...between nurses has been an important process in clinical nursing practice. Allowing nurses to exchange vital patient information to ensure continuity of care and patient safety. Therefore, the chance of potential communication gaps causing an error is high. According to the Joint Commission, communication is the primary cause of medical errors, with handoffs accounting for 80% of these errors [ (Zhani, 2012) ]. The most commonly practiced model of report takes place in the staff room, at the nurses’ station, or other locations away from the patient’s bedside. However, more institutions are implementing the Bedside Report hand-off model to communicate patient care information. Research articles has identified the benefits of bedside report in conjunction with structured reporting tool (e.g. SBAR) as: (1) improvements in patient-centered care and nursing services, (2) less chance of medical errors, (3) decreasing the length of stay in patients [ (Chaboyer W, 2009) ]. Upon observing the shift to shift report in SMMC, it was evident that some nurses failed to provide effective communication and did not utilized the SBAR format tool as stated in the hospital’s guidelines. Hand-off reports were being done in the nurse’s station and along the unit’s hallways. Fatigue and distractions contributed to ineffective communication. As a result shift reports are often unstructured, repetitive, and lacked consistency in the type of information provided by each individual nurse. According...
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...situations where errors occur, often due to how shift changes are structured as much as mistakes by individual nurses (Halm, 2013). Wooldridge Place, for example, has a number of systemic deficiencies that contribute to communication breakdown between shifts and compromise patient care. It is anticipated that switching to a bedside handoff and addressing factors that contribute to negative outcomes from shift changes will allow Wooldridge to increase its patient safety and standards of care, and to meet National Patient Safety Goals and reduce overall costs to the organization. Background Significance While medical record-keeping is vital to patient care, nurses also...
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...communication between the nurses. At the end of the shift, the off going nurse is responsible to give a detail report on the patient to the incoming nurse who will be caring for the patient, so that they are up-to-date on the patient treatment needed for the shift. Change of shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The hand over process of communication between nurses to nurses with the intention of transferring essential information for safe, and holistic care of patients. Traditionally, this shift report has been done away from the patient’s bedside, at the nurse’s station, or other place like staff’s room. In addition,...
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...The goal of Banner Health will be to improve communication processes within nurses. Within a year, the goal will be to improve the bedside handoff report with nurses by implementing a standard of nurse handoff by 10%. This will be done by the implementation of bedside report. This paper will discuss a strategy for communication, including management strategies, personal leadership development, managerial decision-making, business function, and leadership strategies. Management Strategies In order to reach this goal, a team will be first built to take on the challenge presented. To improve planning, a team will need to be formed, such as a guiding team to be able to create support around the plan (Kotter, & Cohen, 2012). The team will be able to research what is best for the company, while following the legislative processes as well. This team will be responsible for addressing the plan and forming it to how the company would approve of it. This will build on learning and growth goals, to develop education plans on increasing communication within nurses. To develop customer service and meet financial goals, the management by objectives method will be used. First, the guiding team will set goals to implement bedside report in each unit (Daft, 2014). Next, the action plan will be done and reviewing the progress. Corrective action will be taken on those nurses who do not implement bedside report. Lastly, the performance will be appraised each year to reach the 10% a year increase...
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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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...the accepting nurse. With this in mind, a change is needed so that there is an optimum patient outcome for each and every one of the people that walk through the doors of the emergency room and get admitted. A1. The current practice in the emergency department that I work in when admitting a patient to the medical floor goes something like this. 1. Emergency department doctor enters orders for a consulting doctor to come and look at the patient to determine if an admission is warranted. 2. The consulted admission doctor assesses the patient and determines admission diagnosis. 3. Orders are written for admission. 4. Admission orders and chart is assessed to determine if the patient meets inpatient or observation criteria by case management registered nurses. 5. Once inpatient vs. observation status is determined, case management puts up an indicator on patient chart that bed can be ordered. 6. Primary RN requests bed from bed board using computerized bed request form. 7. Bed board assigns room to patient and places an indicator on patient chart with room number. 8. Primary nurse calls floor that patient is assigned to and asks to speak to nurse assigned to patient. 9. Phone report is given to accepting nurse. 10. Patient care tech transports patient to room. 11. Accepting nurse and CNA from the floor settle patient into room. 12. If accepting nurse has any questions, they call back down to the nurse they received report...
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...Standardizing Shift-to-Shift Reports This paper will examine the best nursing practice for standardizing shift-to-shift reports. I became interested in this topic after hearing my mother talk about her day floating to a floor at her hospital. She received report on her patients from two different nurses that morning. Each nurse gave her different information and both were missing information that she considered vital to the care of her patients. She normally works in the ICU and on the step-down medical surgical floor, which both use a version of a template that was designed by one of the nurses to facilitate a standardized shift-to-shift report. When I attended the shift-to-shift reports in the clinical setting, I noticed that you never got a consistent picture of the patients. With the advance of the electronic medical records, the ease of finding relevant patient information has been made easier, but the shift-to-shift report is still an important tool for nurses to learn more detailed information about their patients then what is in their charts. In 2006, the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) included “Standardizing communication during patient handoff (shift report)…” as one of their National Patient Safety Goals (Schroeder, 2006, p. 22). This paper will explore two articles that present evidence on different options for a shift-to-shift template and a third article talks about implementing a standardization of the shift-to-shift report...
