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Clinical Handover

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https://www.readbyqxmd.com/read/28634908/an-entrustable-professional-activity-epa-based-framework-to-prepare-fourth-year-medical-students-for-internal-medicine-careers
#1
D Michael Elnicki, Meenakshy K Aiyer, Maria L Cannarozzi, Alexander Carbo, Paul R Chelminski, Shobhina G Chheda, Saumil M Chudgar, Heather E Harrell, L Chad Hood, Michelle Horn, Karnjit Johl, Gregory C Kane, Diana B McNeill, Marty D Muntz, Anne G Pereira, Emily Stewart, Heather Tarantino, T Robert Vu
The purpose of the fourth year of medical school remains controversial. Competing demands during this transitional phase cause confusion for students and educators. In 2014, the Association of American Medical Colleges (AAMC) released 13 Core Entrustable Professional Activities for Entering Residency (CEPAERs). A committee comprising members of the Clerkship Directors in Internal Medicine and the Association of Program Directors in Internal Medicine applied these principles to preparing students for internal medicine residencies...
June 20, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28606198/clinical-information-transfer-between-ems-staff-and-emergency-medicine-assistants-during-handover-of-trauma-patients
#2
Seyedeh Almas Fahim Yegane, Ali Shahrami, Hamid Reza Hatamabadi, Seyed-Mostafa Hosseini-Zijoud
Introduction Clinical handover by Emergency Medical Services (EMS) staff, as the first people who have contact with trauma patients, in the emergency department (ED), is very important. Therefore, effective communication to transfer clinical information about patients in a concise, rational, clear, and time-bound manner is essential. In Iran, the transfer of necessary information in clinical handover in EDs was carried out orally and without following standard instructions. This study aimed to audit the current clinical handover according to the Identify, Situation, Background, Assessment, and Recommendation (ISBAR) tool and survey the effect of training the ISBAR tool to Emergency Medicine Assistants (EMAs) and EMS staff on improvement of the clinical handover of patients to the ED...
June 13, 2017: Prehospital and Disaster Medicine
https://www.readbyqxmd.com/read/28595847/interprofessional-communication-supporting-clinical-handover-in-emergency-departments-an-observation-study
#3
Bernice Redley, Mari Botti, Beverley Wood, Tracey Bucknall
BACKGROUND: Poor interprofessional communication poses a risk to patient safety at change-of-shift in emergency departments (EDs). The purpose of this study was to identify and describe patterns and processes of interprofessional communication impacting quality of ED change-of-shift handovers. METHODS: Observation of 66 change-of-shift handovers at two acute hospital EDs in Victoria, Australia. Focus groups with 34 nurse participants complemented the observations...
June 5, 2017: Australasian Emergency Nursing Journal: AENJ
https://www.readbyqxmd.com/read/28595111/similarity-and-accuracy-of-mental-models-formed-during-nursing-handovers-a-concept-mapping-approach
#4
Anat Drach-Zahavy, Chaya Broyer, Efrat Dagan
BACKGROUND: Shared mental models are crucial for constructing mutual understanding of the patient's condition during a clinical handover. Yet, scant research, if any, has empirically explored mental models of the parties involved in a clinical handover. OBJECTIVES: This study aimed to examine the similarities among mental models of incoming and outgoing nurses, and to test their accuracy by comparing them with mental models of expert nurses. DESIGN: A cross-sectional study, exploring nurses' mental models via the concept mapping technique...
May 20, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28560035/completeness-in-clerking-the-surgical-admissions-proforma
#5
Kunal Bhanot, Jordan Abdi, Prashant Bamania, Maria Samuel, Josef Watfah
BACKGROUND: The accessibility of surgical patient data is a key safety concern, and relies on efficient clerking and handovers. This project assessed whether the introduction of a surgical clerking proforma improved the recording of patient information in the surgical admissions unit (SAU) at Northwick Park Hospital. MATERIALS AND METHODS: Existing patient notes were assessed on content and ease of access, using two independent surveys conducted over a 5-day period...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28524382/an-observational-study-of-patient-care-outcomes-sensitive-to-handover-quality-in-the-post-anaesthetic-care-unit
#6
Nichole Lillibridge, Mari Botti, Beverley Wood, Bernice Redley
AIMS AND OBJECTIVES: To identify patient care outcome indicators sensitive to the quality of interprofessional handover between the anaesthetist and the Post-Anaesthetic Care Unit nurse. BACKGROUND: The relationship between interprofessional clinical handover when patients are transferred from the operating theatre to the Post-Anaesthetic Care Unit and patient outcomes of subsequent patient care delivery is not well understood. DESIGN: Naturalistic, exploratory descriptive design using observation...
