With the evolution of healthcare, patient handovers have become not only a concern in Ontario, but an international concern. The handover (or handoff), also known as a critical transfer point, is the communication between units and healthcare teams that involves the transition of patient information. During a period of care, a patient can potentially be treated by multiple healthcare members in various clinical settings across the continuum of care. The handoff can occur between specialized outpatient, emergency, surgical, and intensive care units and include encounters with numerous staff members at each interval. Some nursing units transfer or discharge their patients at a rate of 40-70% everyday (Friesen, White & Byers, 2009). Consequently,
Recovery Nurse – The patient was transitioned from the operating room to the recovery room. As previously noted, there is no formal hand off process from one area to another within the ambulatory surgical center. The recovery nurse attempted to locate the mother in the waiting area. As noted above, there was no hand off of the mother’s cell phone number or alternate contact information.
The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk.
There are handovers in hospitals among all professions – physicians, nurses, pharmacists, and other team members – to provide 24-hour care to patients. The rotating schedule and vast array of professionals that provide care leaves room for a large margin of error. This means that teams caring for patients overnight often are not as familiar with individual patients and rely heavily on ''signout,'' a practice where physicians relay information about their patients, including current and anticipated problems, to other physicians providing care overnight or on weekends and holidays. It also means that after a critical event, it may take the team longer to identify the potential causes for a particular
Handoffs during shift change between nurses is one of the most important ways to communicate essential information related to the patients’ care and their safety. This is an evidence-based practice that improves communication among nurses and patients since the handoffs are conducted at the patients’ bedside, face-to-face, with the computer using SBAR. The patients are involved in the update of their care with the incoming nurse, enabling them to share concerns and to add valuable information, which increases patients’ satisfaction. Additionally, during the handoffs, the nurses with the patients are able to review and update the patients’ white board with the goals, activities, procedures, labs, consults, and symptom management for the incoming
This study evaluated if changing the process of shift handover from traditional form conducted in an off stage area to handover at the bedside could lead to improved safety for patients and cost reductions by shortening the duration of handover. The researchers also examined staff perceptions and satisfaction with the traditional method of handover versus th
This systemic review was completed to evaluate articles that discussed nursing handoff. 95 articles met the inclusion criteria and 20 of those articles involved research on nursing handoffs. A Quality Scoring System went on to assess each article with scores ranging from 1 to 16. “Quality assessment scores for the 20 research studies ranged from 2 to 12” (Riesenberg et al, 2010, p. 28). This goes to show us that there is a lack of high-quality articles on the subject matter of nursing handoff. From this article the reader can also learn about barriers and strategies of effective handoff in more depth.
In this article, the authors investigated the vulnerabilities in emergency department to internal medicine patient transfers through self-administered surveys of all emergency medicine house staff. More specifically, the survey investigated adverse events due to faulty communications during handoffs. According to this survey, 29% of the emergency staff reported either an adverse or near-miss event due to errors during handoffs. Furthermore, the survey respondents identified inaccurate or incomplete information, cultural and professional conflict, crowding, and many other factors as the contributors to handoff errors. By identifying specific contributors to handoff errors, this article serves as guidance for handoff intervention.
The Joint Commission defines handoffs as “the transfer of information, responsibility and authority regarding a patient’s care from one caregiver to another” (textbook). Although this is the general definition, there are many variations especially within the different healthcare agendas.
Verbal communication between the nurses during shift change or simply writing a progress report on the status of the patient does not cater to the needs of the patient, it is a mere communication method that is unreliable and nurse perception of the written report are often molded with bias and does not wholly represent the patient’s holistic health care needs. As dictated by Caruso (2007), “Change of shift signifies a time of carful communication in order to promote patient safety and best practices... [the risk exists of] relaying important information becomes muddled by irrelevant information instead...” (p.17). In essence, implementation of bedside nurse shift report/handover deems to provide the most opportune outcomes and focuses on patient-centered
In every profession there are changes that propel how tasks are done; nursing is no stranger to this. One of the biggest changes that have come into nursing’s daily events is how report hand-offs are being done. Gone are the days of taped report that each off going nurse must tape about each patient and the oncoming nurse must listen to. Nurses are now being encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very important to know how this can affect the patient and even the nurse’s schedule. With every change, there are positives and negatives that can finalize the decision to keep or forego
Nursing handover is the primary method of sharing patient information between shifts and ensuring continuity of care from shift to shift. Hand over between shifts is a practice that is basic to the organization of the health works and is an essential aspect of health care delivery. Nursing handover at the bedside should be an interactive process, providing opportunities for introducing the staff to the patient as well as for obtaining the patient’s viewpoint. In particular, bedside handover ensures that patients remain at the center of their
Effective communication during a patient handoff is critical in ensuring patient-care quality and safety and bedside shift reports have been found to increase patient involvement and satisfaction (Wakefield, Ragan, Brandt, and Tregnago, 2012). Bedside shift report is viewed as an opportunity to reduce errors and ensure improved communication between nurses (Gregory, Tan, Tilrico, Edwardson, and Gamm, 2014). Improved communication between nurses can be beneficial for all involved. In response to the Joint Commission’s National Patient Safety Goals, bedside report has been supported as improving patient safety, patient-centered care, and nurse communication as well as reducing medical errors (Gregory, et al., 2014). Ofori-Atta, Biniend, and Chalupka’s (2015) article examines statistics regarding hospital care and shows that according to the Inspector General Office, Health and Human Services
The nursing handover was defined in 1969 by Clair and Thrussel as the oral communication of pertinent information about patients. This was supported by Thurgood in 1995 who adopted the view that patient centred care is central to any definition of handover and that it is its primary function.
Currently, at Rutland Regional Medical Center (RRMC) there is no structured process for case management to provide handoff to the primary care offices when patients are discharged from the hospital. The transition of care from hospital to home is a critical time, during which the risk of adverse event occurrence is high. According to Shivji, Ramoutar, Bailey, & Hunter (2015), 19%-23% of patients experience an adverse event following discharge to home. Elderly patients are at greater risk due to functional and cognitive limitations; this is compounded by the presence of co-morbidities and multiple providers (Nelson, & Carrington, 2011). According to the Rutland County Health Assessment (2012-2015), by 2017 it is estimated that the elderly (age > 65) will comprise approximately 21.1% of the county’s population. Clear, concise, and timely communication with cooperative care providers at discharge is critical for the elderly population (Morris & Hoke, 2015). Furthermore, according to Lattimer (2011), the lack of cooperation between providers at discharge can endanger patients ' lives and waste fiscal and human resources. The purpose of this paper is to examine the problem of handoff communication to primary care offices and to plan a recommendation for change to provide a consistent and structured process; thereby ensuring the safety of the community during transitions of care.
Very good your participation. As part of my practice I had the opportunity to witness a shift handover between supervisor and nurse manager who then verifies the population of each department, the staff had in the shift, if there were absences, the category of patients and if necessary reassigned staff from one department to another where there was the need always taking into consideration the competence of the employee to be moved that will be able to provide the service. If absences arises for other shifts the program is verified for possible movement and if not being able to perdiems are approved or overtime but the staff is completed to not affect the service and expose personnel to make mistakes that with good programming can be avoided.