Introduction
In order to safely deliver competent care, a nurse must be armed with all of the pertinent information about a patient. Breakdowns in communication have been known to cause adverse and sentinel events, making it extremely important for nurses to pass on relevant information at shift change in a timely manner. Although no known best practice currently exists for communication during patient handovers, various strategies have been implemented and studied. One strategy to attempt to improve the quality and delivery of end of shift report in a timely manner includes the employment of a standardized template to complement verbal patient handovers. In an experimental study by Wilson (2007), she implied that the initiation of a standardized
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Increasing the amount of information the nurse assuming care of the patient possess, while decreasing the amount of time to deliver report may improve the quality of care delivered and prevent adverse events. However, standardizing verbal handovers stands as an exceedingly difficult intervention to implement due to the fact that nurses’ personalize the manner in which they deliver patient handovers. Altering the framework of delivering a verbal handover also forces nursing staff to alter the manner in which they process information and deliver it to one another. Therefore, education and time is necessary for an intervention such as altering the patient handover process. Lewin’s model for change, which involves the steps of unfreezing, moving, and refreezing, will be utilized throughout the initiation of the intervention. By utilizing a standardized template to complement verbal patient handovers, the amount of time required to deliver a comprehensive report may decrease. Hopefully standardizing the manner in which medical staff, especially nurses, communicate will encourage the elimination of gaps in patient handovers and decrease errors with causes rooted in poor …show more content…
Non-comprehensive and non-uniform patient handovers stand as a current concern within the department. Inadequate handovers may lead to delays in care and communication errors. Additionally, poor communication and poor teamwork in relation to handovers pose a threat to patient safety. The proposed intervention is to implement the utilization of a paper, SBAR formatted, standardized template with patient information on it that can be passed on from nurse to nurse at shift change. The template will be updated throughout the patient’s stay at the facility and will help provide a comprehensive view of the patient. This SBAR formatted template will provide the framework for the verbal report given during patient handovers on medical-surgical units of a Midwestern, rural hospital. The review of the literature supports the implementation of this intervention, by noting error reduction with the employment of a template. The results of a study by Triplett and Schuveiller (2011) suggested that over half of the nurses surveyed had discovered errors during the patient handover process with the addition of the template. According to Johnson, Jefferies, and Nicholls, (2012) not only did the employment of a template complement verbal handover, but it also provided a tool to allow for easy access to comprehensive information on any given patient in the units. Overall, the
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.
nurses who frequently enhance the communication problems in discharge planning, and who strive to improve the working relationship, collaboration and who use the teamwork approach to patient and family centered discharge planning will greatly reduce patient readmission (Lo, Stuenkel, and Rodriguez, 2009, p. 160). Lo, Stuenkel and Rodriguez (2009) emphasize that an organized and well prepared discharge planning, education of patients with multi-lingual services and use of different methods of teaching greatly improves the patients’ outcome (p.157). These include an experienced and well-taught phone call follow-up sessions after discharge along with ensuring the extension of adequate postoperative care. Another way nurses can deliver a planned discharged teaching is by providing direct checklist for patient and family to follow. One must understand that these approaches will enforce the staff nurses and other health care providers to develop the safe patient transition to home.
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.,
Teaching effective communication strategies to healthcare professionals – staff need to be trained in the appropriate strategies for communication during patient handover to ensure that all of the relevant and required information is adequately shared between the healthcare professionals during this transfer.
Mindful communication is one of the most powerful tools a nurse can use when delegating responsibility to an unlicensed assistive personnel (UAP). In order to effectively delegate patient care to the UAP, the nurse must use the right communication. The right communication provides safe, quality outcomes for the nurse, the UAP, the patient, and the facility. The processes at the core of communication that are suggested to improve synchronization of a care team are effective, patient-centered, timely, and equitable care (Anthony & Vidal, 2010, p. 1). The registered nurse (RN) must assume responsibility for delegation, as well as client outcome. This makes it important for the RN to foster an open, truthful, and trusting environment with coworkers. Even the smallest piece of information left out of, or misinterpreted in
The end of shift handover nursing report is the time when the off going nurse hands over patient care to the oncoming nurse. During this process critical information about patient’s status and plan of care must be communicated properly. Conducting the shift-to-shift report at the bedside allows patients and families to become involved in their care. It also lets them participate in the sharing of information, which ensures that patient, family and team goals are identified and aligned. Bedside shift-to-shift nursing reports increases patients’ satisfaction, improves the nurse-patient relationship, decreases patient falls, discharge time occurs faster, strengthens teamwork, and leads to better nurse
Professor Cantu and Class, 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 to 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.
The problem of poor communication stems from an environment of high stress levels. After a consulting company scrutinized processes throughout the hospital related to care coordination and patient flow, the evidence was clear. The company identified areas for improvement around communication at many different levels. In order for patients to have a seamless transition from admission to discharge, the lines of communication needed to change. Daily face-to-face meetings were productive for the staff, hospital and overall satisfaction. The consulting firm worked for the hospital for several months, but as they departed, the prior culture of poor communication started to engulf...
...an be seen that effective communication during handover is essential to providing reliable care (Smith & Pressman, 2010) tailored to a patient's individual needs. As healthcare professionals who can make a difference in life and death for patients, it is therefore crucial to promote active dialogue and exchange of relevant information.
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.
When it comes to switching shifts, nurses usually give a quick report on the patient, so the oncoming nurse knows what is going on with the patients. Sometimes nurses are rushing through the report, skipping through vital information, which can cause harm in our patients. We must have a standard hand off report each nurse must follow to provide patient safety and satisfaction.
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
It is essential for a nurse to be able to demonstrate and practice professional communication skills, provision of information and handover to provide a holistic approach to treating and caring for patients. Professional communication skills not only allows the nurse to provide different methods and tactics to communicate with patients of different needs and ages, but it enables the nurse to understand and to give the best possible care and outcome for the patient. Provision of information and handover is another major point for nurses and relates to professional communication. Nurses need to be able to get a detailed diagnosis from the patient through communication, and therefore allows for the nurse to handover vital information to other doctors or nurses who take over to provide the correct and best possible treatments and care. The nursing profession requires a nurse to uphold professional communication, provision of information and handover in order to care for the patient with the right treatment, and to provide the best health outcome.
Preoperative Briefing and Its Effect in the Operating Room Improvement in the safety of the operating room is important when it comes to efficiency, as well as patient outcomes post-surgery. Memorial Health System in Colorado Springs, Colorado implemented the use of preoperative briefing prior to the operation to improve efficiency and communication among the operating room staff during the surgery. The idea behind including this in the plan of care, was to allow more time for the operating room staff to ask questions about the procedure and to further address any patient history that may result in problems or a change in care for the operating room staff. The briefing resulted in the circulating nurse needing to leave the operating room to
Even though the majority of hospitals and health care facilities are computerized, the charge nurse has to communicate with a multitude of health care professionals during every shift. Society’s strong reliance on technology emphasizes the importance of electronic writing and communication for all nurses. Throughout the shift, the charge nurse will have to send urgent text messages and emails to their supervisor or coworkers to ensure everything is running smoothly on the floor. Even though email and text might be thought of as informal communication, writing skills must be professional when speaking with superiors and coworkers to maintain an appropriate appearance (Knab,