May 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28524253/improving-patient-safety-the-impact-of-an-outpatients-electronic-handover-system-in-a-tertiary-dermatology-department
#7
Flora Poon, Raymond Martyres, Anthony Denahy, George Varigos
BACKGROUND/OBJECTIVES: Electronic medical records (EMR) can improve quality healthcare, patient safety and streamline workflow to improve efficiency of a department. Despite the known benefits and difficulties of EMR systems, there is limited data on the impact and definable effectiveness it can have within a dermatology unit. We present an outpatients' EMR known as an electronic handover system (EHS) from its inception, delivery and audit of its use in evaluating the true impact. METHODS: An audit of the EHS was conducted from 1 March to 31 August 2014...
May 19, 2017: Australasian Journal of Dermatology
https://www.readbyqxmd.com/read/28523364/-structured-patient-handovers-in-perioperative-medicine-rationale-and-implementation-in-clinical-practice
#8
M J Merkel, V von Dossow, B Zwißler
Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies)...
May 18, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28482890/crisis-checklists-for-in-hospital-emergencies-expert-consensus-simulation-testing-and-recommendations-for-a-template-determined-by-a-multi-institutional-and-multi-disciplinary-learning-collaborative
#9
Christian P Subbe, John Kellett, Paul Barach, Catriona Chaloner, Hayley Cleaver, Tim Cooksley, Erik Korsten, Eilish Croke, Elinor Davis, Ashley Jr De Bie, Lesley Durham, Chris Hancock, Jilian Hartin, Tracy Savijn, John Welch
BACKGROUND: 'Failure to rescue' of hospitalized patients with deteriorating physiology on general wards is caused by a complex array of organisational, technical and cultural failures including a lack of standardized team and individual expected responses and actions. The aim of this study using a learning collaborative method was to develop consensus recomendations on the utility and effectiveness of checklists as training and operational tools to assist in improving the skills of general ward staff on the effective rescue of patients with abnormal physiology...
May 8, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28433731/effectiveness-of-a-role-play-simulation-program-involving-the-sbar-technique-a-quasi-experimental-study
#10
Mi Yu, Kyung Ja Kang
BACKGROUND: Accurate, skilled communication in handover is of high priority in maintaining patients' safety. Nursing students have few chances to practice nurse-to-doctor handover in clinical training, and some have little knowledge of what constitutes effective handover or lack confidence in conveying information. OBJECTIVES: This study aimed to develop a role-play simulation program involving the Situation, Background, Assessment, Recommendation technique for nurse-to-doctor handover; implement the program; and analyze its effects on situation, background, assessment, recommendation communication, communication clarity, handover confidence, and education satisfaction in nursing students...
June 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28420502/the-impact-of-situation-background-assessment-recommendation-sbar-on-safety-attitudes-in-the-obstetrics-department
#11
Wan-Hua Ting, Fu-Shiang Peng, Ho-Hsiung Lin, Sheng-Mou Hsiao
OBJECTIVE: Previous studies evaluating the situation-background-assessment-recommendation (SBAR) have been shown to increase effective nurse-physician communication and collaboration. The purpose of this study is to evaluate the impact of the SBAR technique on safety attitudes in the obstetrics department. MATERIALS AND METHODS: This study implemented the SBAR Collaborative Communication Education course and was conducted in a medical center from February 2012 to March 2015, which included an educational session on fetal heart rate monitoring, a case-based discussion, and a video demonstration on traditional and SBAR communication...
April 2017: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/28401728/developing-a-guideline-for-structured-content-and-process-in-mental-health-nursing-handover
#12
Darrin Cowan, Scott Brunero, Xiaoou Luo, Dean Bilton, Scott Lamont
The process of handover has received recent attention within Australian health care, as evidence linking patient safety with the quality of handover emerges. Such links between clinical handover and patient safety have been reported elsewhere in the literature, where it is posited that the safe care of patients relies not only on the expertise and judgment of individual clinicians, teamwork, and effective management, but hinges to a large extent on the quality of information transferred from team to team. The present qualitative, descriptive study used participant observations, focus groups, and interviews to investigate the nursing handover in two acute mental health inpatient units in New South Wales, Australia...
April 12, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28397007/preparing-medical-students-for-clinical-practice-easing-the-transition
#13
Alexandra R Teagle, Maria George, Nicola Gainsborough, Inam Haq, Michael Okorie
The transition from medical student to junior doctor is a challenge; the UK General Medical Council has issued guidance emphasizing the importance of adequate preparation of medical students for clinical practice. This study aimed to determine whether a junior doctor-led simulation-based course is an effective way of preparing final year medical students for practice as a junior doctor.We piloted a new 'preparation for practice' course for final year medical students prior to beginning as Foundation Year 1 (first year of practice) doctors...
