Assessing Nurses’ Knowledge Sharing Problems Associated with Shift Handover in Hospital Settings

In hospital settings, the quality and effectiveness of shift handover are critical for continuous and high quality patient care. This paper explores nurses’ knowledge sharing problems during shift handover in 6 Australian hospitals. A single focus group was conducted to collect empirical evidence of knowledge sharing problems during shift handover, across the hospitals. Findings indicate a broader set of problems that hinder effective knowledge sharing and suggest that handover standards, codification guidelines, the format of templates, and training in conducting handover need to be improved. Additionally, knowledge codification by health professionals other than nurses needs to be encouraged to improve shift handover. Finally, more guidance and training in using various IT hospital systems are necessary to give entry-level and graduate nurses adequate skills to ensure more effective shift handover. This study emphasizes the importance of people, technology, systems, standards and routine activities to capture and share important shift knowledge

Barriers to effective communication between doctors at shift handover.

Shift handover is a process during which doctors can exchange information, authority and primary responsibility for patient care. The level of handover standardisation may vary across departments and hospitals, and handover may be affected by the context in which it occurs. If during handover communication doctors do not transfer information pertinent to a patient's care delivery, it may lead to unintended negative consequences.An explanatory, mixed-methods study, using the principles of critical realism was conducted to investigate whether or not similar barriers to effective shift handover communication between doctors identified in hospitals around the world are identified by doctors working in hospitals in the Czech Republic and to develop hypotheses regarding how various individual performance-, work environment- and system-related factors may collectively contribute to ineffective shift handover communication between doctors. In accordance with the principles of critical realism the study included theory-testing phases: (i) a critical review of literature; (ii) a cross-sectional questionnaire survey; and (iii) semi-structured interviews with doctors.The results of the study show that doctors working in hospitals in the Czech Republic identify similar barriers to effective shift handover communication between doctors identified in hospitals around the world. However, handover between the Czech Republic doctors has its own specific characteristics. The inadequacies of the social, systemic and environmental features that make up different contexts in which handover is conducted collectively contribute to ineffective shift handover communication. For example, a systemic feature (e.g. the absence of training), may lead to specific doctors' beliefs (e.g. handover is meaningless), which in turn trigger certainbehaviours (e.g. doctors go home without communicating either verbally or in writing the work carried out during the previous shift), that tend towards a particular kind of outcome (e.g. the absence of handover). Consequently, the division of barriers to handover into one-dimensional categories such as 'the individual performance', 'the system' or 'the social environment', has emerged as superficial as it does not adequately reflect the reality of the context and process of handover communication. Any interventions and programmes, which aim to enhance communication between doctors at shift handover, may need therefore to address the multidimensional nature of handover communication

Passing the Baton: An Experimental Study of Shift Handover

Shift handovers occur in many safety-critical environments, including aviation maintenance, medicine, air traffic control, and mission control for space shuttle and space station operations. Shift handovers are associated with increased risk of communication failures and human error. In dynamic industries, errors and accidents occur disproportionately after shift handover. Typical shift handovers involve transferring information from an outgoing shift to an incoming shift via written logs, or in some cases, face-to-face briefings. The current study explores the possibility of improving written communication with the support modalities of audio and video recordings, as well as face-to-face briefings. Fifty participants participated in an experimental task which mimicked some of the critical challenges involved in transferring information between shifts in industrial settings. All three support modalities, face-to-face, video, and audio recordings, reduced task errors significantly over written communication alone. The support modality most preferred by participants was face-to-face communication; the least preferred was written communication alone

