Patient Safety Part-1
Transition and handoff reporting are vital tools that are used by nurses in healthcare agencies where there is a continued need for improvement. After reviewing Handoff in Inpatient Surgical Teams, that was developed by the Agency for Healthcare Research Quality [AHRQ] as an educational tool to demonstrate the way a transition and handoff report should be given. The handoff that was exhibited was a great example of why a thorough and complete handoff is necessary. AHRQ Patient Safety (2016) displayed a rapport between the recovery nurse and the unit nurse, which was both professional and detail oriented; the receiving nurse made sure all aspects of the transition and handoff were covered before ending the conversation.
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Varskey, Reller, and Resar (2007) define quality improvement as the desire and drive of an organization to continually improve their procedures, methods, and activities to meet all patient needs (p.736). Although, handoff reporting is something that has already been implemented in many acute care setting, I feel it is a task that is often put on the back burner and not utilized as it was intended. From my experience, when information is missing from the handoff report, many nurses rely on the electronic health records to retrieve information about the previous shift. Although, a majority of this information should be available in the electronic health record and this has helped “improve communications, in some cases they have the opposite effect” (Bailey, 2016, p.1) because of improper documentation and loss of information. I believe that the purpose behind handoff reports was so they could be used much like a “surgical time out”, which allows time for the health team to stop and focus on the patient and their plan of care. Therefore, this video is important to my transition and handoff quality improvement project, because it emphasized proper utilization of a handoff, and showed how it could help a nurse identify aspects of patient care that may have been missed, leading to a better quality of
Interprofessional teams in health care are considered to be one of the best approaches to improve patient outcomes. Interprofessional teams provide the means to integrate patient care with input from many different professional disciplines (Rose, 2011). Nurses are an important part of the interprofessional team, since they are often the team member that is closest to the patient (Miers & Pollard, 2009). I recently participated in a team that developed a work flow for daily readmission rounds. The team was interprofessional, the hospitalist, who was an APRN led the team. There was the case manager and the primary nurse who were both RN’s. The team also consisted of a resident, pharmacist, nutritionist, physical therapist, and social worker.
It is obvious that a great deal of interprofessional research has been aimed to educate practitioners and nurses over the past decade for interprofessional practice (Orchard, King, Khalil & Beezina, 2012). The Institute of Medicine (IOM) “The Future of Nursing Leading Change, Advancing Health” (2010) recommend that private and public organizations, nursing programs and associations increase opportunities for nurses to lead and manage collaborative teams. Health care reform has created a shift in the healthcare delivery to place more emphasis on interprofessional health care teams (Sinfield, Donoghue, Horobi & Anderson, 2012). New implications are directed towards continuing education for health care workers to understand the meaning of interprofessional collaboration to support the changes in collaborative practice to improve patient outcomes (Orchard et.al, 2012). Encouraging health care professional to collaborate as a team more effectively may seem as the answer to improve the quality of care, but ineffective communication from team members to collaborate on the care needs often attributed to patient safety issues. Consequently, even when professional collaborative teams work together, there is no means to validate and measure the impact on continuing education for nurses about interprofessional collaborative practice (Sinfield, et al., 2012).
Ignatavicius, D. D., & Workman, M. L. (2013). Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier Saunders.
This systems limits patient involvement creates a delay in patient and nurse visualization. Prior to implementation of bedside shift reporting an evidenced based practice educational sessions will be provided and mandatory for nursing staff to attend (Trossman, 2009, p. 7). Utilizing unit managers and facility educators education stations will be set up in each participating unit. A standardized script for each nurse to utilize during the bedside shift report will be implemented to aid in prioritization, organization and timeliness of report decreasing the amount of information the nurse needs to scribe and allowing the nurse more time to visualize the patient, environment and equipment (Evans 2012, p. 283-284). Verbal and written bedside shift reporting is crucial for patient safety. “Ineffective communication is the most frequently cited cause for sentinel events in the United States and in Australian hospitals 50% of adverse events occur as a result of communication failures between health care professionals.” Utilizing written report information creates accountability and minimizes the loss in important information during the bedside shift report process (Street, 2011 p. 133). To minimize the barriers associated with the change of shift reporting process unit managers need to create a positive environment and reinforce the benefits for the procedural change (Tobiano, et al.,
Medical-surgical nursing: patient-centered collaborative care (7th ed.). St. Louis: Elsevier University. Taylor, C. (2011). The 'Standard'. Introduction to Nursing -.