April 10, 2017: Perspectives on Medical Education
https://www.readbyqxmd.com/read/28384314/patient-satisfaction-after-implementation-of-person-centred-handover-in-oncological-inpatient-care-a-cross-sectional-study
#14
Anna Kullberg, Lena Sharp, Hemming Johansson, Yvonne Brandberg, Mia Bergenmar
Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure...
2017: PloS One
https://www.readbyqxmd.com/read/28376872/barriers-and-facilitators-to-improve-safety-and-efficiency-of-the-icu-discharge-process-a-mixed-methods-study
#15
Nelleke van Sluisveld, Anke Oerlemans, Gert Westert, Johannes Gerardus van der Hoeven, Hub Wollersheim, Marieke Zegers
BACKGROUND: Evidence indicates that suboptimal clinical handover from the intensive care unit (ICU) to general wards leads to unnecessary ICU readmissions and increased mortality. We aimed to gain insight into barriers and facilitators to implement and use ICU discharge practices. METHODS: A mixed methods approach was conducted, using 1) 23 individual and four focus group interviews, with post-ICU patients, ICU managers, and nurses and physicians working in the ICU or general ward of ten Dutch hospitals, and 2) a questionnaire survey, which contained 27 statements derived from the interviews, and was completed by 166 ICU physicians (21...
April 4, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28375938/-being-in-the-know-nurses-perspectives-on-the-role-of-end-of-shift-verbal-handover
#16
Antoinette David, Eleanor Holroyd, Mervyn Jackson, Sonja Cleary
AIM: To explore and qualitatively review 'end-of-shift' verbal communication practices and processes; and to further develop a core theoretical construction of nurses' perspectives on handover in contemporary Australian clinical settings. METHOD: The following study will report the results from phase 1 of a two-phase study examining the Australian nurse's perspective of verbal handover. The data were gathered over a 2-month period in 2013 for phase 1 of the study...
June 2017: International Journal of Evidence-based Healthcare
https://www.readbyqxmd.com/read/28371469/improving-emergency-department-medical-clinical-handover-barriers-at-the-bedside
#17
Gerrard Oren Marmor, Michael Yonghong Li
OBJECTIVE: The present paper describes our experience of developing and piloting a best practice model of medical clinical handover. Secondary aims were to improve reliability of communication, identify negative effects on patient care and assess staff adherence and acceptance of the process. METHODS: We described existing handover practice. We designed and implemented a process incorporating bedside handover, the Identification, Situation, Background, Assessment, Requirements and Requests (ISBAR) tool and handover documentation...
June 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28352468/introduction-of-a-microsoft-excel-based-unified-electronic-weekend-handover-document-in-acute-and-general-medicine-in-a-dgh-aims-outcomes-and-challenges
#18
Pablo Kostelec, Pietro Emanuele Garbelli, Pietro Emanuele Garbelli
On-call weekends in medicine can be a busy and stressful time for junior doctors, as they are responsible for a larger pool of patients, most of whom they would have never met. Clinical handover to the weekend team is extremely important and any communication errors may have a profound impact on patient care, potentially even resulting in avoidable harm or death. Several senior clinical bodies have issued guidelines on best practice in written and verbal handover. These include: standardisation, use of pro forma documents prompting doctors to document vital information (such as ceiling of care/resuscitation status) and prioritisation according to clinical urgency...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28339636/a-before-after-study-of-multidisciplinary-out-of-hours-handover-combining-management-and-frontline-efforts-to-create-sustainable-improvement
#19
Christopher Pennell, Lorna Flynn, Belinda Boulton, Tracey Hughes, Graham Walker, Peter McCulloch
Objective: The importance of implementation strategy in systems improvement is increasingly recognized and both 'bottom-up' and 'top-down' approaches have significant barriers. A trial of a combined approach involving frontline and managerial staff therefore seems merited. We attempted to improve handover using a Human Factors-based approach integrated with a combined 'top and bottom' implementation strategy. Design: A before-after study was conducted across 9 months...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28238586/developing-a-minimum-dataset-for-nursing-team-leader-handover-in-the-intensive-care-unit-a-focus-group-study
#20
Amy J Spooner, Leanne M Aitken, Amanda Corley, Wendy Chaboyer
BACKGROUND: Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. OBJECTIVES: The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. METHODS: This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited...
February 23, 2017: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
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