in obstetrics, and improve shift handover quality and patient satisfaction. Methods: A total of 240 pregnant women who delivered in our hospital from April 2023 to September 2024 were selected and divided into control group (120 cases) and experimental group (120 cases). The control group implemented a routine shift handover method, while the experimental group adopted an improvement plan based on SBAR. Observation indicators included the scores of the nurse handover scoring scale, the unqualified rate of handover, the scores of the nurse satisfaction scale and the scores of the patient satisfaction scale. Independent sample t-test and chi-square test were used for statistical analysis. Result: After intervention, the handover score of nurses in the experimental group was significantly higher than that in the control group (94.87 ± 2.34 vs. 81.45 ± 3.67, t = 26.32, P < 0.001), and the failure rate of handover was significantly reduced (2.5% vs. 18.3%, χ² = 15.87, P < 0.001). The scores of nurse satisfaction scale (79.56 ± 4.12 vs. 64.89 ± 5.14, t = 20.45, P < 0.001) and patient satisfaction scale (81.32 ± 3.76 vs. 66.43 ± 5.31, t = 21.56, P < 0.001) were significantly improved. Conclusion: The SBAR-based quality improvement plan can effectively improve the quality and satisfaction of bedside handover in obstetrics, and has clinical promotion value.