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Olga Bljashkina

North-Estonia Medical Center

(PERH)

Mentors: Milvi Moks PhD, EneKotkas

17.05.2010

NURSINGCOMMUNICATION DURING

A PATIENT HANDOVER


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The aimof the research is to describenurses' communication during a patient

handover from one department toanother.


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This research is a qualitativeone,which is based on the literature

review. 68 literature sources were used in

this research.

Information retrieval wasaccomplished

in EBSCOhost and OVID databases

and sources of literature in TallinnHealth Care College and SatakuntaCentral Hospital libraries were used.


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Handover

Handover isthe transfer ofprofessional responsibility and

accountability for some or all

aspects of care for a patient, orgroup of patients, to another person

or professional group on a temporary

or permanent basis.

Australian Medical Association in their SafeHandover: Safe

Patients guideline (AMA, 2006)and United Kingdom

National Patient Safety Agency (2004)


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Patient handover process I

A significant part of patient handoverprocess concerns the exchange ofinformation between healthcare

professionals.

Traditionally, handovers are focusedon what nurses have already done

rather than being patient-centeredand meeting the needs of patient.


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Handover process II

Has many functions:

-nurses use the handover to

demonstrate their knowledge,expertise and protect their role inpatient care,

-may facilitate nurses in performing

certain nursing procedures.


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Nurses` communicationduring a patient handover I

The aim of communication during thehandover is to give high-quality andappropriate clinical information fromone healthcare professional to another.

Information exchange between nurses isessential to achieve the continuity ofeffective, individualized and safe patientcare.

It helps to avoid errors and gives anopportunity to ask questions and ensurethat after handover all members of theteam will have the same understandingand set of priorities.


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Poor communication might lead toinaccurate sharing information about

patient details and some importantaspects may be missed.

Staff communication should be moredeveloped and facilitated in healthcare

organizations.

Improving communication betweennurses can be an important factor in

creating patient safety.

Nurses`s communicationduring a patient handover

II


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Factorsinfluencing verbalcommunication

- environment

(interruptions,

noise),

- handoverer as aspeaker,

- receiver as a

listener.

Human factors

- human failure,

- human mistakes.

Barriers to effectivecommunication


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Communication methods Verbal

Written

Electronic Combination of

them


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Verbal report:

- the oldest handover format;

- is usually given in a setting away frompatients and is supported by nursing

documentation;

- provides more opportunity to clarifyinformation.

Verbal communicationmethods I


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Bedside handover:

- individualized and patient- centered

care;- based on a patient involvement and

participation in handover process;

- promotes a mutual respect betweenpatients and caregivers.

Verbal communicationmethods II


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The medical record

- written account of a person`s condition

and response to the treatment andcare;

- permanent and legal document.

Written documents


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Ssituation (discussion of the currentpatient condition).

Bbackground ( discussion of the

background and patient history). Aassessment .

Rrecommendations (and orders thatneed to be completed).

This method allows to reportinformation in a systematic way and

decrease confusion

SBAR method


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Electronic patient record (EPR)

- quick, easy access to the patient

record by multiple caregivers in

multiple places;

- takes time for nurses to become

enough experienced;

- reduce duplication;

- gives opportunity for automating and

structuring.

Electronic informationhandover


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Audiotapes provide fast means ofcommunication and detailedassessment.

The record can be reviewed many times. Excludes the social and emotional

aspects and opportunity to ask andanswer questions.

Difficult to understand if those whomade the tape are not present.

Tape- recorded handover


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For a report to be

meaningful the

information to the receiver

has to be given in aneffective way.

Nursing handover using

accurate and documentedinformation promotes

effective time

management.

Nursing report andinformation sharing


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The information needs to be providedin a prioritized, clear, concise and

chronological manner. Information should contain patient

care plan, treatment, currentcondition and any recent oranticipated changes.

Information handover


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The handovers often lack formalstructure and this can be explained by alack of guidelines for nurses.

Formal direction for handover would

ensure an adequate level of the processconsistency and provide support to thenurse delivering handover. Thus, theformal direction increases the quality ofthe report given.

Feedback from staff is important tomonitor effectiveness of handover.

Standardized guidelines


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Introductory briefing.

Written materials

like educational booklets, posters.

Training/education


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Nurses` communication is an importantpart of a patient handover process from

one department to another.

The aim of nurses`communication is togive and receive accurate patient

information in a way, which enables

nurses to continue high-quality care

and reduces errors.

Conclusion I


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Nurses can use

different communication methods (like

verbal, written, electronic or

combination of them) to achieve moreeffective outcomes.

Conclusion II


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Requirementsfor effective nurses`communication and work productivity

improvement are:

- Considerationwith barriers.- Reducing or minimazing their negative

impact.

- Acknowledgementof human factors(how human beings make errors).

- Creatingappropriate workenvironment.

Conclusion III


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Nurses` communication optimization

opportunities:

Choice of an appropriate

communication method. Presence of appropriate documentation.

Attentive listening.

Standardized guidelines acceptation andimplementation.

Conclusion IV


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Investigate current policies andguidelinesrelated to sharinginformation during patient handover.

Investigate verbal, written andelectronic-based practicesofcommunication at handover.

Examine nurses' beliefs andperceptionsregarding their role duringpatient handover.

Research suggestions I


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Pay attention to nursing timemanagement and provide appropriate

environment. Training programs compilation and

implementation in the hospital.

Research suggestions II


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Thank you for your

attention

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