The first article is, Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Chapter 34 “Handoffs: Implications for Nurses”, this article is applicable not only to my unit, but every nurse in the profession. It is imperative that the translation of patient information from one person to the next during shift change, patient transfer, or transfer to another facility is clear, accurate, understandable, and complete conveying all pertinent information about that patient. The article discusses why we have problems with handoffs, and different methods for handoff styles. There is no specific hand-off tool that is universal. With that being said it is important that research continues so that possibly in the
Ignatavicius, D.D. & Workman, M.L.(2010). Medical-Surgical Nursing: Patient-Centered Collaborative Care. (6th ed.). St. Philadelphia PA: Saunders Elsevier
The authors consist of nurses, specifically: a Chief Nursing Officer, a Nursing Informatics Officer, and a Dean/Professor of Nursing at Belmont University. The article described how vital nursing documentation is to achieve optimal patient care, including improving patient outcomes & collaborating with other healthcare providers. Using Henderson’s 14 fundamental needs as a framework for their research, the authors proved a definition of basic nursing care and incorporated it into an electronic health record. The authors utilized a team of 16 direct care nurses who were knowledgeable with documenting ele...
Patient follow-up after discharge is a critical component of discharge coordination. Follow-up call programs, especially those done by nurses, should be utilized to support discharge transitions and reduce readmissions by reinforcing health goals, providing patient teaching, assessing ongoing care needs, and evaluating patient satisfaction. In the Wee et al., 2014 article, the Care Transitions Program utilized care coordinators to provide coaching aimed at helping individuals and their families understand the individual’s condition, effectively articulate their preferences, enable self-management and care planning (Wee et al., 2014). During hospitalization, the care coordinator worked with families and other hospital staff to develop the most appropriate care plans and followed up with telephone calls and home visits hospitalization (Wee et al.,
Electronic medical records not only effect health care professionals, but the patients of those health care providers as well. However, nurses spend the most time directly using electronic medical records to access patient date and chart. Nurses now learn to chart, record data, and interact with other health care providers electronically. Many assume that electronic means efficient, and the stories of many nurses both agree, and disagree. Myra Davis-Alston, a nurse from Las Vegas, NV, says that she “[likes] the immediate access to patient progress notes from all care providers, and the ability to review cumulative lab values and radiology reports” (Eisenberg, 2010, p. 9). This form of record keeping provides health care professionals with convenient access to patient notes, vital signs, and test results from multiple providers comprised into one central location. They also have the ability to make patients more involved in their own care (Ross, 2009). With the advancement in efficiency, also comes the reduction of costs by not printing countless paper records, and in turn, lowers health care
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
Objective: Implement that nurses use the same handoff report at change of shift with patient at bedside by May 2018.
Ignatavicius, D. D. & Workman, M.L. (2010). Medical-surgical nursing: Patient-centered collaborative care. St. Louis, Missouri: Saunders Elsevier.
Although students were not allowed in the recovery unit, I was able to talk to one of the recovery nurses. I learned that a nurse’s duty of care includes monitoring the patient’s vital signs and level of consciousness, and maintaining airway patency. Assessing pain and the effectiveness of pain management is also necessary. Once patients are transferred to the surgical ward, the goal is to assist in the recovery process, as well as providing referral details and education on care required when the patient returns home (Hamlin, 2010).
I went to the operating room on March 23, 2016 for the Wilkes Community College Nursing Class of 2017 for observation. Another student and I were assigned to this unit from 7:30am-2:00pm. When we got their we changed into the operating room scrubs, placed a bonnet on our heads and placed booties over our shoes. I got to observe three different surgeries, two laparoscopic shoulder surgeries and one ankle surgery. While cleaning the surgical room for the next surgery, I got to communicate with the nurses and surgical team they explained the flow and equipment that was used in the operating room.