SBAR Yotsanangurirwa Nezviyenzaniso Zvechokwadi

Chii chinonzi SBAR?

Pakazara, SBAR inzira yakarongeka yekukurukurirana yakagadzirirwa kupa kuchinjana kwakajeka uye kwakajeka kwemashoko akakosha. Chidimbu chinomirira:

• S - Situation (Mamiriro ezvinhu)
• B - Background (Nhoroondo)
• A - Assessment (Ongororo)
• R - Recommendation (Kukurudzira)

Funga nezvazvo semufananidzo wemubvunzo. Inovimbisa kuti mashoko ese akakosha anopiwa mune yakarongwa uye yakatarisirwa, ichibvisa kufungidzira uye ichidzikisa mukana wezviyeuchidzo zvakakosha kusafarirwa.

Kunyangwe zvichinyatsogadzirirwa nyika inomhanyisa yemishonga, chimiro cheSBAR chine nyaya yekuvapo inoshamisa: US Navy. Yakatanga kugadzirwa kuti ive nechokwadi chekukurukurirana kwakakwana pachikepe chenyukireya, uko rairo imwe chete isina kunzwisiswa inogona kuva nemhedzisiro yakaipa. Hondo yaida nzira yakavimbika yekutumira mashoko akakurumidza kumusoro mukati mehurongwa hweurongwa, uye SBAR ndiyo yaiva mhinduro.

Kuziva kugona kwayo, muvambi wemishonga Kaiser Permanente akagadziridza chishandiso cheSBAR kune zvigadzirwa zvekiriniki mukutanga kwe2000s kuti avandudze kukurukurirana kuchengetedza varwere. Nhasi, inotsigirwa nemasangano akaita seWorld Health Organization uye ipfungwa yekukurukurirana kunoshanda pakati pevanamukoti navanachiremba nekubatana kwechikwata pasi rese.

Manondo Mana eSBAR: Tsanangudzo Yakadzama

Runako rwemuenzaniso wekukurukurirana kweSBAR iri mukurukurama kwayo. Tsamba imwe neimwe inokukumbira kuti upe chimedu chetsanangudzo, uchisika mufananidzo wakazara wekiriniki kune anoteerera. Ngatitsanangurei chimiro cheMamiriro ezvinhu, Nhoroondo, Ongororo, Kukurudzira chimedu nechimedu.

S - Mamiriro ezvinhu: “Ndeiyi dambudziko razvino.”

Iyi ndiyo musoro wako wenhau. Iri ndiro chirevo chimwe chete, chakaomarara chinokwezva pakarepo kutarisisa kwemuteereri uye chinotaura dambudziko.

• Uyu ndiani uye uripi: “Ndiri Sarah, namukoti akanyoreswa muchikamu chekudzikama kwemoyo.”
• Murwere ndiani: “…ndichifonera VaJohn Doe mumba 412.”
• Chikonzero chaunokurukurirana nacho: “…ndine hanya nekuderera kamwe kamwe kwe BP yangu uye nechichemo chavo chekurwadziwa kwakanyanya muchipfuva.”

Chinangwa ndechekugadzira hurukuro mumaminitsi anodarika 15. Munhu ari kune rimwe divi anobva aziva kuti uri ani, kuti murwere upi waunotaura naye, uye nei zvichikurumidza.

B - Nhoroondo: “Ndeiyi ruzivo rwakakodzera.”

Zvino sezvo wava nechimiro chavo, peedza chete mashoko akakodzera zvikuru ane chekuita nemamiriro ezvinhu. Iri harisi nguva yekuvhiya kwemurwere kuzara. Gara pamashoko akakosha anodiwa kuti unzwisise dambudziko.

• Diagnosis yekubvumidzwa uye Zuva: “VaDoe vakaiswa mazuva maviri apfuura nekuda kwe myocardial infarction.”
• Nhoroondo Yakakodzera Yemishonga: “Vaine nhoroondo ye hypertension uye Type 2 chirwere cheshuga.”
• Pfupiso Pfupi yeKurapa kusvika Nhasi: “Vakagamuchira Cardiac stent placement nezuro. Chiziviso chavo chepost-op chaive chakadzikama kusvika zvino.”
• Zvazvino Zvibvumirano Zvakanyanya Zvekurarama: “BP yavo yaive 120/80 awa rapfuura; zvino iri 85/50. Kutsvedzera kwavo kwemoyo kuri 110.”
• Mushonga Wakakodzera: “Vari paheparin drip uye beta-blocker.”

A - Ongororo: “Ndiwo maonero angu.”

Iyi ndiyo nzvimbo yaunogovera nehunyanzvi hwako hwekliniki. Pakati pemamiriro ezvinhu nenzara, unotenda kuti dambudziko nderei? Nhanho iyi yakakosha kuratidza kufunga kwako kwekiriniki uye inovaka mufananidzo wakajeka.

