基于ISBAR沟通模式提高儿童急诊科护士 抢救室交接班完整率的品管圈实践

Quality Control Circle Practice Based on the ISBAR Communication Model to Improve the Completeness Rate of Shift Handover in the Rescue Room for Nurses in the Pediatric Emergency Department

摘要: 目的：运用品管圈质量管理工具，构建基于ISBAR沟通模式的儿童急诊抢救室交接班标准化流程，提高交接班完整率。方法：2025年12月~2026年5月，曲靖市妇幼保健院儿童急诊科成立“童安脉动圈”，按照品管圈十大步骤推进：主题选定、活动计划拟定、现状把握、目标设定、解析、对策拟定、对策实施与检讨、效果确认、标准化、检讨与改进。通过根因分析明确交接班遗漏的关键要因，设计儿科抢救室专用ISBAR交接核查表，实施“培训–演练–督查–反馈”的闭环改进策略。结果：实施后抢救室交接班完整率由72.5%提升至94.8%，目标达成率112.3%，进步率30.8%；圈员品管圈手法运用能力、团队协作能力及问题解决能力均显著提升。结论：品管圈活动能有效整合ISBAR结构化沟通工具与儿科急诊抢救室工作特点，系统提升交接班质量，其标准化成果可作为护理质量持续改进的范例推广。

Abstract: Objective: To utilize quality management tools from the quality control circle to establish a standardized shift handover process for the pediatric emergency room based on the ISBAR communication model, thereby improving the completeness rate of shift handovers. Method: From December 2025 to May 2026, the Children’s Emergency Department of Qujing Maternity and Child Health-Care Hospital established the “Tong’an Pulse Circle” and promoted it according to the ten steps of quality management circles: theme selection, activity plan drafting, current situation grasp, goal setting, analysis, countermeasure drafting, countermeasure implementation and review, effect confirmation, standardization, review and improvement. Through root cause analysis, the key factors leading to omissions during shift handovers were identified, and a dedicated ISBAR handover checklist for the pediatric emergency room was designed. A closed-loop improvement strategy of “training-drilling-supervision-feedback” was implemented. Results: After the implementation of the results, the completeness rate of shift handover in the emergency room increased from 72.5% to 94.8%, with a target achievement rate of 112.3% and a progress rate of 30.8%. The ability of circle members to apply quality control circle techniques, team collaboration skills, and problem-solving abilities have all significantly improved. Conclusion: Quality control circle activities can effectively integrate the ISBAR structured communication tool with the work characteristics of pediatric emergency rooms, systematically improve the quality of shift handover, and its standardized achievements can be promoted as a paradigm for continuous improvement of nursing quality.