Reflection on Nursing Handover

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.

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.

Nursing handoffs is a type of report between two clinicians that are responsible for patients care and is an important part of transferring patient information (what, how, who and where) from one healthcare provider to another in clinical practice (Smith and Schub, 2014). Ineffective, inconsistent and incongruent communication during these handoffs continues to be a problem and a threat to patient safety. Effective handoffs are instrumental in providing for the successful quality of care that the patient is to receive (Abraham, Kannampallil & Patel, 2013). Medical errors, treatment delays, inappropriate treatment and/or care omissions can happen as a result of miscommunication during handoffs which could potentially lead to patient harm, longer stays, readmissions and/or increased costs.

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

Communication breakdown is among the leading cause of medical errors such as gaps in health care, incomplete or missing information, and medication errors. Most importantly, communication supports the foundation of patient care. According to The Joint Commission (formerly Joint Commission for Accreditation of Healthcare Organizations [JCAHO]) improved communication among nurses during shift changes reduces injuries due to medical errors by 30 percent. So, hand-off reporting during shift change is a critical process that is crucial in protecting a patient’s safety. Throughout the hand-off report, it is vital to provide accurate, up-to- date and pertinent information to the oncoming nurse. An estimate of 80 percent of the most serious medical

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.

Barrier to handoff communication is the number of individuals involved in patient care according to a study conducted a surgical patient sees an average of 26 health providers during their hospital stay. As patient transits each complex phase of care in an operating room each team of care givers with different types of responsibilities and objectives it is very important to deliver effective communication among health providers to reduce adverse

We started our day at Heartland, attending a care plan meeting for the patient with the nursing care team who is worked at the facility. The patient that we were visiting is an 80-year-old female who was diagnosed with lung cancer. The staff caring for her at facility were beginning to worry because she was losing weight and not eating the food they were providing for her. The Hospice nurse, Ginger, wrote an order to change the diet so that the patient could eat whatever she wanted. The orders that Ginger wrote throughout the day would later be signed by the physician by telephone. After the care plan meeting, Ginger went through the patient’s chart, reviewing the nurse’s notes and reviewing the care plan to confirm that it works with the patient. After reviewing the chart and notes, Ginger introduced us to the patient and did a mini head to toe

Adams, J. M. and Osborne-McKenzie, T. (2012). Advancing the evidence base for a standardized provider handover structure: Using staff nurse descriptions of information needed to deliver competent care. Journal of Continuing Education in Nursing, 43(6), 261-266.

Literature reporting on bedside nursing handoffs in recent years has shown such benefits as patient satisfaction improvement, better communication among nurses, and less time needed to complete change of shift reports. These all seem like positive outcomes, but I see several areas that might be concerning in bedside reports. Patient privacy must be respected, and two-patient rooms do not provide for this privacy. Second, nurses may not want to share some of the information in the change of shift report with the

Nursing bedside handover is as an important part in the transferring of nursing responsibilities of clinical care for all patients from one nurse to another nurse at the end of the shift (Chin, Warren, Kornman & Cameron, 2012). Nursing handover is significant in maintaining the continuity of patient care for better health outcomes. If the information provided to another person is poorly conveyed may lead to major issues such as communication barrier, patient’s privacy, and confidentiality at the bedside (Anderson, Malone, Shanahan & Manning, 2014).

The purpose of this study was to identify and describe the structures, processes, and perceptions of the outcomes of bedside handovers in nursing practice.

After the pre-brief we headed into the simulation lab, where I was the observer. The hand-off nurse did a great job at providing the primary and secondary nurses with important and relevant information. The nurses then provided excellent client-centered care and communicated in a therapeutic way. Both nurses addressed the client concerns and provided ways to cope, mainly with the smell, diet, and sexual health. I placed myself in the client’s shoes and critiqued the nurses from that perspective. I came to the conclusion that if the two nurses were taking care of me, I would feel the nurses were listening and addressing my concerns, providing a safe and clean environment, and treating me with respect.

Nursing handoffs should involve the departing nurse informing the oncoming nurse about his or her patients. After all pertinent information has been exchanged an in-room report should be done with both nurses and the patient. This initiates a time where the incoming nurse and patient can get acquainted and any questions can be addressed.

Continuity of patient care during unit transition is highly significant for patient safety. This can only be achieved by continuous, well-coordinated communication amongst nurses. Transfer to another unit should not compromise the continuity of patient care. So, proper nursing handoff is a vital component in continuity of patient care. Nursing handoff or handover is the exchange of information about a patient and transferring of responsibility of that patient from one nurse to another (Drach-Zahavy & Hadid, 2015). Research has identified handoff as risky time in care process where information can be lost, misinterpreted or distorted (Drach-Zahavy & Hadid, 2015). There are three different modes of handoff: written, verbal and tape recorded.