Evolution Of Patient Handoff

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.

Traditionally, nursing shift-to-shift reports were organized methods of communication between only the oncoming and leaving nurse, designated to a location such as the central nursing station or nook of a hallway. Shift reports can be considered the foundation of how the day is going to plan out because it introduces the patient, diagnoses, complications, medications, consults, upcoming test and the entire plan of care. These reports are full of complicated and vital information and while set in certain locations that are vulnerable to interruptions, such as the nursing station, medical errors and miscommunication are more likely to be made. The Joint Commission’s 2009 and 2010 National Patient Safety Goals (Joint Commission, 2015) included two patient safety standards, first to encourage patients to be involved in their health care plan and second, to implement a standardized communication process for handoff reports between providers. Soon after in 2013, The Agency for Healthcare Research and Quality under the United States Department of Health and Human Services introduced a set of strategies to improve patient engagement along with safety and quality in patient care. Within these strategies the new method of nurse bedside shift report was developed, which suggests nurses to conduct shift-to-shift reports at bedside in the room of each patient, rather than out of the room. The benefits of this new method were

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

Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover - an integrated review of issues and tools. Journal Of Clinical Nursing, 24(5/6), 662-671. doi:10.1111/jocn.12706.

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

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.

Nurses must never stop learning and always need to strive to discover better ways to provide care for their patients. One important factor in achieving this goal is involving patients in their own care. This can be established by doing a handoff report at the bedside between nurses. Bedside report has been studied in various settings, and its effectiveness has been proven in the literature. However, more evidence-based research on this topic is needed.

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.