• Taura Chibvumirano Chako: “Ndinotenda kuti murwere anogona kunge achiona cardiogenic shock” kana “Ndinotenda kuti ari kuona chiitiko chemoyo chakanyanya.”
• Kana Usina Chokwadi, Taura Zvakadaro: “Handina chokwadi kuti dambudziko ndereipi, asi mamiriro avo anoita sekuderera nekukurumidza.”
• Zvimiro Zvakakosha Zviratidzo: “Ganda ravo raitonhora uye rakaoma, uye vanooneka vane hanya.”

Ongororo yako inopa chiremba kana mubatsiri nzvimbo yekutangira yakakosha uye inoratidza kuti wakaongorora zvakadzama data.

R - Kukurudzira: “Ndinoda izvi kubva kwauri.”

Iyi ndiyo yekudaidzira kuti chiito. Chii chaunoda kuti mumwe munhu aite? Iva wakajeka, wakajeka, uye wakakwana. Izvi zvinogona kuva zvakaoma, kunyanya kune vanamukoti vatsva, asi zvingangoita kuti ndiwo danho rakanyanya kukosha. Iwe uri mutsigiri wemurwere.

• Ita Chikumbiro Chakatarwa: “Ndinoda kuti uuye uone murwere pakarepo.”
• Kurudzira Nzira Yechiito: “Ndinokurudzira kuti tigamuchire stat EKG uye chest x-ray” kana “Unoda kupa mvura yakawanda here?”
• Tsanangura Chirongwa: “Ndinogona kutarisira kuti iwe ugouya riini? Ndifanire kuita chero zvinhu ndichimirira?”

Kukurudzira kunovimbisa kuti hurukuro inopera nechirongwa chakajeka, ichivhara mudenderedzwa uye ichitanga chiito.

SBAR Pakushanda: Zviyenzaniso zveKiriniki Hupenyu Hwechokwadi

Kuona nzira yeSBAR pakushanda ndiyo nzira yakanakisisa yekunzwisisa simba rayo. Hezvino zviyenzaniso zvishoma zvakajairika.

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SBAR Chiyenzaniso 1: Namukoti kuna Chiremba (Mamiriro Akakomba)

Namukoti Jessica anoFonera Dr. Evans pamusoro pemurwere ane mamiriro ake akawedzera.

(S) Mamiriro ezvinhu: “Dr. Evans, uyu ndiJessica, RN pachikamu chekuvhiya. Ndiri kufonera murwere wenyu, Mai Smith mumba 204. Ndine hanya nekushatirwa kwavo kunowedzera uye fivha diki.”

(B) Nhoroondo: “Ndivo mukadzi ane makore 65, mazuva maviri mushure mekuvhiyiwa kwecolectomy. Vakanga vari kupora zvakanaka, asi mumwaka wekupedzisira maviri, kurwadziwa kwavo kwawedzera kubva pa4/10 kusvika pa8/10, uye hazvitsvambuki nemorphine yavo yakasarudzwa. Chiyero cheavo chave 101.2°F (38.4°C), uye dumbu ravo rine hasha uye rinorwadza pakubata.”

(A) Ongororo: “Ndinotenda kuti vanogona kunge vachiona peritonitis kana kuvuza kweanastomotic. Zvibvumirano zvavo zvekurarama zviri kutongwa nekuenda mune zvisina kunaka.”

(R) Kukurudzira: “Ndinotenda kuti unofanirwa kuuya kuzovatarisa pakarepo. Ndifanire kupa stat abdominal CT scan nemabasa mukati memusangano?”

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SBAR Chiyenzaniso 2: Namukoti kuna Namukoti (Chinzvimbo Chekufambidzana)

Namukoti Tom ari kupa mushumo wekutumirwa kwechinzvimbo kuna Namukoti Maria.

(S) Mamiriro ezvinhu: “Mhoro Maria, ndiri kupa VaDavis mumba 310. Vane simba, asi tanga tiri kuongorora zvakanyanya mamiriro avo ekufema.”

(B) Nhoroondo: “Ndiye murume ane makore 72 akaiswa nezuro nekuda kwe community acquired pneumonia. Vane nhoroondo yeCOPD. Parizvino vari pa2 litasi eroxygen kuburikidza nemhino cannula, uye O2 sats avo anga ari kusimba pa94%. Dose yavo yekupedzisira ye IV antibiotics yaive na4 PM.”

(A) Ongororo: “Mapapu avo anoita seasina kusimba asi akajeka kubva kumvura. Vane kufema zvakanaka uye vakachenjera uye vanozivana. Zvibvumirano zvavo zvekurarama zvakagadzikana. Pakazara, vanoita sekupindura nemazvo kurapwa, asi COPD yavo inovaita kuti vave nemamwe matambudziko.”

(R) Kukurudzira: “Ndinokurudzira kuenderera mberi nekutarisa O2 saturation yavo maawa maviri. Dose yavo inotevera yeantibiotics iri due na10 PM. Ndapota fonerai respirator therapist kana basa ravo rekufema rikawedzera kana sats avo kuderera pasi pe92%.”

