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Clinical Handover

Katherine Lambe, Judy Currey, Julie Considine
BACKGROUND: Understanding of clinical deterioration of emergency department patients is rapidly evolving. The aim of this study was to investigate the frequency and nature of vital sign collection and clinical deterioration in emergency care. METHODS: A descriptive exploratory approach was used. Data were collected from the records of 200 randomly selected adults with presenting complaints of abdominal pain, shortness of breath, chest pain and febrile illness from 1 January to 31 December 2014 at a 22 bed emergency department in Melbourne, Australia...
October 7, 2016: Australasian Emergency Nursing Journal: AENJ
Emma Saunsbury, Gabrielle Howarth
Blood tests are a seemingly basic investigation, but are often a vital part of directing patient management. Despite the importance of this everyday process, we indentified the potential for improvement of the current phlebotomy service in our hospital, as both junior doctors and phlebotomists reported a lack of communication and standardised practice across the wards. Resulting delays in obtaining blood test results can impact detrimentally on patient safety and management. We designed a survey which highlighted inefficient handovers and discrepancies between wards as driving factors behind this...
2016: BMJ Quality Improvement Reports
George J E Crowther, Michael I Bennett, John D Holmes
INTRODUCTION: in the United Kingdom dementia is generally diagnosed by mental health services. General hospitals are managed by separate healthcare trusts and the handover of clinical information between organisations is potentially unreliable. Around 40% of older people admitted to hospital have dementia. This group have a high prevalence of psychological symptoms and delirium. If the dementia diagnosis or symptoms are not recognised, patients may suffer unnecessarily with resulting negative outcomes...
September 10, 2016: Age and Ageing
Mareike Przysucha, Daniel Flemming, Ursula Hübner
Innovations are typically characterised by their relative newness for the user. In order for new eHealth applications to be accepted as innovations more criteria were proposed including "use" and "usability". The handoverEHR is a new approach that allows the user to translate the essentials of a clinical case into a graphical representation, the so-called cognitive map of the patient. This study aimed at testing the software usability. A convenience sample of 23 experienced nurses from different healthcare organisations across the country rated the usability of the handoverEHR after performing typical handover tasks...
2016: Studies in Health Technology and Informatics
Noa Segall, Alberto S Bonifacio, Atilio Barbeito, Rebecca A Schroeder, Sharon R Perfect, Melanie C Wright, James D Emery, B Zane Atkins, Jeffrey M Taekman, Jonathan B Mark
BACKGROUND: Patient handovers (handoffs) following surgery have often been characterized by poor teamwork, unclear procedures, unstructured processes, and distractions. A study was conducted to apply a human-centered approach to the redesign of operating room (OR)-to-ICU patient handovers in a broad surgical ICU (SICU) population. This approach entailed (1) the study of existing practices, (2) the redesign of the handover on the basis of the input of hand over participants and evidence in the medical literature, and (3) the study of the effects of this change on processes and communication...
September 2016: Joint Commission Journal on Quality and Patient Safety
Maria Raisa Jessica Ryc V Aquino, Ellinor K Olander, Justin J Needle, Rosamund M Bryar
OBJECTIVES: Interprofessional collaboration between midwives and health visitors working in maternal and child health services is widely encouraged. This systematic review aimed to identify existing and potential areas for collaboration between midwives and health visitors; explore the methods through which collaboration is and can be achieved; assess the effectiveness of this relationship between these groups, and ascertain whether the identified examples of collaboration are in line with clinical guidelines and policy...
October 2016: International Journal of Nursing Studies
Sharifah Munirah Alhamid, Desmond Xue-Yuan Lee, Hei Man Wong, Matthew Bingfeng Chuah, Yu Jun Wong, Kaavya Narasimhalu, Thuan Tong Tan, Su Ying Low
PROBLEM: Effective handovers are critical for patient care and safety. Electronic handover tools are increasingly used today to provide an effective and standardized platform for information exchange. The implementation of an electronic handover system in tertiary hospitals can be a major challenge. Previous efforts in implementing an electronic handover tool failed due to poor compliance and buy-in from end-users. A new electronic handover tool was developed and incorporated into the existing electronic medical records (EMRs) for medical patients in Singapore General Hospital (SGH)...
