Nursing Handoff During Change Of Shift

Contents

TOC o “1-3” h z u HYPERLINK l “_Toc380137914” Abstract PAGEREF _Toc380137914 h 1

HYPERLINK l “_Toc380137915” Introduction PAGEREF _Toc380137915 h 1

HYPERLINK l “_Toc380137916” Project to Improve Communication During Handoffs PAGEREF _Toc380137916 h 2

HYPERLINK l “_Toc380137917” Benefits of Bedside Shift Reports PAGEREF _Toc380137917 h 3

HYPERLINK l “_Toc380137918” Barriers to implementation of the project PAGEREF _Toc380137918 h 4

HYPERLINK l “_Toc380137919” Facilitation and implementation of Project Completion PAGEREF _Toc380137919 h 5

HYPERLINK l “_Toc380137920” Lessons learnt PAGEREF _Toc380137920 h 6

AbstractThis paper outlines the implementation of a project aimed at improving nursing handoff in the course of change of shift. It is built on the premise that the provision of healthcare services usually involves a change of healthcare providers. The incoming and outgoing nurses must, therefore, exchange information crucial to the provision of healthcare to the patient. However, many are the times when miscommunication occurs during handoffs. This may jeopardize the safety of the patient. This paper examines the problem and comes up with a solution for it. It presents the likely barriers to the success of the project, as well as efforts that can be done to safeguard its success.

IntroductionNursing has been a fundamental component of the healthcare sector for a long time. It is charged with the responsibility of providing varied scopes in different levels of healthcare aimed at assisting individuals to maintain, attain, or even recover quality of life and optimal health. Needless to say, the safety of patients tops the list of priorities for nurses. Unfortunately, many are the times when the safety of compromised especially in instances where there is a change of nurses under whose care a patient is (Cairns et al, 2013). The transition is known as a handoff, which refers to the transfer of authority, responsibility, as well as information in the course of exchanges in care (Cairns et al, 2013). Underlining the importance of communication during handoffs is the increased likelihood that information will be lost or missed. Studies show that missing or incomplete information is one of the key causes of adverse events in the healthcare sector. On the same note, communication failure in the course of handoffs is the most often cited predisposing factor to sentinel events (Cairns et al, 2013).

Scholars note that the efficacy of handoffs primarily depends on the communication skill and style of the healthcare providers, as well as the knowledge and experience of the two healthcare professionals involved (Fitzsimons & Reinbeck, 2013). My interest in the issue of nursing handoffs rests on the enormous role that it plays in enhancing trust and patient safety. Scholars have noted that accurate and consistent exchange of information pertaining to the patient is imperative in maintaining patient, as well as promoting the safety of patients.

According to the American Nurses Association, approximately 80 percent of the serious medical errors occurring in the healthcare sector revolve around miscommunication between the incoming and outgoing healthcare providers in the course of handing off the patients (Fitzsimons & Reinbeck, 2013). On the same note, scholars underline the fact that defective handoffs may result in inappropriate treatment, delays in treatment, as well as increase the duration of time within which an individual stays in the hospital (Fitzsimons & Reinbeck, 2013).

Project to Improve Communication During HandoffsEnhancing effective communication in the course of handoffs comes as imperative especially considering the adoption of pay-for-performance and value-based purchasing measures. This, in fact, is not only viable from the patient safety perspective but also considering the financial aspects. Effective communication would enhance patient experience, as well as offer a trusting and safe environment for provision of healthcare services.

In solving the problem of miscommunication, a bedside shift report would be inculcated in the hospitals. This comes as one of the most effective techniques that would improve the experience of patients in healthcare centers, as well as ensure their safety. The implementation of the bedside shift reports is speedy.

The incoming nurse checks the chart, treatments, and medical history, as well as other pending aspects prior to getting into the patient’s room. Both the incoming and outgoing nurse then proceed to the bedside where the outgoing nurse would introduce the incoming one to the patient.

The incoming nurse would then have the responsibility of asking the patient certain details such as name and date of birth, as well as checking the armband to ensure safety, after which he ensures that the whiteboard is updated and checks the accuracy of intravenous medications (Baker, 2010). Patients must also be advised, as well as educated as to the occurrence of the bedside shift report before its occurrence (Baker, 2010). After this, the nurse would use the Situation Background Assessment Recommendation technique to frame his conversations with the outgoing nurse even in front of the patient so as to ensure that crucial information is relayed in the bedside shift report.