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Kubatsirwa kweKubatanidza SBAR Mukushanda Kwako

Kugamuchira chimiro cheSBAR hakungori kungodzidza chidimbu chitsva; kungogadziridza zvakanyanya kuti isu tinorapa sei varwere. Kubatsirwa kwakajeka uye kwakadzama:

• Inovandudza Kuchengetedza Varwere: Nekugadziridza kuchinjana kwemashoko akakosha, SBAR inoderedza njodzi yemashandisirwo akashata emishonga achikonzerwa nekusanzwisisana. Inosika neti yekuchengetedza kuti ivimbise kuti zviyeuchidzo zvakakosha hazvifari.
• Inosimbisa Kurongeka uye Kushanda: SBAR inobvisa kutaura kwakareba uye inoenda kunongedzero. Iri rakakosha mumamiriro ekukurumidzira apo masekondi ega ega akaverengerwa. Inobatanidza mukana wekukurukurirana pakati pevanamukoti, vanowanzofunga zvakajeka, navanachiremba, vanowanzoda nzira ye “zvakanaka zvemashoko”.
• Inogadziridza Kukurukurirana: Kunyange uri mudzidzi mutsva kana kuti ane makore 30 ekuberekwa, chishandiso cheSBAR chinopa mutauro wakajairika. Kusagadzikana uku pakati pezvidzidzo nezvimwewo zvezviitiko kunovaka tsika yekukurukurirana yakajeka, yakatarisirwa yeSBAR.
• Inosimbisa Vashandi veKiriniki: Danho re “Kukurudzira” muSBAR nursing rinopa vanamukoti simba rekutaura maonero avo ehunyanzvi uye kutsigira varwere vavo. Inovashandura kubva pakutaura kwepasivhi kwedata kuita vanhu vanoshanda mukurongwa kwekutarisira.
• Inosimbisa Kubatana: Paunenge munhu wese achishandisa mutambo wakafanana wekukurukurirana, zvinovaka kuvimba uye zvinogadzira modhi yemepfungwa yakagovaniswa. Iyi ndiyo nheyo yekukurukurirana kunoshanda pakati pevanamukoti navanachiremba uye zvikwata zvemishonga zvine kushanda kwakanyanya.

Mazano Ekubata Nzira yeSBAR

Senge chero hunyanzvi, kushandisa SBAR nemazvo kunoda kudzidzira. Hezvino mazano mashoma ekukubatsira kuti uibate:

1. Gadzirira Usati Wataura: Usati watora foni kana kupinda mukamuri, tora masekondi makumi matatu kuti uronge mafungiro ako. Iva nechitsiviso chemurwere, zviyeverero zvazvino zvekurarama, uye zvabuda mumabasa ari pamberi pako. Nyora mapoinzi ako eSBAR pachitsimiro kana zvichibatsira.
2. Iva Wakaomarara asi Wese: Chinangwa ndechekupfupisa, kwete kusiya mashoko akakosha. Tarisa pane izvo zvine chekuita nemamiriro ezvinhu azvino. Dzivisa kutsvedzama kune zviyeuchidzo kubva mazuva matatu apfuura kunze kwekunge zvichipesana nedambudziko razvino.
3. Dzidzira, Dzidzira, Dzidzira: Ronga zviyenzaniso zveSBAR nevakwikwidzani vako. Ivashandise kune zvitsva zvisina kukurumidza kuti ugare wakasununguka nechimiro. Paunonyanya kuishandisa, ndipo paunonyanya kuva chikamu chenzira yako yekukurukurirana.
4. Usatye Kuita Kukurudzira: Iri rinowanzova danho rakaoma kune vadzidzi navanamukoti vatsva. Yeuka, kukurudzira kwako kunogona kungova nekuti, “Ndinoda kuti uuye uone murwere ikozvino,” kana kuti, “Ndinotenda kuti tinofanira kuwana chechipiri maonero.” Uri pamutsetse wekutanga, uye ongororo yako yakakosha.

Chibvumirano

Mune zvakabikwa uye kazhinji zvakaparadzana zvakagadzirirwa zvekurapa, kurongeka kwakatsveyamira - uye zvakare chinhu chakakosha chekuchengetedza murwere. Chimiro cheSBAR chinopfuura kungova chidimbu; ichishandiso chinochengetedza hupenyu chinorongedza hurukuro, chinosimbisa vanachiremba, uye chinodzivirira varwere.

Nekutora maminetsi mashoma kurongeka mafungiro ako muMamiriro ezvinhu, Nhoroondo, Ongororo, Kukurudzira chimiro, unovimbisa kuti meseji yako haingotumirwi chete asiwo kugamuchirwa, kunzwisiswa, uye kutarisirwa.

Wakagadzirira kuishandisa? Nguva inotevera paunoda kurukura update yemurwere, tora chinyorwa che sticky uye nyorora yako S, B, A, uye R. Uchashamiswa nezvinoita zvishoma zvakarongeka zvinounza kurongeka kwakawanda.