August 10, 2016: International Journal for Quality in Health Care
Claire van Deventer, Glenn Robert, Anne Wright
BACKGROUND: A significant proportion of children admitted to a hospital in a South African sub-district in 2010 were severely malnourished and - when concurrently HIV positive - were not correctly initiated on antiretroviral therapy. Audit data over a subsequent four year period revealed that 60 % of malnourished children admitted to the hospital were HIV positive. To supplement an ongoing local quality improvement (QI) intervention addressing poor nutritional outcomes in children in this setting, Experience-based Co-design (EBCD) was used to enhance previously low levels of mother, carer and staff engagement...
2016: BMC Health Services Research
C Langelotz, G Koplin, A Pascher, R Lohmann, A Köhler, J Pratschke, O Haase
Background: Between the conflicting requirements of clinic organisation, the European Working Time Directive, patient safety, an increasing lack of junior staff, and competitiveness, the development of ideal duty hour models is vital to ensure maximum quality of care within the legal requirements. To achieve this, it is useful to evaluate the actual effects of duty hour models on staff satisfaction. Materials and Methods: After the traditional 24-hour duty shift was given up in a surgical maximum care centre in 2007, an 18-hour duty shift was implemented, followed by a 12-hour shift in 2008, to improve handovers and reduce loss of information...
August 5, 2016: Zentralblatt Für Chirurgie
Rebecca Mathew, Serena Gundy, Diana Ulic, Shariq Haider, Parveen Wasi
PURPOSE: To assess senior internal medicine residents' experience of the implementation of a reduced duty hours model with night float, the transition from the prior 26-hour call system, and the new model's effects on resident quality of life and perceived patient safety in the emergency department and clinical teaching unit at McMaster University. METHOD: Qualitative data were collected during May 2013-July 2014, through resident focus groups held prior to implementation of a reduced duty hours model and 10 to 12 months postimplementation...
September 2016: Academic Medicine: Journal of the Association of American Medical Colleges
Bernice Redley
No abstract text is available yet for this article.
October 2016: Evidence-based Nursing
Pauline Calleja, Leanne Aitken, Marie Cooke
AIMS AND OBJECTIVES: To understand: (1) staff perceptions of best practice for information transfer for multitrauma patients on discharge from the emergency department; (2) what information should be conveyed at transfer and (3) how information is transferred. BACKGROUND: Information transfer for multitrauma patients is an integral factor for continuity of care, safety, quality assurance and patient outcomes; however, this has not been the focus of previous studies...
October 2016: Journal of Clinical Nursing
Bernice Redley, Tracey K Bucknall, Sue Evans, Mari Botti
OBJECTIVES: To examine quality and safety in inter-professional clinical handovers in Post Anaesthetic Care Units (PACUs) and make recommendations for tools to standardize handover processes. DESIGN: Mixed methods combining data from observations and focus groups. SETTING: Three PACUs, one public tertiary hospital and two private hospitals. PARTICIPANTS: Observations were made of 185 patient handovers from anaesthetists to nurses...
July 15, 2016: International Journal for Quality in Health Care
Jennifer Brook, Marilia Amaro Calcia
Handover is a high risk point for errors in clinical care, in many cases leading to adverse events or near misses. The timely transfer of accurate and useful information between professionals is vital to ensure quality and safety, and to ensure the transfer of accountability for care. In this project standards were developed for quality handover between doctors in a liaison psychiatry department. The aim of these were to ensure adequate identification of patients, clear communication of tasks to be completed and relevant risk issues, as well as a guide to the priority of jobs...
