Clinical handovers between prehospital and hospital staff: literature review http://emj.bmj.com/content/early/2014/09/01/emermed-2013-203165.short A common ethical issue within the paramedic discipline that can have a positive or negative result with patient care and safety is clinical handovers. Emerging research of clinical handovers between paramedics and emergency department staff has shown that effective patient handover has been linked to not only improving patient care and safety, but it has been shown to also improve decision making and documentation.
On a day to day basis paramedics face a multitude of challenges when obtaining patient information or receiving a patient handover themselves when outside of the hospital setting. These clinical and social patient findings occur in various locations that may be calm or chaotic and are relayed through various routes. Having excellent communication is a key component to effectively relay patient information over to receiving staff. This requires the paramedic to not only be self-confident and concise but to be able to assert themselves and speak loudly. In contrast the receiving staff
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This issue also tends to arise with negative interprofessional relationships
The standardisation of handovers with the use of mnemonics has been greatly useful in developing consistency and a basis for providing essential information which has in turn resulted in decreased questioning from emergency department staff. On the contrary it was founded that using mnemonics did not improve the ability to recall information compared to handovers that had no structure.
Poor communication was evident where health care professionals were not listening, mistrust founded upon relational problems and misunderstandings between personnel. Apart from evident poor communication there are also challenges such as noise, chaos and interruptions that
Communication is cited as a contributing factor in 70% of healthcare mistakes, leading to many initiatives across the healthcare settings to improve the way healthcare professionals communicate. (Kohn, 2000.)
...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.
“Physicians and other health care professionals all agree on the importance of effective communication among the members of a health care team. However, there are many challenges associated with effective interprofessional (between physicians and other health care providers) communication, and these difficulties sometimes lead to unfavourable patient outcomes” (Canadian Medical Protection Association, 2011 p. 11).
Clinical handover (handover) is a fundamental element of safe patient care, however, it has emerged as a key area of concern. Failure of handover is a major preventable cause of patient harm in which studies have highlighted adverse events resulting from inadequate handover. Effective handover is a predominant element of several of the National Safety and Quality Health Service (NSQHS) Standards which ensures the driven implementation of safe and quality care. Current practice of handover within Mater has fallen short of these standards in several aspects. Handover is a high-risk area in which improvement solutions are urgently required. This project will outline three key concepts that the Mater can integrate in both practice and policy from
Understanding that all patients needed to be treated justly and given the opportunity to make decisions in their care is important. Not causing harm and preventing them from harm is also the duty of health care workers. These ethical principles are essential to keep in mind with interdisciplinary communication. Ineffective communication has been associated with medical errors, patient harm, and increase length of stay. Failure to communicate properly has been associated with 79% of sentinel events (Dingley, Daugherty, Derieg & Persing, 2008). Good communication has been shown to improve patient satisfaction, increase in patient safety, as well as a decrease in health care costs (Paget et al.,
Medical office managers in today’s healthcare environment are confronted with many challenges in an office. In a work place Medical office managers should be able to communicate with staff, patients, and to the public in a professional manner. Most managers believe that the way they communicate with people is the best way to communicate with patients. There are different ways to communicate with patients, physicians, and other professionals in the workplace. When it comes to handling a problem with a person the manager needs to speak to the person in a professional way in order for them to have control of the situation when it comes to a conflict. Not all people can be handled the same way and spoken to in the same way, because everyone has different solutions in resolving a conflict. A manager may have to resolve a conflict between co-workers in the office and may have to handle the situation differently between each person. Improving performance in a medical office as a medical office manager they will need to improve team work on their team. A medical office manager needs good communication skills in order to communicate with patients, physicians and other healthcare professionals run the office smoothly.
Clinical handover is a form of communication in the clinical setting which allow nurses to plan and prioritize patient care and manage their workload effectively. Clinical handover encompasses the exchange of patient information from one shift to another and it has been known for benefits such as being a platform for exchange of opinions amongst nurses, expression of feelings, teaching and learning. Bedside clinical handover was reported to be a patient-centred initiative that enhanced the standards of healthcare and reduced adverse events in the healthcare setting. The implementation of bedside clinical handover was found to be time-effective, reduced the risks of error and enabled nurses to spend more time with their patients.
“Communication is the heart of nursing… your ability to use your growing knowledge and yourself as an instrument of care and caring and compassion” (Koerner, 2010, as cited in Balzer-Riley, 2012, p. 2). The knowledge base which Koerner is referring to includes important concepts such as communication, assertiveness, responsibility and caring (Balzer-Riley, 2012). Furthermore, communication is complex. It includes communication with patients, patient families, doctors, co-workers, nurse managers and many others. Due to those concepts and the variety of people involved, barriers and issues are present. Knowing how to communicate efficiently can be difficult.
Communication involves the exchange of information between two or more people. Whether verbal or nonverbal, communication serves as the bridge that allows people to share ideas and thoughts. Clinical professionals converse with patients, relatives, and other professionals daily. Conversely, despite having multiple encounters with patients every day, physicians fail to enact the necessary communication and interpersonal skills to effectively listen, instill confidence, and promote following medical advice in patients.
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
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...
Ritin Fernandez, Duong Tran, Maree Johnson, and Sonya Jones, in their 2010 article “Interdisciplinary communication in general medical and surgical wards using two different models of nursing care delivery” published in the Journal Of Nursing Management conducted a study to compare the effect of the Shared care in nursing (SCN) model with the existing model of patient allocation (PA) on nurses’ perception of interdisciplinary communication in general medical and surgery wards in Australia. Ineffective communication is a leading cause of patient injuries and death. From the Joint Commission, “communication breakdown was identified as the root cause of more than 60% of 2034 medical errors, of which 75% resulted in a patient’s death (Fernandez, et.al, 2010). Many of the reasons why ineffective communication even occurs could due to stressful environment in health care, a hierarchy
For this reason, it is imperative that individuals improve communication among these stakeholders. In the course of 4days in a hospital, a patient can come into contact with about 50 different employees including nurses, technicians and physicians. As a result, for effective clinical practice, critical information MUST be passed on with complete accuracy. According to Rosenstein & O’Daniel 2008, some of the obstacles to Interprofessional Collaboration and Communication include Gender, hierarchy, differences in languages and jargon, the diverse levels of preparation, qualifications and status, the complexity of the care, the historical Interprofessional and Interprofessional contentions, differences in professional routines and agenda, the emphasis on quick decision-making, the fear of diluting one’s professional identity among others. Additionally, those who have the most barriers tend to be physicians and nurses. Despite their numerous interactions in one day, they have differing perceptions about their responsibilities and roles concerning the requirements the patient may have so they end up having different goals for the patient. Due to the ethnic diversity
Despite the frequency of verbal interactions, miscommunication of patient information occurs that can lead to patient safety issues. . . . ‘Effective communication occurs when the expertise, skills, and unique perspectives of both nurses and physicians are integrated, resulting in an improvement in the quality of patient care’ (Lindeke & Sieckert, 200...
Communication involves relaying information from an individual to another through the use of verbal and nonverbal techniques. Many factors affect the effectiveness of information relay. It involves evaluating verbal aspects such as tone of voice, the emotional content being communicated, the timing and rapport of the interaction with patients, and nonverbal techniques such as facial expressions, time invested. It is necessary for productive and satisfactory work environment, improved patient outcomes, and settling conflicts. The purpose of this paper is to identify issues with ineffective communication and ways to improve proper communication throughout the a hospital’s interdisciplinary team and patients.