Benefits of Bedside Shift ReportsResearch shows that bedside shift reports coupled with enhanced patient participation would promote trust and respect between patients and the caregivers thereby enhancing accuracy in the information exchanged between nurses (Cairns et al, 2013). Bedside shift reports also come as an excellent technique for enhancing employee teamwork, accountability and ownership. On the same note, it comes as a direct response to varied goals of Joint Commission named Patient Safety Goals. These are enhancing the accuracy pertaining to patient identification, enhancing the efficacy of communication among healthcare providers and managing handoff communications especially with regard to providing a chance for asking and replying to questions (Baker, 2010). The third goal revolves around encouraging active involvement of the patients in their healthcare as a way of safeguarding the safety of patients.

Bedside shift reports also come as opportunities for real-time conversations for nurses. This is because nurses are likely to be more thorough, comprehensive and accurate in compiling their reports as they know that someone else will be checking them (Baker, 2010). They would ensure that the reports are in order before the shift takes place. Bedside shift reports also come in handy in mentoring new nurses as they become disciplined right from the beginning as their documentation would be reviewed by other nurses, who would take them through other processes such as medical therapy, environmental factors, assessments, and even take a physical examination of their patients (Baker, 2010).

Barriers to implementation of the projectAs much as the project comes with a number of positive effects, its implementation faces a number of barriers. This is especially from the concerned nurses. It is worth noting that the bedside shift reports are a relatively new thing in the nursing profession. As much as many healthcare professionals acknowledge its importance, they object to its implementation as they view it as cumbersome and too much work to compile. Implementing or introducing change is never easy and nurse as the key participants would be likely to raise some issues.

On the same note, there are concerns as to the privacy of the information placed on the bedside shift report. This is especially with regard to passing confidential or highly sensitive information in the presence of the patient.

Further, there are concerns pertaining to the length of time spent on the bedside shift report as it may put the incoming nurse behind schedule or delay the outgoing nurse.

On the same note, all levels of leadership in the healthcare institution must show the willingness to implement the changes, offer support to the staff, as well as offer some boundaries especially in instances where some outliner would be unwilling to participate in the shift.

Facilitation and implementation of Project CompletionThe implementation of the project is undoubtedly a crucial aspect to patient safety in the course of treatment. Nevertheless, its introduction and implementation necessitates that some efforts be made especially with regards to eliminating or neutralizing the effects of barriers to its implementation.

One of the things that must be done is creating awareness and the support of the key participants i.e. the nurses who will be using these reports. It is imperative that they are made to understand the importance of the reports, as well as their effects in the overall safety of patients in the healthcare centers. In addition, any fears that they may be having pertaining to their cumbersomeness must be addressed before the implementation of the reports. It is imperative that one emphasizes on the positive impact that the project would have on their work. Incoming nurse team should be educated as pertaining to the bedside shift report in case they are registry or float personnel (Baker, 2010).

In addition, gaining the support of the leaders in all levels is imperative to the overall success of the project. The leaders will not only be involved in the implementation of the project but also in laying the policy frameworks pertaining to the same, as well as the rules and standards to which the nurses must adhere.

On the same note, it is imperative that the implementing nurses are sensitive to information, as well as privacy of the patient. Key words should be used to inform the patient as to the maintenance of his privacy and safety of his information (Baker, 2010). Confidentiality should be maintained by discussing sensitive details away from patients. Opinions must be excluded from reports as criticism would create the impression that the nurse is not credible (Baker, 2010). Nurses should not be put on the spot in the patient’s vicinity rather clarification pertaining to sensitive issues should be sought after completing bedside shift report. Clear rules of engagement must be defined so as to ensure or safeguard the overall success of the project.

Lessons learntThe implementation of any project comes with unique and fundamental lessons for all parties involved. One of the key lessons in the implementation of the project is the importance of safeguarding the participation of all stakeholders, especially those involved in direct application of the same. Employees (or nurses in this case) own the implementation process in instances where they feel that their opinion is valued or even inculcated in the implementation process. This is the basis of participatory leadership, as it allows the stakeholders to own the process and drive its success. It is imperative that all parties are brought on board so as to safeguard the success of the project. On the same note, leaders must be willing to take charge of any project that they introduce, while also inviting the input of other stakeholders.

References

Cairns, L.L., Dudjak, L.A., Hoffmann, R.L & Lorenz, H.L. (2013). Utilizing Bedside Shift Report to Improve the Effectiveness of Shift Handoff. Journal of Nursing Administration. Volume 43 Number 3., pp 160 – 165

Baker, S.J (2010). Bedside Shift Report Improves Patient Safety And Nurse Accountability. Journal of Emergency Nursing; 36: 355-8.

Fitzsimons, V & Reinbeck, D.M (2013). Evidence-based nursing: Improving the patient experience through bedside shift report. Nursing Management. Volume 44. Number 2 pp. 16 – 17