NURSING COMMUNICATION NURSING COMMUNICATION DURING A PATIENT DURING A PATIENT

HANDOVERHANDOVER

The aimThe aim of the research is to describe of the research is to describe nurses' communication during a nurses' communication during a patient handover from one patient handover from one department to another.department to another.

This research is a qualitativeThis research is a qualitative one, one, which is based on the literature which is based on the literature review. review.

68 literature sources were used i68 literature sources were used in n this researchthis research..

Information retrieval was Information retrieval was accomplishedaccomplished› in EBSCOhost and OVID in EBSCOhost and OVID

databases and sources of databases and sources of literature in Tallinn Health Care literature in Tallinn Health Care College and Satakunta Central College and Satakunta Central Hospital libraries were used.Hospital libraries were used.

HandoverHandover Handover isHandover is ‘the transfer of ‘the transfer of

professional responsibility and professional responsibility and accountability for some or allaccountability for some or all aspects of care for a patient, or aspects of care for a patient, or group of patients, to another group of patients, to another person or professional group onperson or professional group on a a temporary or permanent basis.’temporary or permanent basis.’ Australian Medical Association in their ‘SafeAustralian Medical Association in their ‘Safe Handover: Handover: Safe Patients’ guideline (AMA, 2006)Safe Patients’ guideline (AMA, 2006) and United Kingdom and United Kingdom National Patient SafetyNational Patient Safety Agency (2004)Agency (2004)

Patient handover Patient handover process Iprocess I

A significant part of patient A significant part of patient handover process concerns the handover process concerns the exchange of information between exchange of information between healthcare professionalshealthcare professionals..

Traditionally, handovers are Traditionally, handovers are focused on what nurses have focused on what nurses have already done rather than being already done rather than being patientpatient--centered and meeting the centered and meeting the needs of patientneeds of patient..

Handover process IIHandover process II

Has many functionsHas many functions::

-- nurses use the handover to nurses use the handover to demonstrate their knowledge, demonstrate their knowledge, expertise and protect their role in expertise and protect their role in patient carepatient care, ,

-- may facilitate nurses in may facilitate nurses in performing certain nursing performing certain nursing procedures.procedures.

NNursesurses` communication ` communication during a patient during a patient

handover Ihandover I The aim of communication during The aim of communication during the the

handover is to handover is to givegive high-quality and high-quality and appropriate clinical information from appropriate clinical information from one healthcare professional to another. one healthcare professional to another.

Information exchange Information exchange between nurses between nurses is essential to achieve is essential to achieve thethe continuity of continuity of effective, individualized and safe effective, individualized and safe patient care. patient care.

It helps to avoid errors and gives an It helps to avoid errors and gives an opportunity to ask questions and opportunity to ask questions and ensure that after handover all members ensure that after handover all members of the team will have the same of the team will have the same understanding and set of priorities.understanding and set of priorities.

Poor communication might lead to Poor communication might lead to inaccurate inaccurate sharing informasharing informattion aboution about patient details and patient details and some some important important aspectsaspects may be missed. may be missed.

Staff communication should be more Staff communication should be more developed and facilitated in developed and facilitated in healthcare organizations.healthcare organizations.

Improving communication between Improving communication between nurses can be an important factor in nurses can be an important factor in creating patient safety.creating patient safety.

NNursesurses`s communication `s communication during a patient handover IIduring a patient handover II

Factors Factors influencing influencing verbal verbal communicationcommunication- eenvironmentnvironment

(interruptions,(interruptions, noise) noise),,

- hhandoverer as a andoverer as a speakerspeaker,,

- rreceiver as a eceiver as a listenerlistener..

Human factorsHuman factors- human failurehuman failure,,- human mistakeshuman mistakes..

Barriers to effective Barriers to effective communicationcommunication

Communication methodsCommunication methods

VerbalVerbal WrittenWritten ElectronicElectronic Combination Combination of of

them them

Verbal reportVerbal report::- tthe oldest handover formathe oldest handover format;; - is usually given in a setting away is usually given in a setting away

from patients and is supported by from patients and is supported by nursing documentationnursing documentation;;

- provides more opportunity to clarify provides more opportunity to clarify information.information.

Verbal communication Verbal communication methods Imethods I

Bedside handoverBedside handover::- individualized and patient- centered individualized and patient- centered

carecare;;- based on based on a a patient involvement and patient involvement and

participation in handover processparticipation in handover process;;- promotes a mutual respect between promotes a mutual respect between

patients and caregiverspatients and caregivers..

Verbal communication Verbal communication methods IImethods II

The medical record The medical record - written account of a personwritten account of a person`s `s

condition and response to the condition and response to the treatment treatment and careand care;;

- permanent and legal documentpermanent and legal document..

Written documentsWritten documents

SS – situation – situation (discussion of the current (discussion of the current patient condition).patient condition).

