...safe handover : safe patients guidance on clinical handover for clinicians and managers diSclaimer This publication has been produced as a service to ama members. although every care has been taken to ensure its accuracy, this publication can in no way be regarded as a substitute for professional legal or financial advice and no responsibility is accepted for any errors or omissions. The ama does not warrant the accuracy or currency of any information in this publication. The australian medical association limited disclaims liability for all loss, damage, or injury, financial or otherwise, suffered by any persons acting upon or relying on this publication or the information contained in it, whether resulting from its negligence or from the negligence of employees, agents or advisers or from any cause whatsoever. cOPyriGhT This publication is the copyright of the australian medical association limited. Other than for bona fide study or research purposes, reproduction of the whole or part of it is not permitted under the copyright act 1968, without the written permission of the australian medical association limited. safe handover : safe patients guidance on clinical handover for clinicians and managers PREPARED BY THE AUSTRALIAN MEDICAL ASSOCIATION LIMITED ABN: 37 008 426 793 2006 Adapted from the British Medical Association’s resource ‘Safe Handover: Safe Patients.’ Dr Mukesh Haikerwal President, Australian Medical Association Dr Geoff Dobb Chair, AMA Coordinating...
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...Evidence Based Practice Task 1 Western Governors University Evidence Based Practice and Applied Nursing Research The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk. Part A The article being analysed is: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal of Clinical Nursing, 22, 192-200. The analysis of the primary research report is done in the form of a graph (figure 1). Each of the four analysis areas is rated within a scale of 1-10; 1 denotes extremely weak while 10 denotes very strong. Table 1 then gives justifications for the rating by explaining why each area of analysis was rated that way in the analysis chart. [pic] Figure 1 Table 1 |A1 Article: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal | |of Clinical Nursing, 22, 192-200. | |A2 Background or introduction |The researchers provided an in depth introduction of the research topic outlining | | |important issues, previous research on the topic and their findings. The introduction | | ...
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...The National Health and Safety Standards that have not been observed in Betty's care are the following: The Governance for Safety and Quality in Health Service Organisations, The Partnering with Consumers, Preventing and Controlling Healthcare Associated Infections, The Medication Safety, The Clinical Handover, The Preventing Falls and Harm from Falls Standards. The purpose of Standard 1: Governance for Safety and Quality in Health Service Organisations is to establish consolidated managing processes that keep and augment the integrity and quality of patient care resulting in positive patient outcomes. This standard has been breached as this is known as the fundamental standard which outlines all the requirements that determine the successful application of all other NSQHS Standards. This works in collaboration with Standard 2: Partnering with Consumers. Upon Betty's arrival at the Emergency Department, the attending staff failed to...
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...Reflection on the Handover Video Vignette The issue of inter-professional communication is a critical aspect of contemporary healthcare to enhance team communication and collaboration; its unique principle is the ability of building mutual trust, understanding and support in healthcare environment (Portsmouth, Coyle & Trede, 2012). More importantly, it ensures patient’s intensive care and outcomes effectively. In this reflective essay, by approaching the 5Rs framework for reflection, I will be evaluating and analysing my personal characteristics, namely assertiveness and active listening skills compared to characteristics of two health professionals working in multidisciplinary team through a pregnancy related stroke handover. On the video vignette, James, a paramedic was conducting a clinical handover with Louise, an emergency department nurse about Sally, 35 - year - old woman in 28 - pregnancy - week. She was found to have vital signs of loss of consciousness and trouble of talking; moreover, she was noted that she had a family history of stroke and heart hypotension. The handover was entirely comprehensive and pertinent because both James and Louise possessed communicative competence skills in healthcare team. In my view, the two most meaningful characteristics were the paramedic’s assertive manner and the nurse’s active listening skill which are related to my personality traits. Therefore, I would like to achieve these skills that are key elements of inter-professional...
