基于ISBAR沟通模式在儿童急诊医护一体化中的应用研究

Research on the Application of ISBAR Communication Model in the Integration of Medical and Nursing Care in Pediatric Emergency Department

摘要: 目的：探讨ISBAR标准化沟通模式在儿童急诊科医护一体化实践中的应用效果，评价其对提升沟通效率、保障患者安全、改善团队协作及提高医护满意度的临床价值。方法：选取2025年1月至6月我院儿童急诊科实施常规沟通模式的医护团队及对应患儿作为对照组，2025年7月至12月实施基于ISBAR的医护一体化沟通模式的团队及患儿作为观察组。比较两组在交接班耗时、信息传递完整率、医嘱开具及时性、不良事件发生率以及医护人员的沟通满意度等方面的差异。结果：观察组在交接班耗时上显著短于对照组(P < 0.05)，信息传递完整率、医嘱开具及时率显著高于对照组(P < 0.01)。观察组的不良事件(如用药错误、识别延迟)发生率显著降低(P < 0.05)。医护人员的团队协作效能与工作满意度评分均显著高于对照组(P < 0.01)。结论：将ISBAR标准化沟通模式嵌入儿童急诊科的医护一体化工作流程中，能有效构建高效、精准、结构化的沟通桥梁，显著降低沟通缺陷导致的风险，提升医疗质量与护理安全，是优化儿童急危重症救治流程的重要策略，具有显著的临床应用与推广价值。

Abstract: Objective: To explore the application effect of the ISBAR standardized communication model in the practice of integrated medical and nursing care in pediatric emergency departments, and to evaluate its clinical value in improving communication efficiency, ensuring patient safety, enhancing team collaboration, and enhancing satisfaction among medical and nursing staff. Method: We selected the medical and nursing teams and corresponding pediatric patients who implemented the conventional communication mode in our pediatric emergency department from January to June 2025 as the control group, and the teams and pediatric patients who implemented the integrated medical and nursing communication mode based on ISBAR from July to December 2025 as the observation group. We compared the differences between the two groups in terms of shift handover duration, completeness rate of information transmission, timeliness of medical orders issuance, incidence rate of adverse events, and communication satisfaction of medical and nursing staff. Results: The observation group exhibited a significantly shorter shift handover time compared to the control group (P < 0.05), and demonstrated significantly higher rates of complete information transmission and timely issuance of medical orders than the control group (P < 0.01). The incidence of adverse events (such as medication errors and delayed recognition) was significantly reduced in the observation group (P < 0.05). Both the team collaboration effectiveness and job satisfaction scores of medical staff were significantly higher in the observation group than in the control group (P < 0.01). Conclusion: Integrating the ISBAR standardized communication model into the integrated medical and nursing workflow in pediatric emergency departments can effectively establish an efficient, precise, and structured communication bridge, significantly reducing risks caused by communication deficiencies and enhancing medical quality and nursing safety. It is an important strategy for optimizing the treatment process of pediatric acute and critical illnesses, and holds significant clinical application and promotion value.