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...provided for patients in many facilities today. Different techniques play a big part when trying to communicate with patients. Therapeutic touch, facial expression, and non-verbal techniques are the factors that helps create meaning. The nursing practice utilizes constant communication between the patient, family, co-workers, and other member’s involved in the plan of care. The important components of successful communication are a sender, a receiver, and the messenger. In the nursing profession a lot of information is sent out to a receiver in a short period of time. When there is a breakdown in the communication this can cause negative outcomes. Many factors can influence how a message is interpreted. Each day nurses have to handoff report to the oncoming nurse at shift change. When important information is not received by the sender, treatments, medications, and interventions are missed. Speak on situations that have occurred where important interventions are missed. Trust is a huge component with patients and their family. When an individual is admitted in the hospital the change in the environment causes a change in their mental status. This mostly occurs in the developmental stage of infants to school-aged- children and the elderly population. Family members become very concerned because of the difference in the patients behavior. When this occurs it is important for medical staff to reorient the patient and develop a trust relationship to ensure they are secure and safe...
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...Clinical Documentation System Excelsior College October 6, 2013 Clinical Documentation System Clinical information system (CIS) collects patient data in real time, stores healthcare data and information using secure access to the healthcare team. (McGonigle & Garver Mastrian, 2012, p. 554). The CIS that is used at Texas Health Dallas is CareConnect. CareConnect is used by all of the Texas Health Resources (THR) encompassing 25 hospitals, affiliated physician offices, and ancillary facilities. CareConnect allows physicians and management to access the system on their mobile devices and home computer for real time data. The shift for CIS is set for implementation throughout the United States by 2015. The clients served are those in the community that THR provides healthcare services to. The electronic health record is shared amongst the healthcare team and other affiliates. Data collection can be continuously updated, used for “statistical evaluation for purposes of quality improvement, outcome reporting, resource management, and public health surveillance.”(Yamada, 2008, p. 5). Data collection is generally initiated in the ER, and other times when the patient is at the physician's office or in the outpatient service line. To reference inpatient services, data collection begins in the ER. The patient's allergies, current medications, medical history, vital signs, immunizations, suicide screening and domestic violence screening are all obtained...
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...Skills Validation PNCI Eliana Ruiz Age: 86 Weight: 55 kg Base: Standard Adult Overview Synopsis The learner will be providing care to an 86-year-old Hispanic female admitted to the MedicalSurgical Unit with a non-healing wound on her right upper leg where a femoral-popliteal bypass graft was performed two weeks ago. She is diabetic and injured her left ankle by tripping on a curb on the way to the hospital. She is anxious about not being able to care for herself when she returns home. She lives alone but has a daughter close by, and has no insurance. This Simulated Clinical Experience™ (SCE™) has five states, that are transitioined manually. With manual transitions, the instructor should advance to the applicable state when appropriate interventions are performed. Initially, in State 1 0900 Hours Assessment, the learner is presented with a patient who is febrile and exhibiting other signs of infection. Initial assessment reveals a temperature of 38.6o Celsius, HR in the 80s, BP in the 140s/80s, RR in the low 20s and SpO2 in the mid 90s on room air. Breath sounds demonstrate crackles bilaterally. The patient is anxious and incontinent of urine. She has a non-productive cough and reports tenderness over the left ankle. Initial treatment includes application of an elastic bandage to the left ankle, assessment of pain level, administration of pain medications, insertion of a urinary catheter and a sterile wet-to-moist dressing change to the graft site. If learners request...
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...University In our practice, professional presence is the foundation on which we establish what it means to be human and to care for our fellow man. To be a nurse and choose the many sacrifices it takes to spend one’s life caring for others requires knowledge of one’s own personal beliefs and values. Our own past experiences with life and how they have shaped us also influence how we relate and treat our patients. These things work together to create our mindful presence. Throughout our years of practice, our experience with patients, coworkers and physicians as well as a growing knowledge base help us develop a road map which we follow in our everyday work. These things help us better understand others and what it truly means to be human. As we gain a better understanding for the very people we serve, we can better create a healing environment. Jean Watson, a nurse theorist, best defines a human as “a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted. He is to be viewed as greater than and different from the sum of his or her parts.” She then says that nursing is “a human science of persons and human health, illnesses, and experiences that are mediated by professional, personal, scientific, esthetic, and human transactions.” (Watson, 1999) Surely, with her definition of nurses, we are to be held to a very high standard as well as charged with the difficult task of caring for our patients from many different aspects than just physically...
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...The World is Flat Thomas L Friedman Kq p K To Matt and Kay and to Ron Kq p K Contents How the World Became Flat One: While I Was Sleeping / 3 Two: The Ten Forces That Flattened the World / 48 Flattener#l. 11/9/89 Flattener #2. 8/9/95 Flattener #3. Work Flow Software Flattener #4. Open-Sourcing Flattener #5. Outsourcing Flattener #6. Offshoring Flattener #7. Supply-Chaining Flattener #8. Insourcing Flattener #9. In-forming Flattener #10. The Steroids Three: The Triple Convergence / 173 Four: The Great Sorting Out / 201 America and the Flat World Five: America and Free Trade / 225 Six: The Untouchables / 237 Seven: The Quiet Crisis / 250 Eight: This Is Not a Test / 276 Developing Countries and the Flat World Nine: The Virgin of Guadalupe / 309 Companies and the Flat World Geopolitics and the Flat World Eleven: The Unflat World / 371 Twelve: The Dell Theory of Conflict Prevention / 414 Conclusion: Imagination Thirteen: 11/9 Versus 9/11 / 441 Acknowledgments I 471 Index I 475 Kq p K :::::How the World Became Flat ::::: ONE While I Was Sleeping Your Highnesses, as Catholic Christians, and princes who love and promote the holy Christian faith, and are enemies of the doctrine of Mahomet, and of all idolatry and heresy, determined to send me, Christopher Columbus, to the above-mentioned countries of India, to see the said princes, people, and territories, and to learn their disposition and the proper method of converting them to our...
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