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Bedside handoff

Laura J Olivieri, David Zurakowski, Karthik Ramakrishnan, Lillian Su, Fahad A Alfares, Matthew R Irwin, Jenna Heichel, Axel Krieger, Dilip S Nath
BACKGROUND: Postoperative care delivered in the pediatric cardiac intensive care unit (CICU) relies on providers' understanding of patients' congenital heart defects (CHDs) and procedure performed. Novel, bedside use of virtual, three-dimensional (3D) heart models creates access to patients' CHD to improve understanding. This study evaluates the impact of patient-specific virtual 3D heart models on CICU provider attitudes and care delivery. METHODS: Virtual 3D heart models were created from standard preoperative cardiac imaging of ten patients with CHD undergoing repair and displayed on a bedside tablet in the CICU...
March 2018: World Journal for Pediatric & Congenital Heart Surgery
Donna K Bigani, Andrea M Correia
PURPOSE: The purpose of this study was to explore nurse, patient, and family perceptions about change-of-shift bedside report in the pediatric setting and to describe specific safety concerns that were identified during change-of-shift handoff. DESIGN AND METHODS: An exploratory-descriptive qualitative study designed to elicit nurse, patient, and family experience with change-of-shift bedside report was utilized for this study. Interviews were conducted and reviewed to identify common themes...
March 5, 2018: Journal of Pediatric Nursing
Christopher R Leon Guerrero, Tracy Anderson, Allyson R Zazulia
OBJECTIVE: To determine the relationship between neurology inpatient satisfaction and (1) number of physicians involved in the patient's care and (2) patients' ability to identify their physicians. METHODS: A 10-item questionnaire addressing patient satisfaction and identification of physicians on the care team was administered to patients admitted to an academic, tertiary care, inpatient neurology service from May 1 to October 31, 2012. We hypothesized higher satisfaction among patients having fewer physicians on the care team and among patients able to identify their physicians...
January 19, 2018: Neurology
Katherine M Ernst, Sara A McComb, Cathaleen Ley
AIMS AND OBJECTIVES: To qualitatively investigate the medical-surgical nurse shift handoff as a process within the workflow of the exchanging nurses. Specifically, this study sought to identify the ideal handoff, ways the handoff deviated from ideal, and subsequent effect on nursing care. BACKGROUND: The functions as well as information content of the handoff have been studied. However, typical studies look at the handoff as an isolated activity utilising nurse perceptions as the primary measure of quality...
January 4, 2018: Journal of Clinical Nursing
Laura M Mussulman, Babalola Faseru, Sharon Fitzgerald, Niaman Nazir, Vivek Patel, Kimber P Richter
INTRODUCTION: The prevalence of smoking among people living with HIV/AIDS (PLWHA) remains higher than the general population. Life expectancy among PLWHA has increased over the past decade, however, PLWHA who smoke will die younger than their non-smoking peers. The primary aim of this pilot study was to examine the effects of warm handoff versus fax referral to the quitline for smoking cessation among hospitalized smokers living with HIV/AIDS. METHODS: 25 smokers with a diagnosis of HIV/AIDS hospitalized at a Midwestern academic medical center in 2012-2013 (19 male; mean age=47...
March 2018: Addictive Behaviors
Arvis K Connolly
Numerous attempts to move nursing handoff to the bedside failed within our organization. Upon retrospect, previous attempts lacked standardization, coordination, and clear expectations. With emphasis on implementing patient- and family-centered care to increase patient experience scores, we developed a standardized staff training methodology using didactic and simulation to address staff barriers to adoption, a standardized implementation process, and a process to hardwire the practice.
December 2017: Journal of Nursing Administration
Vincent Olshove, Nicole Berndsen, Veena Sivarajan, Pooja Nawathe, Alistair Phillips
BACKGROUND: Cardiac surgery on Jehovah's Witnesses (JW) can be challenging, given the desire to avoid blood products. Establishment of a blood conservation program involving the pre-, intra- and post-operative stages for all patients may lead to a minimized need for blood transfusion in all patients. METHODS: Pre-operatively, all JW patients were treated with high dose erythropoietin 500 IU/kg twice a week. JW patients were compared to matching non-JW patients from the congenital cardiac database, two per JW to serve as control...
October 1, 2017: Perfusion
Harry S Saag, Jingjing Chen, Joshua L Denson, Simon Jones, Leora Horwitz, Patrick M Cocks
BACKGROUND: Hospitalized medical patients undergoing transition of care by house staff teams at the end of a ward rotation are associated with an increased risk of mortality, yet best practices surrounding this transition are lacking. AIM: To assess the impact of a warm handoff protocol for end-of-rotation care transitions. SETTING: A large, university-based internal medicine residency using three different training sites. PARTICIPANTS: PGY-2 and PGY-3 internal medicine residents...
August 14, 2017: Journal of General Internal Medicine
Mary K Anthony, Janet Kloos, Patricia Beam, Kathleen Vidal
When nurses integrate patient expertise, nurse-to-nurse handoff becomes patient-centered (nurse and patient), and the weak link between quality and safety is mitigated. The existing paradigm for handoff is an ineffective measure to minimize errors. This article describes a reimagined bedside handoff-transitioning handoff from its prescriptive nurse-centered interaction to a patient-centered partnership using the principles of complex adaptive systems, simple rules, and partnerships that address the uniqueness of each patient and nurse interaction...
August 1, 2017: Journal of Nursing Care Quality
Charlie M Wray, Vineet M Arora, Donald Hedeker, David O Meltzer
BACKGROUND: Inpatient service handoffs are a vulnerable transition during a patients' hospitalization. We hypothesized that performing the service handoff at the patients' bedside may be one mechanism to more efficiently transfer patient information between physicians, while further integrating the patient into their hospital care. METHODS: We performed a 6-month prospective study of performing a bedside handoff (BHO) at the service transition on a non-teaching hospitalist service...
July 5, 2017: Healthcare
Anne Mørk, Anna Krupp, Jennifer Hankwitz, Ann Malec
This article describes the planning, implementation, and outcomes of 2 complementary quality initiatives, bedside handoff and nurse-initiated interdisciplinary bedside rounds, in a 24-bed medical/surgical intensive care unit. Systematic approaches such as Kotter's change model and unit-based champions were used to redesign care processes and standardize daily communication and workflows. Active partnership with the patient and the family during these changes promoted a strong intensive care unit culture of patient- and family-centered care...
January 2018: Journal of Nursing Care Quality
Christine M Riley, Amber D Merritt, Justine M Mize, Jennifer J Schuette, John T Berger
OBJECTIVE: To understand sustainability and assure long-term gains in multidisciplinary performance improvement using an operating room to cardiac ICU handoff process focused on creation of a shared mental model. DESIGN: Performance improvement cohort project with pre- and postintervention assessments spanning a 4-year period. SETTING: Twenty-six bed pediatric cardiac ICU in a tertiary care children's hospital. PATIENTS: Cardiac surgery patients admitted to cardiac ICU from the operating room following cardiac surgery...
September 2017: Pediatric Critical Care Medicine
Kevin L Crezeé, Robert J DiGeronimo, Marilyn J Rigby, Rick C Carter, Shrena Patel
BACKGROUND: Unplanned extubations (UEs) have been associated with increased ventilator days, risk of infection, cardiopulmonary resuscitation, and resuscitation medication usage. The UE rate in our level 4 NICU is lower than the national average. Efforts to further reduce UE events at our institution led an interdisciplinary group to define steps to eliminate UEs. Steps included: (1) requiring at least 2 care providers at the bedside for movement of an intubated subject; (2) standardizing head and endotracheal tube (ETT) position; (3) defining a set methodology for ETT securing; (4) introducing a postoperative handoff to improve communication; and (5) implementing a post-UE assessment tool...
