There have been numerous studies and reports released through the years indicating that inadequate dissemination of information among healthcare providers is detrimental to patient safety. In the acute care setting, the exchange of vital patient information between nurses is endorsed through a shift report; which typically takes place at the nurse’s station. There are many threats to patient safety that could be linked to the process of poor hand off reporting and communication.
Normally, a significant amount of communication takes place during nursing handoff. Sand-Jecklin and Sherman (2014) notes, “The safety of the patient can be compromised at this time” (2014, 2854). Adverse patient outcomes is a very serious matter for healthcare organizations.
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As a result, patient safety is improved and poor outcomes are decreased. Communication of vital information was reported as being more complete among these research. Sand-Jecklin and Sherman (2014) identified an increase in report accuracy and the increase in nurse perceived accountability. This study reported that patient falls during bedside handoff reporting decreased from twenty pre-implementation to thirteen post implementation at 3 months to four at 13 months (Sand-Jecklin and Sherman, 2014). The practice of bedside handoff reporting offers the opportunity to address toileting and other needs thus decreasing the incidents of falls. Kerr et al. (2014) reported that participants in their studies believed that early encounters with their patients during bedside handoff reporting afforded them early assessment of their patients’ condition. This particular finding is relevant to our area, since the deterioration of most of patients condition could be identified during handoff bed reporting. Ultimately, this would improve patient safety and clinical outcome. Jeff et al. (2013) study reported that since bedside handoff reporting provided patients the opportunity to ask questions or clarify concerns. It also serves as trigger for the patient to update caregivers on new developments or concerns. During bedside handoff report nurses are able to assess the clinical environment such as intravenous lines, drainage tubes and infusion flow rates. “Patient reported that they felt safe when experiencing shift report at the bedside” Gregory et al., 2014,
The adoption of clinical information systems is one way that healthcare organizations are making an effort to improve patient safety, provide a means to exemplify regulatory compliance, and facilitate exchange of patient information between care providers (Kirkley & Stein, 2004; Nadzam, 2009). To achieve this goal, Barnes-Jewish Hospital (BJH) recently implemented a new CPOE/clinical documentation system. One of the objectives of the new system was to give bedside clinicians a standardized electronic tool, known as the Clinical Summary, for bedside shift hand-off reporting. Soon after go-live, it was identified that the standard nursing Clinical Summary did not meet specialized the reporting needs of the nurses on the Women and Infants divisions. Consequently, an application enhancement request was submitted. The goal of this project is to synthesize the knowledge gained throughout this Masters Degree program to initiate, plan, and execute changes to the current clinical documentation system to provide a standardized Clinical Summary review screen to meet the specialized hand-off reporting needs of the nurses on the Women and Infants divisions at BJH. This paper includes project objectives, a supporting evidence-based literature review, project methodology, formative and summative evaluation criteria, and a graphical timeline with a narrative description for the Women and Infants Clinical Summary project.
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.,
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
The nursing profession is a profession where people put their trust in you to provide care that is not only effective, ethical, and moral, but safe. Not all health situations are simple or by the book. Not all hospitals have the same nurse-patient ratios, equipment, supplies, or support available, but all nurses have “the professional obligation to raise concerns regarding any patient assignment that puts patients or themselves at risk for harm” (ANA, 2009). When arriving at work for a shift, nurses must ensure that the assignment is safe for not only the patients, but also for themselves. There are times when this is not the situation. In these cases, the nurse has the right to invoke Safe Harbor, because according the ANA, nurses also “have the professional right to accept, reject or object in writing to any patient assignment that puts patient or themselves at serious risk for harm” (ANA, 2009).
Nurses have a considerable amount of responsibility in any facility. They are responsible for administering medicines and treatments to there patient’s. While caring for there patients, nurses will make observations on patient’s health and then record there findings. As well as consulting with doctors and other healthcare professionals to plan proper individual patient care. They teach their patients how to manage their illnesses and explain to both the patient and the patients family how to continue treatment when returning home (Bureau of Labor Statistics, 2014-15). They also record p...
Determining nurse-to-patient ratios is a difficult task with no single or definite solution and many variables exist to develop guidelines to cover every possible situation in an acute care facility. There are two boards of the state of Ohio that help with patient safety and keeping a safe workplace for the healthcare professional such a nurse. The first board is the Ohio board of Nursing, and the following is their description of what they are responsible for:
Patients Safety is the most crucial about healthcare sector around the world. It is defined as ‘the prevention of patients harm’ (Kohn et al. 2000). Even thou patient safety is shared among organization members, Nurses play a key role, as they are liable for direct and continuous patients care. Nurses should be capable of recognizing the risk of patients and address it to the other multi disciplinary on time.
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
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
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.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator monitored by the American Nurses Association, National Database of Nursing Quality Indicators and by the National Quality Forum. (NCBI)
Communication in the nursing practice and in healthcare is important because when talking with patients, their families, and staff, the nurse and the nursing student needs to be able to efficiently express the information that they want the other person to understand. “Verbal communication is a primary way of transmitting vital information concerning patient issues in hospital settings” (Raica, 2009, para. 1). When proper communication skills are lacking in nursing practice, the chances of errors and risks to the patient’s safety increases. One crucial aspect of communication that affects the patient care outcome is how the nurse and the nursing student interacts and communicates with the physicians and other staff members. If the nurse is not clear and concise when relaying patient information to other members of the healthcare team the patient care may be below the expected quality.
The introduction paragraph gives information on communication and the impact that it has on patient-nurse relationships. It gives the reader an understanding of what is involved in true communication and how that it is a fundamental part of nursing and skills all nurses need. It leads those interested in delivering quality nursing to read on. Showing us the significance that communication makes in the
Historically, the nursing profession has been actively involved in the health promotion and disease prevention among the general public. However, while caring for others, nurses often neglect their personal safety, which ultimately results in the high level of work-related injuries. Failure to timely address risk factors for nursing can have dire consequences for patient outcomes, since it is often associated with increased medication errors and patient falls, poor quality of care, and permanent disability of the nursing staff (Stokowski, 2014).