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...Examples of Reflective Writing Example 1 I arrived on the ward at 7:30 ready to begin a 12-hour shift. After receiving handover, my mentor assigned me the job of bathing Mr B with the help of a healthcare assistant. Mr B has Creutzfeldt-Jakob disease (CJD), a progressive disease of the nervous system with rapid deterioration due to spongiform encephalopathy. He is not expected to live to Christmas, even though he is only 19 years old. He is mentally aware of what is going on but is physically unable to demonstrate activities of daily living, including eating and drinking, has limited communication skills and is doubly incontinent. He is unsafe on his feet so mobilises with a wheelchair. I approached Mr B’s bed and asked his consent to take him for a bath. While the bath was running we began helping him to undress. He looked rather nervous. At the thought of myself being in his position, being the same age as him, I began to feel embarrassed too. I thought that I could not possibly be a professional individual if I let my embarrassment and sympathy get in the way of my nursing care. We assisted Mr B into the bath and started his wash. I knew he was uncomfortable and wanted to be able to wash himself, but was unable to do so. I was finding it difficult to look him in the eye, especially when it came to washing his genitalia. I tried to ease this by making conversation, but in a way this made matters worse. After the bath we dried Mr B, dressed him and returned him...
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...Examples of Reflective Writing Example 1 I arrived on the ward at 7:30 ready to begin a 12-hour shift. After receiving handover, my mentor assigned me the job of bathing Mr B with the help of a healthcare assistant. Mr B has Creutzfeldt-Jakob disease (CJD), a progressive disease of the nervous system with rapid deterioration due to spongiform encephalopathy. He is not expected to live to Christmas, even though he is only 19 years old. He is mentally aware of what is going on but is physically unable to demonstrate activities of daily living, including eating and drinking, has limited communication skills and is doubly incontinent. He is unsafe on his feet so mobilises with a wheelchair. I approached Mr B’s bed and asked his consent to take him for a bath. While the bath was running we began helping him to undress. He looked rather nervous. At the thought of myself being in his position, being the same age as him, I began to feel embarrassed too. I thought that I could not possibly be a professional individual if I let my embarrassment and sympathy get in the way of my nursing care. We assisted Mr B into the bath and started his wash. I knew he was uncomfortable and wanted to be able to wash himself, but was unable to do so. I was finding it difficult to look him in the eye, especially when it came to washing his genitalia. I tried to ease this by making conversation, but in a way this made matters worse. After the bath we dried Mr B, dressed him and returned him...
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...CHAPTER 1 INTRODUCTION 1.0 INTRODUCTION A handover is defined as “the act of moving power or responsibility from one person or group to another (Oxford Advanced Learner’s Dictionary of Current English 2005)”. In healthcare and clinical context, the term “handover” applies to the transferring of a patient’s information between two health care providers, when the patient receives care in a different location, or when another healthcare provider is responsible of the patient (ACSQHC 2005). The American word “handoff” also signifies the same meaning. Nursing handovers are often being described as a ritual, which stemmed from the medical concept preliminarily in the 1880s, whereby the nursing sister would direct the nurses on duty after hearing reports from the night shift nurses and the doctors’ rounds (Walsh and Ford 1989). The repetitive characteristic of the traditional handover does not encourage nurses to think critically or share different views, therefore depicted as a “ritual” (Kerr et al 2011). 1.1 BACKGROUND OFTHE STUDY The aim of a nursing shift handover is to precisely inform the patient’s general condition, care plan, treatment and expectations in a timely manner (Runy 2008). The process, if made without a systematic standardized method, would lead to errors and jeopardizes patient’s safety (ACSQHC 2010). Reported adverse events from handovers include unnecessary procedure and investigations, delayed diagnosis or treatments, prolonged hospitalization...