BB – background – background ( discussion of the ( discussion of the background and patient history).background and patient history).

AA – assessment – assessment . . RR – recommendations – recommendations (and (and orders that orders that

need to be completedneed to be completed).).This method allows This method allows to to report report

information in a systematic way information in a systematic way andand decrease confusion decrease confusion

SBAR methodSBAR method

Electronic patient record (EPR)Electronic patient record (EPR)- quick, easy access to the patient quick, easy access to the patient

record by multiple caregivers in record by multiple caregivers in multiple placesmultiple places;;

- takes time for nurses to become takes time for nurses to become enough experiencedenough experienced;;

- reduce duplicationreduce duplication;;- gives opportunity for automating and gives opportunity for automating and

structuringstructuring..

Electronic information Electronic information handoverhandover

Audiotapes provide fast means of Audiotapes provide fast means of communication and detailed communication and detailed assessmentassessment..

The record can be reviewed many The record can be reviewed many timestimes..

Excludes the social and emotional Excludes the social and emotional aspects and opportunity to ask and aspects and opportunity to ask and answer questionsanswer questions..

Difficult to understand if those who Difficult to understand if those who made the tape are not presentmade the tape are not present..

Tape- recorded handoverTape- recorded handover

For a report to be For a report to be meaningful the meaningful the information to the information to the receiver receiver has tohas to be given be given in an effective way.in an effective way.

Nursing handover using Nursing handover using accurate and accurate and documented information documented information promotes effective time promotes effective time management. management.

Nursing report and Nursing report and information sharinginformation sharing

The information needs to be The information needs to be provided in a prioritized, clear, provided in a prioritized, clear, concise and chronological manner. concise and chronological manner.

Information should contain patient Information should contain patient care plan, treatment, current care plan, treatment, current condition and any recent or condition and any recent or anticipated changes.anticipated changes.

Information handoverInformation handover

The handovers often lack formal The handovers often lack formal structure and this can be explained by structure and this can be explained by a lack of guidelines for nurses.a lack of guidelines for nurses.

Formal direction for handover would Formal direction for handover would ensure an adequate level of the ensure an adequate level of the process consistency and provide process consistency and provide support to the nurse delivering support to the nurse delivering handover. Thus, the formal direction handover. Thus, the formal direction increases the quality of the report increases the quality of the report given.given.

Feedback from staff is important to Feedback from staff is important to monitor effectiveness of handover.monitor effectiveness of handover.

Standardized guidelinesStandardized guidelines

Introductory briefingIntroductory briefing.. Written materialsWritten materials

like educational booklets, like educational booklets, postersposters..

Training/educationTraining/education

NurseNurses`s` communication is an important communication is an important part of a patient handover process part of a patient handover process from one department to anotherfrom one department to another..

The aim of nursThe aim of nurses`es`communication is to communication is to give and receive accurate patient give and receive accurate patient information in a wayinformation in a way, , which enables which enables nurses to continue high-quality care nurses to continue high-quality care and reduces errorsand reduces errors..

Conclusion IConclusion I

Nurses can useNurses can use different communication methods different communication methods

(like verbal, written, electronic or (like verbal, written, electronic or combination of them) to achieve combination of them) to achieve more effective outcomesmore effective outcomes..

Conclusion IConclusion III

RequirementsRequirements for effective nurse for effective nurses`s` communication and work productivity communication and work productivity improvement areimprovement are::- ConsiderationConsideration with barriers with barriers..- Reducing Reducing or minimazing their or minimazing their

negative impactnegative impact..- AcknowledgementAcknowledgement of human factors of human factors

(how human beings make errors)(how human beings make errors)..- CreatingCreating appropriate work appropriate work

environmentenvironment..

Conclusion IIIConclusion III

NursNurses`es` communication optimization communication optimizationopportunitiesopportunities:: Choice of Choice of an an appropriate appropriate

communication methodcommunication method.. Presence of aPresence of appropriate ppropriate

documentationdocumentation.. Attentive listeningAttentive listening.. Standardized guidelines acceptation Standardized guidelines acceptation

and implementationand implementation..

Conclusion Conclusion IVIV

Investigate current policies and Investigate current policies and guidelinesguidelines relat relateded to to sharing sharing information information during patient during patient handover.handover.

Investigate verbal, written and Investigate verbal, written and electronic-based practiceselectronic-based practices of of communication at handovercommunication at handover..

Examine nurses' beliefs and Examine nurses' beliefs and perceptionsperceptions regarding their role regarding their role during patient handoverduring patient handover..

Research suggestions IResearch suggestions I

Pay attention to nursing time Pay attention to nursing time management and management and provideprovide appropriate environmentappropriate environment..

Training programs compilation and Training programs compilation and implementation in the hospitalimplementation in the hospital..

Research suggestions IIResearch suggestions II

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