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Qualitative research review on nursing handoff report
Reflection on nurse handover
How do language barriers affect patient care
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Introduction
This assignment intends to review the concept of nursing shift handover. Nursing handover can be defined as an important time to exchange information pertinent to the continued care of their patients (Pothier, Monteiro, Nooktlar et al. 2005). Methods of handover are varied, ranging from taped, verbal, by the bedside or with typed sheets.
In 2010 there were 352,104 registered nurses, midwives and health visitors working in the NHS (RCN, 2011). All of these will partake in a handover of information on a regular basis, in hospitals this handover takes place at least twice day. In 2009/2010 there was 16,806,200 hospital stays in NHS hospitals (IC NHS, 2011). Information about their care would have been exchanged at shift changes, with the quality of each handover ensuring relevant care. Consequently, we can see that handovers effects thousands of nursing staff together with the thousands of patients in the hospital setting.
The Health & Safety Executive (1996) stated that handover has several requisites, in particularly that communication between shifts should be accurate and without misunderstandings. The need to improve handovers is international recognized along with the obstacles that need to be overcome. Solutions need to address the healthcare professionals resistance to change, while understanding their time pressures. Additionally, issues relating to staffing levels, language differences and lack of research (WHO, 2007)need to be taken into account.
According to Prouse (1995 cited by Carayon,) the cost of a handover in an UK hospice was approximately £80, (with inflation £125 (This is Money, 2011)). Additionally, Burke (1999) suggested using taped handovers saves a ward £16,000 per annum, which may...
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...400 results when refined with quantitative or qualitative keywords. Lastly, CINAHL produced best results when using a basic search with 'nursing handover' used, resulting in 23 articles.
Each database requires different techniques, sometimes narrowing or opening the search parameters. Parameter of date and location were employed. Consequently, papers needed form 2001 onwards, original research and from the UK, thus avoiding cultural discrepancies and ensuring applicable to practice. Additionally, they needed to be hospital based and preferably in a ward setting.
The qualitative paper selected was 'A qualitative study of shift handover practice and function' (Kerr, 2001) and the quantitative paper was 'A Pilot study to show the loss of important data in nursing handover'(Pothier D., Monteiro P., Nooktlar M. et al., 2005). These will now be critiqued in turn.
Although nurses do not wield the power of doctors in hospital settings, they are still able to effectively compensate for a doctor’s deficits in a variety of ways to assure patient recovery. Nurses meet a patient’s physical needs, which assures comfort and dignity Nurses explain and translate unfamiliar procedures and treatments to patients which makes the patient a partner in his own care and aids in patient compliance. Nurses communicate patient symptoms and concerns to physicians so treatment can be altered if necessary and most importantly, nurses provide emotional support to patients in distress.
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...
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.,
Following the QSEN model, this problem is a concern that falls under the safety category. The Institute of Medicine defines safety as, “minimizes risk of harm to patients and providers through both system effectiveness and individual performance” (IOM, 2003). A nurse manager must address this problem because without nurses who are able to work, patients cannot be taken care of in a safe and effective way. As a nurse manager, it would be ...
...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.
The nurse to patient ratio is unrealistic in many hospitals. In most cases it is almost impossible to give each patient the true amount of detailed care they really need. This is seen in most cases where there is one nurse assigned to 16 patients and each patient requires a different level of attention. Nurses are pressed for time, forcing them to cut corners, resulting in an increase in nosocomial infections and patient deaths. “The past decade has been a unsettled time for many US hospitals and practicing nu...
Nursing is a profession with different categories of nurses who provide nursing care. Nursing is also explained as interpersonal in nature, which means that it exists through interaction between human beings (Me llish & Paton, 1994:4). This definition means that nursing can only exist through interaction. The nurse interacts with his/her patients – for example when taking a nursing history from patients – and with other health team members as they give report to each other when they change shifts. The nurse should possess knowledge and skills to ensure attainment
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
The transitioning nurse must be able to communicate clearly and effectively. Often times nurses working in the community are alone where there is no other health team member present, therefore complete communication is essential. Transitioning nursing must possess knowledge of computer technology. The use of computer technology allows the nurse to communicate with other healthcare providers, facilitate care and manage complex healthcare needs (Bates et al., 2016, p.342). Furthermore, nurses transitioning from an acute care setting must be able to adaptable to any given situation or community. For example, supplies and equipment found in a hospital setting can be different than the one found in a client’s home. They must take the opportunity to gather information on how to utilize the supplies or equipment that may be unfamiliar. Finally, transitioning nurses must be knowledgeable about community resources. Knowledge of community resources can provide the opportunity to access and share information and help to improve the client’s quality of life (Bates et al., 2016, p.
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
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.,
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.
Goal: Improve nursing handoff during change of shift with incoming and outgoing nurses by providing a standard hand of flow sheet, to improve patient safety and quality of care
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd