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Clinical Handover

Shobhana Nagraj, Juliet Harrison, Lawrence Hill, Lesley Bowker, Susanne Lindqvist
BACKGROUND: Collaborative practice between paramedics and medical staff is essential for ensuring the safe handover of patients. Handover of care is a critical time in the patient journey, when effective communication and collaborative practice are central to promoting patient safety and to avoiding medical error. To encourage effective collaboration between paramedic and medical students, an innovative, practice-based simulation exercise, known as interprofessional clinical skills (ICS) was developed at the University of East Anglia, UK...
February 23, 2018: Clinical Teacher
Rikke von Benzon Hollesen, Rie Laurine Rosenthal Johansen, Christina Rørbye, Louise Munk, Pierre Barker, Anette Kjaerbye-Thygesen
BACKGROUND: A safe delivery is part of a good start in life, and a continuous focus on preventing harm during delivery is crucial, even in settings with a good safety record. In January 2013, the labour unit at Copenhagen University Hospital, Hvidovre, undertook a quality improvement (QI) project to prevent asphyxia and reduced the percentage of newborns with asphyxia by 48%. METHODS: The change theory consisted of two primary elements: (1) the clinical content, including three clinical bundles of evidence-based care, a 'delivery bundle', an 'oxytocin bundle' and a 'vacuum extraction bundle'; (2) an implementation theory, including improving skills in interpretation of cardiotocography, use of QI methods and participation in a national learning network...
February 3, 2018: BMJ Quality & Safety
G Sirgo Rodríguez, M Chico Fernández, F Gordo Vidal, M García Arias, M S Holanda Peña, B Azcarate Ayerdi, E Bisbal Andrés, A Ferrándiz Sellés, P J Lorente García, M García García, P Merino de Cos, J M Allegue Gallego, A García de Lorenzo Y Mateos, J Trenado Álvarez, P Rebollo Gómez, M C Martín Delgado
Handover is a frequent and complex task that also implies the transfer of the responsibility of the care. The deficiencies in this process are associated with important gaps in clinical safety and also in patient and professional dissatisfaction, as well as increasing health cost. Efforts to standardize this process have increased in recent years, appearing numerous mnemonic tools. Despite this, local are heterogeneous and the level of training in this area is low. The purpose of this review is to highlight the importance of IT while providing a methodological structure that favors effective IT in ICU, reducing the risk associated with this process...
February 6, 2018: Medicina Intensiva
Atilio Barbeito, Aalok V Agarwala, Amanda Lorinc
Handovers around the time of surgery are common, yet complex and error prone. Interventions aimed at improving handovers have shown increased provider satisfaction and teamwork, improved efficiency, and improved communication and have been shown to reduce errors and improve clinical outcomes in some studies. Common recommendations in the literature include a standardized institutional process that allows flexibility among different units and settings, the completion of urgent tasks before information transfer, the presence of all members of the team for the duration of the handover, a structured conversation that uses a cognitive aid, and education in team skills and communication...
March 2018: Anesthesiology Clinics
Alejandra Bravo-Molina, José Patricio Linares-Palomino, Blanca Vera-Arroyo, Luis Miguel Salmerón-Febres, Eduardo Ros-Díe
BACKGROUND: The aim of this cohort study was to assess the inter-observer agreement of three diabetic foot classification systems: the Wagner, the University of Texas and the PEDIS. METHODS: We included 250 consecutive patients diagnosed of diabetic foot syndrome in 2009-2013. Wound scores were recorded at admission and a reevaluation was performed simultaneously or 24h later by a different evaluator. Demographical, laboratory data and associated risk factors were obtained from the patients' medical records...
February 2018: Foot and Ankle Surgery: Official Journal of the European Society of Foot and Ankle Surgeons
Melissa Desmedt, Jochen Bergs, Benjamin Willaert, Ward Schrooten, Annemie Vlayen, Johan Hellings, Neree Claes, Dominique Vandijck
OBJECTIVES: The primary aim was to measure patient safety culture in two home care services in Belgium (Flanders). In addition, variability based on respondents' profession was examined. METHODS: A cross-sectional study was conducted by administering the SCOPE-Primary Care questionnaire in two home care service organizations. RESULTS: In total, 1875 valid questionnaires were returned from 2930 employees, representing a response rate of 64%...
February 1, 2018: Journal of Patient Safety
U Hamsen, C Waydhas, R Wildenauer, T A Schildhauer, W Schwenk
BACKGROUND: Unplanned admissions or readmissions to the intensive care unit lead to a poorer outcome and present medical, logistic and economic challenges for a clinic. How often and what are the reasons for readmission to the intensive care unit? Which strategies and guidelines to avoid readmission are recommended. MATERIAL AND METHODS: Analysis and discussion of available studies and recommendations of national and international societies. RESULTS: Many studies show that unplanned admissions and readmissions to the intensive care unit represent an independent risk factor for a poor outcome for patients...
January 30, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Sami Alsolamy, Atheer Al-Sabhan, Najla Alassim, Musharaf Sadat, Eman Al Qasim, Hani Tamim, Yaseen M Arabi
BACKGROUND: Clinical handover is an important process for the transition of patient-care responsibility to the next healthcare provider, but it may divert the attention of the team away from active patients. This is challenging in the Emergency Department (ED) because of highly dynamic patient conditions and is likely relevant in conditions that requires time-sensitive therapies, such as sepsis. We aimed to examine the management and outcomes of patients presenting with sepsis and septic shock to the ED during nursing handover...
January 18, 2018: BMC Emergency Medicine
Elizabeth Reine, Johan Ræder, Tanja Manser, Milada C Småstuen, Tone Rustøen
This cross-sectional study assessed how nurses transferring and receiving patients in the postoperative care unit evaluate quality in patient handovers. Analysis of 192 questionnaires showed that transferring nurses had more positive evaluations of handover quality compared with the receiving nurses. Handovers evaluated as having lower quality had a higher frequency of time pressure, uncertainty, and clinical problems. The findings in the study point at a need to assess handover quality in a wider perspective...
January 16, 2018: Journal of Nursing Care Quality
Olly Bannon, Emma Greenwood
: In recent years the RVH Emergency Department (ED) had been under intense pressure and public scrutiny. This led to a demoralised workforce who had become disengaged with quality improvement (QI). QI projects had become an exercise in data collection with little focus on improving care for patients.Two consultants undertook training in QI and then decided to develop a QI project aiming to empower staff and embed QI as daily practice. An ED QI steering group of interested multidisciplinary members was formed and devised an improvement plan to increase staff engagement with QI...
December 2017: Emergency Medicine Journal: EMJ
Amy J Spooner, Leanne M Aitken, Wendy Chaboyer
INTRODUCTION: There is widespread use of clinical information systems in intensive care units however, the evidence to support electronic handover is limited. OBJECTIVES: The study aim was to assess the barriers and facilitators to use of an electronic minimum dataset for nursing team leader shift-to-shift handover in the intensive care unit prior to its implementation. METHODS: The study was conducted in a 21-bed medical/surgical intensive care unit, specialising in cardiothoracic surgery at a tertiary referral hospital, in Queensland, Australia...
November 15, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, Wendy Chaboyer
BACKGROUND: Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES: To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN: Systematic mixed- methods review. DATA SOURCES: Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching...
October 24, 2017: International Journal of Nursing Studies
Malcolm Moore, Chris Roberts, Jonathan Newbury, Jim Crossley
BACKGROUND: Good clinical handover is critical to safe medical care. Little research has investigated handover in rural settings. In a remote setting where nurses and medical students give telephone handover to an aeromedical retrieval service, we developed a tool by which the receiving clinician might assess the handover; and investigated factors impacting on the reliability and validity of that assessment. METHODS: Researchers consulted with clinicians to develop an assessment tool, based on the ISBAR handover framework, combining validity evidence and the existing literature...
November 15, 2017: BMC Medical Education
Daryl R Cheng, James Liddle, Emily Mailes, Mike South
BACKGROUND: Clinical medical handover between doctors forms a critical part of the patient care process. However, with the evolution of junior medical staff (JMS) working conditions, time pressure and increasing clinical and administrative loads mean that quality clinical handover is increasingly important yet more challenging to achieve. This study evaluated the impact of a newly integrated electronic handover tool on JMS adoption and usage of the tool, as well as impacts on the quality (accuracy and redundancy) of handover data, JMS perceived workflow (time management and communication) and JMS satisfaction...
December 2017: International Journal of Medical Informatics
Benjamin J Sandefur, Diana M Shewmaker, Christine M Lohse, Steven H Rose, James E Colletti
BACKGROUND: The Accreditation Council for Graduate Medical Education (ACGME) implemented revisions to resident duty hour requirements (DHRs) in 2011 to improve patient safety and resident well-being. Perceptions of DHRs have been reported to vary by training stage and specialty among internal medicine and general surgery residents. The authors explored perceptions of DHRs among all residents at a large academic medical center. METHODS: The authors administered an anonymous cross-sectional survey about DHRs to residents enrolled in all ACGME-accredited core residency programs at their institution...
November 10, 2017: BMC Medical Education
Sandra Moss, Marion Mitchell, Angela Thomson, Monica Piskor, Cathy Biles, Veronica Casey
No abstract text is available yet for this article.
November 2017: Nursing Management
R Ellen Pearlman, Melissa Pawelczak, Andrew C Yacht, Salaahuddin Akbar, Gino A Farina
BACKGROUND : The Association of American Medical Colleges describes 13 core entrustable professional activities (EPAs) that every graduating medical student should be expected to perform proficiently on day 1 of residency, regardless of chosen specialty. Studies have shown wide variability in program director (PD) confidence in interns' abilities to perform these core EPAs. Little is known regarding comparison of United States Medical Licensing Examination (USMLE) scores with proficiency in EPAs...
October 2017: Journal of Graduate Medical Education
J J Coughlan, T Mross, F Gul, A Abbott, R Say, A Nawaz, C O'Brien, R Liston
INTRODUCTION: Clinical handover is defined as inter-clinician communication occurring at care interfaces. In this study, we analyse the clinical outcomes and physician attitudes associated with the implementation of a electronic clinical handover system in our medical department. AIM: The aim of this project was to introduce a reliable, standardised, reproducible method of communicating information regarding inpatients within our medical department. We also sought to assess the attitudes of physicians within our department to medical handover...
October 23, 2017: Irish Journal of Medical Science
Shannon Bakon, Tracey Millichamp
BACKGROUND: The effective handover of patient health data from the emergency department to other hospital units is integral for the continuity of patient care. Yet no handover process has been identified as superior to others within this context. METHODS: This study within a regional Australian hospital employed mixed methods approach including focus groups and key stakeholder consultation to develop a handover form appropriate for patient transfer from the emergency department to a variety of clinical areas...
October 13, 2017: Australasian Emergency Nursing Journal: AENJ
Mubiana Inambao, William Kilembe, Lauren A Canary, Nancy L Czaicki, Matilda Kakungu-Simpungwe, Roy Chavuma, Kristin M Wall, Amanda Tichacek, Julie Pulerwitz, Ibou Thior, Elwyn Chomba, Susan A Allen
INTRODUCTION: Most HIV infections in Africa are acquired by married/cohabiting adults and WHO recommends couple's voluntary HIV counseling and testing (CVCT) for prevention. The handover from NGO-sponsored weekend CVCT to government-sponsored services in routine weekday antenatal care (ANC) and individual voluntary testing and counseling (VCT) services in Zambia's two largest cities from 2009-2015 is described. METHODS: Government clinic counselors were trained to provide CVCT, and along with community health workers they promoted CVCT services in their clinic and surrounding areas...
2017: PloS One
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