2016: BMJ Quality Improvement Reports
Gerard Fealy, Deirdre Munroe, Fiona Riordan, Eilish Croke, Celine Conroy, Martin McNamara, Michael Shannon
OBJECTIVE: the objective was to examine and describe clinical handover practices in Irish maternity services. DESIGN: the study design incorporated interviews and focus group discussions with a purposive sample of healthcare practitioners working in Irish maternity services. SETTING: five maternity hospitals and fourteen co-located maternity units. PARTICIPANTS: midwives, obstetricians and other healthcare professionals, specifically physiotherapists and radiologists, midwifery students and health care assistants working in maternity services...
August 2016: Midwifery
Natasha Johan Bauer
BACKGROUND: Novel research has revealed that the relative risk of death increased by 10% and 15% for admissions on a Saturday and Sunday, respectively. With an imminent threat of 7-day services in the National Health Service, including weekend operating lists, handover plays a pivotal role in ensuring patient safety is paramount. This audit evaluated the quality, efficiency, and safety of surgical handover of pre- and postoperative cardiothoracic patients in a tertiary center against guidance on Safe Handover published by the Royal College of Surgeons of England and the British Medical Association...
2016: Advances in Medical Education and Practice
Briony Campbell, Christine Stirling, Elizabeth Cummings
BACKGROUND: Transfer of older people from Residential Aged Care Facilities to Emergency Departments requires multiple comprehensive handovers across different services. Significant information gaps exist in transferred information despite calls for standards. AIM: To investigate: (1) presence of minimum standard elements in the transfer text written by RACF nurses, paramedics and ED triage nurses, and (2) the transfer documentation used by services. METHODS: We analysed retrospective cross-sectional transfer narratives from the digital medical record system of an Australian tertiary referral hospital using the mnemonic SBAR (Situation, Background, Assessment Recommendation) as the measure of comprehensiveness...
May 28, 2016: International Emergency Nursing
Teddy Suratos Fabila, Hwan Ing Hee, Rehena Sultana, Pryseley Nkouibert Assam, Anne Kiew, Yoke Hwee Chan
INTRODUCTION: The efficiency of postoperative handover of paediatric patients to the children's intensive care unit (CICU) varies according to institutions, clinical setup and workflow. Reorganisation of handover flow based on findings from observational studies has been shown to improve the efficiency of information transfer. This study aimed to evaluate a new handover process based on recipients' perceptions, focusing on completeness and comprehensiveness of verbal communication, and the usability of a situation, background, assessment and recommendation (SBAR) form...
May 2016: Singapore Medical Journal
Kathleen Huth, Francine Hart, Katherine Moreau, Katherine Baldwin, Kristy Parker, David Creery, Mary Aglipay, Asif Doja
OBJECTIVE: A standardized handover curriculum (I-PASS) has been shown to reduce preventable adverse events in a large multicenter study. We aimed to study the real-world impact of the implementation of this curriculum on handover quality, duration, and identification of unstable patients. METHODS: A prospective intervention study was conducted. We implemented the I-PASS curriculum via faculty education and resident workshops. Resident handover on the clinical teaching unit was videorecorded, and written handover documents were collected for 2 weeks before and after the intervention...
August 2016: Academic Pediatrics
Tiffany S Moon, Michael X Gonzales, Amy P Woods, Pamela E Fox
STUDY OBJECTIVE: To evaluate the efficacy of a bundled intervention to improve the quality of the operating room to intensive care unit (ICU) clinical handover. DESIGN: Prospective, interventional study. SETTING: An urban, public teaching hospital with more than 1500 direct postoperative ICU admissions each year. INTERVENTIONS: A bundled intervention to include the addition of a direct anesthesia provider to ICU nurse telephone report, a mnemonic to standardize the handover process, and improved template for postoperative documentation by the anesthesia team...
June 2016: Journal of Clinical Anesthesia
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