May 30, 2017: Respiratory Care
Christine A Wollenhaup, Eleanor L Stevenson, Julie Thompson, Helen A Gordon, Gloria Nunn
The most frequent cause of sentinel events is poor communication during the nurse-to-nurse handoff process. Standardized methods of handoff do not fit in every patient care setting. The aims of this quality improvement project were to successfully implement a modified bedside handoff model, with some report outside and some inside the patient's room, in a postpartum unit. A structured educational module and champion nurses were used. The new model was evaluated based on the change in compliance, patient satisfaction, and nursing satisfaction...
June 2017: Journal of Nursing Administration
Rebecca L Hoffman, Jason Saucier, Serena Dasani, Tara Collins, Daniel N Holena, Meghan Fitzpatrick, Boris Tsypenyuk, Niels D Martin
Quality problem: Patients recently discharged from the intensive care unit (ICU) are at high risk for clinical deterioration. Initial assessment: Unreliable and incomplete handoffs of complex patients contributed to preventable ICU readmissions. Respiratory decompensation was responsible for four times as many readmissions as other causes. Choice of solution: Form a multidisciplinary team to address care coordination surrounding the transfer of patients from the ICU to the surgical ward...
June 1, 2017: International Journal for Quality in Health Care
Mark E Barry, Beth R Hochman, Meghan B Lane-Fall, Denise Zappile, Daniel N Holena, Brian P Smith, Lewis J Kaplan, Ann Huffenberger, Patrick M Reilly, Jose L Pascual
PURPOSE: To analyze in-room video recordings of operating room (OR) to intensive care unit (ICU) handoffs to determine tempo and quality of team interactions on nights and weekends compared with weekdays, and to demonstrate how existing telemedicine technology can be used to evaluate handoffs. METHOD: This prospective observational study of OR-to-ICU bedside handoffs was conducted in the surgical ICU of the Hospital of the University of Pennsylvania in July 2014-January 2015...
July 2017: Academic Medicine: Journal of the Association of American Medical Colleges
Kamna S Balhara, Susan M Peterson, Mohamed Moheb Elabd, Linda Regan, Xavier Anton, Basil Ali Al-Natour, Yu-Hsiang Hsieh, James Scheulen, Sarah A Stewart de Ramirez
Standardized handoffs may reduce communication errors, but research on handoff in community and international settings is lacking. Our study at a community hospital in the United Arab Emirates characterizes existing handoff practices for admitted patients from emergency medicine (EM) to internal medicine (IM), develops a standardized handoff tool, and assesses its impact on communication and physician perceptions. EM physicians completed a survey regarding handoff practices and expectations. Trained observers utilized a checklist based on the Systems Engineering Initiative for Patient Safety model to observe 40 handoffs...
February 3, 2017: Internal and Emergency Medicine
Lindsey J Patton, Jerithea D Tidwell, Karie L Falder-Saeed, Virginia B Young, Brennan D Lewis, Jacqueline F Binder
BACKGROUND: During a single hospital stay, a patient's care is transferred several times between health care clinicians requiring multiple handoffs. Nurses often voice concerns about feeling unsafe when receiving patients from other areas. AIMS: The aims of the intradepartmental quality improvement project were to identify the safest way to transfer care of pediatric patients and to improve bedside nurses' knowledge on conducting an evidence based practice project...
January 25, 2017: Journal of Pediatric Nursing
Sangil Lee, Jaime Jordan, H Gene Hern, Chad Kessler, Susan Promes, Sarah Krzyzaniak, Fiona Gallahue, Ted Stettner, Jeffrey Druck
INTRODUCTION: We aimed to assess the current scope of handoff education and practice among resident physicians in academic centers and to propose a standardized handoff algorithm for the transition of care from the emergency department (ED) to an inpatient setting. METHODS: This was a cross-sectional survey targeted at the program directors, associate or assistant program directors, and faculty members of emergency medicine (EM) residency programs in the United States (U...
January 2017: Western Journal of Emergency Medicine
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January 2017: Journal of Nursing Care Quality
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