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...In this essay, I aim to elaborate on my knowledge and understanding of therapeutic communication prior to and after observing the video ‘Handover’ relating to ‘Pregnant stroke’; scenario-based videos. In particular, my focus is to relate the techniques utilized in the video for therapeutically communicating with the client with construction and enhancement of my personal skills of therapeutic communication, through analyzation and reflection. The video initiated as the paramedic staff informed the client, Sally that he was going to handover the related information to the nurse. It progressed with inter-professional communication between the professionals starting with their introduction, description of the event involved, a brief clinical background of the client and related observations. Following the handover, the paramedic staff reassured the client before he left. Finally, towards the end of the video, the nurse involved in a remarkable therapeutic communication with the client. I observed that this interaction incorporated therapeutic communication skills which can be substantial in a therapeutic relationship. Therapeutic communication takes place when the nurse utilizes effective techniques to construct a therapeutic relationship and also to cultivate an understanding with the client. Such communication might not necessarily be verbal, it includes the understanding of the client’s facial expressions, body language and cues which requires skills such as empathy, informing...
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...The aim of this essay is to explore an aspect of clinical practice that I have experienced whilst working as a first year student midwife in hospital. The clinical aspect I will examine will be the handover of care. The reflective model I will be using is Stephenson’s, 1993 cited in Benbow et al (2013). Stephenson’s model of reflection will enable me to use a framework specifically targeted at health professionals; this will enable me to link theory to practice and given up to date evidenced based care. The purpose of reflection is to explore the science and art of Midwifery, it is essential for decision making (Raynor, 2010). The essay will examine the psychosocial and communication surrounding handover. Midwives are faced with handover of care on every working day. Handover is a summary of details regarding the woman’s physical condition, personality, relationship, capability and overall judgement from one midwife to another midwife (Wickham, 2008). Midwives are placed to be with woman supporting, informing and educating at a vulnerable time of their lives which can result in emotional instability; midwives need to be effective at taking care of woman’s emotional needs as well as their physical ones (Raynor, 2010.) The sociology aspect of handover has been affected by the government as there are less midwives working, the birth rate is rising and there is a shortage of beds so it is in the agenda to discharge women when it is possible to (Deery et al, 2015). In accordance...
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...handoff; the need for a culture of always. Journal of Nursing Care Quality, 29(4), 371-378. A2. Graphic Background Information | The purpose of this article was to identify patient perceptions of bedside handover through directly asking patients about their care. The study was done on a two in-patient medical-surgical departments at Borgess Medical Center in Michigan. They had implemented bedside handoff at shift change 18 months prior to this study. Then a sample of patient participants was chosen from the two nursing departments for the study. They had to meet certain criteria to be a participant and they had to experience three handoffs. Then they were given a survey to fill out after the beside handovers. Participants were positive about the RN bedside handoff process. The overall mean from the survey was 3.32 on a scale of 1 (strongly disagree) to a 4 (highly agree). | Review of Literature | There were multiple references that provided statistics and facts during this study. Most of these studies have focused on implementing bedside handoffs and nurse perceptions of the handoff. Published studies that focused on patients’ perceptions of beside handoff have been mainly qualitative. Recently, researchers have published studies that seek to measure bedside handover quantitatively. Whether qualitative or quantitative, all studies report an increase in patient satisfaction with bedside handover. | Methodology | This quantitative study was to identify...
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...Communication is a key skill for any health care professional, but for nurses, we ‘are in an occupation that has interpersonal communication at its core. Virtually all nursing work revolves around the need for nurses to be effective communicators, whether relating to colleagues or with service users. (Morrall 2001). This essay seeks to discuss an evidence based experience learnt in clinical practice. For the purpose of this essay the author has chosen communication skills, since it is the basis for which verbal, non verbal and written ideas are conferred among the nursing staff. Some key policies and evidence taken from (research evidence or from this essay) will be identified and discussed. It also seeks to conclude with a general analysis from the overall main findings of this essay. The National Midwifery Council (NMC) (2008) state that nurses must take part in appropriate learning and practice activities that maintain and develop their competence and performance. As a nurse in training, I had been given the opportunity to complete a four weeks placement in a rehabilitation unit. The services provided included the admission of patients requiring rehabilitation therapy and specialist nursing attention. I was elected by my mentor to sit in their weekly review meeting consisting of the Multidisciplinary Team (MDT) in order to facilitate my learning objectives. As a student my role was to observe how the MDT addressed, planned and implemented patient care. This was necessary since...