ICU handover procedure: the Greek perspective

Background: Passing the right information poses a challenge in clinical practice. This is the first study in Greece that tries to describe the handover procedure in an intensive care unit to a tertiary hospital.Methods: A two phase study was conducted during a 155 days period. It included a blind and open observational study which examined the quality and content of clinical handover by night shift doctor to the medical team and a survey about the process. Retrospective cross-checking of the information handed over with one written down in the actual patient record was also conducted.Results: A total of 800 set of patients’ daily records were examined. A structure of system-based approach of the handover was recorded, with system coverage varying from 21% (nutrition) to 86% (respiratory system) and good relation with the actual record in most areas of interest. Other areas, such as comorbidities, and relatives’ issue were poorly covered. Education meeting that was held between the two phases did ameliorate the content and the quality of information passed over, and in some areas, proved to have a positive effect on certain aspect of handover like e.g. frequency of interruptions, infection status, relatives’ issues and proposed management plan coverage.Conclusions:Handoverprocess is vital for maintaining stability and quality of care in intensive care unit. Its continual efficiency reevaluation is at least as important as the handover itself for preserving it as a valuable tool in everyday practice.

Cognitive Artifacts in Support of Medical Shift Handover: An In Use, In Situ Evaluation

Technologies introduced to support complex and critical work practices merit rigorous and effective evaluation. However, evaluation strategies often fall short of evaluating real use by practitioners in the workplace and thereby miss an opportunity to gauge the true impact of the technology on the work. This article reports an in use, in situ evaluation of 2 cognitive artifacts that support the everyday work of handover in a healthcare setting. The evaluation drew inspiration from the theoretical viewpoint offered by distributed cognition, focusing on the information content, representational media, and context of use of the artifacts. The article discusses how this approach led to insights about the artifacts and their support of the work that could not have been obtained with more traditional evaluation techniques. Specifically, the argument is made that the ubiquitous approach of user testing with its reliance on think-alouds and observations of interaction is inadequate in this context and set an initial agenda for issues that should be addressed by in use, in situ evaluations

Pengaruh Pelatihan Timbang Terima Pasien Terhadap Penerapan Keselamatan Pasien Oleh Perawat Pelaksana di RSUD Raden Mattaher Jambi

The patient handover help nurses to identify the service area that require improvement to improve patient safety. The purpose of this research was to identify the effect of training on patient handover with an effective communication approach integrated to the implementation of patient safety to the implementation of handover and patient safety by nurse practitioner at RSUD Raden Mattaher Jambi. This research used preexperimental design, with one group pretest posttest design. The sample is 43 nurse practitioner. From the data analysis, it has been recognized that there is a significant improvement in the implementation of patient handover and patient safety after getting a training and guidance on patient handover (p value : 0.000). The conclusion, there is an effect of training on patient handover to the implementation of handover and patient safety. Hospital should implements patient handover effectively in the form of policies, direction and evaluation to continuity of nursing care that have an impact on improving the implementation of patient safety

The effect of Situation, Background, Assessment, Recommendation (SBAR) education on the quality of student nurses handoff report

Leaders in patient safety initiatives have promoted the use of standardized communication at the time of handoff as a means to decrease the margin for errors during the transmission of critical information. One means of standardizing handoff is by using the framework provided by the Situation, Background, Assessment, Recommendation (SBAR) communication technique. This framework provides specific guidelines for organizing and communicating relevant patient information at the time of handoff. To date there is a gap in training and education of handoff practices at the academic level of healthcare students. Potential interventions to address this gap include the positive benefits of appropriate handoff education and training among student nurses. This aim of this study was to address the quality of student nurses\u27 handoff reports and its significance to a culture of safety. A quasi-experimental pilot study was conducted to assess the effect of an SBAR education program on the quality of student nurses\u27 handoff report. Six students were randomly placed into one of two groups. The intervention group attended an education program designed by the researcher. The control group did not attend the education program. Statistical analysis revealed a significant difference in the quality of content of handoff reports between students who received SBAR education and those who did not. However, there was no significant difference in the organization of the handoff report between cohorts. The education program on the tenets of SBAR proved to be beneficial in teaching student nurses how to conduct a quality handoff report. Implications from this study include the positive benefit that introducing quality improvement initiatives at the academic level can have on patient safety