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...1. INTRODUCTION The Quality Improvement Network was established by the RCN’s Quality Improvement Programme in 1989 to contribute to the quality of patient care through the sharing of knowledge, skills and information on quality improvement, patient safety, clinical governance and leadership. The safe transfer of care is a vital component of the quality of care and safe practice (Pothier, et al., 2005). When the process of transfer of care is inadequately undertaken risks to the patient are increased and may subsequently lead to harm (BMA, 2005; Joint Commission, 2007). The Network organised a series of patient safety road shows which were specifically designed to build consensus and concentrate activities on the key topic of transfer of care, to facilitate networking between members of the Network’s regional groups and a range of colleagues working across all care sectors, and to identify the actions required to improve the patients’ experience of transfer of care across all health and social settings. 1.1 Literature Review “A good…handover process is a crucial part of providing quality…care…The conservation of patient data during the handover process is vital to ensure good continuity of care and safe practice. Any errors or omissions made during the handover process may have dangerous consequences…” (Pothier, et al., 2005) Delays in transferring or discharging patients can result in a range of problems for both patients and organisations (Bryan, et al., 2005)...
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...help me develop clinical skill (Knowledge and self-awareness) in either therapeutic communication or inter-professional communication? The video I have chosen to reflect upon is the handover of the pregnant stroke patient from the Paramedic to the Nurse. The paramedic introduces himself and the patient Sally. The paramedic describe the past events that lead to sally being brought into hospital and his observation made at the patient’s home. For example her age and weeks of pregnancy and that she is not on any medications that they know of.The paramedic completes his handover leaving the patient in the care of the nurse. The nurses takes over care of the patient and comes down to the patient’s level and introduces herself to patient. The Nurse also explains what will happen next and remains forces on the care of the patient, using Therapeutic communication. This video shows many techniques that may benefit my development of clinical skills and knowledge in relation to Therapeutic communication. This form of communication that is used in the clinical environment is a collaborative partnership between the carer, the patient and their family and/or partner. This partnership as the main interest of meeting the best possible outcomes for the patient within the mutually agreed upon goals for the individual who is in care (Berman, Kozier, & Erb, 2015) . This form of communication is based on mutual trust, respect and acceptance. Currently I have limited clinical skills as I have...
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...Bedside nursing handover: A case study 1. Purpose of the study: The purpose of this study was to identify and describe the structures, processes, and perceptions of the outcomes of bedside handovers in nursing practice. 2. Research design: The authors used a descriptive case study which is a methodological approach that can use a number of different methods to conduct an instrumental investigation that is bounded by place and time. Case study research asks questions of ‘what’, ‘why’, and ‘how’ in a non controlled or non artificial environment to analyse existing, real life situations with all their complexity 3. Sampling technique and characteristics of the sample: The study involved three wards in two hospitals in Australia, thus six wards where ultimately included. Wards that where included where medical, surgical and rehabilitation wards. Team leaders, shift coordinators, nursing managers, and educators where the focus of the study in which all participants gave their consent. A total of 32 female participants where interviewed from both hospitals. No male participants where included. From these participants seven where under the age of 30, ten between the age of 30 and 40, eleven between the age of 40 and 50 and six where aged over 50. with regards to nursing classifications, from the 32 participants, 7 where enrolled nurses, 15 where level 1 registered nurses, 7 where level 2 registered nurses and 5 where level three nurses. Only 16 out of the 32 participants...
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...This essay will follow the steps as described within the Clinical Reasoning Cycle; introducing Mrs Alice Palmer a 54-year-old who has recently suffered an ischaemic stroke and is now undergoing further care and rehabilitation in the acute stroke unit. Firstly, the implications of stroke and the risk factors will be briefly observed, secondly, how her demographic is affected by the issue at hand will be discussed. Thirdly, handover information will be analysed and further required information will be identified in regards to the collected cues. Health assessments and histories needed to be undertaken will then be determined as well as how they will be performed, and reasons why. An ischaemic stroke is characterised by accelerated brain cell...
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