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Perioperative Handoff Communication

A Thesis Presented to the Faculty of the Graduate School of Our Lady of Fatima University
by

Jordan Albert Cruz

on 19 March 2013

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Transcript of Perioperative Handoff Communication

Educational Attainment
•BSN – 76%
•MA with Units – 20%
•MAN – 3%
•Doctoral with Units – 1%
•Doctoral – 0%
Length of Stay in the Specified Area
•2-4 years – 37%
•5-7 years – 26%
•8-10 years – 16%
•10 years and above – 21% Problems on handoff communication could be a cause for concern, too in the Philippines. This behooves that the issue be given sufficient attention and concern in terms of research. While there have been a lot of concerns raised about the effectiveness of the handoff process, there are relatively few studies describing or promoting safe transition methods in the Philippines. • Nurses from public and private tertiary hospitals who have not finished their Master’s degree to be reminded to finish their graduate studies because educational attainment tends to make communication strategies sophisticated. • Nurses from public tertiary hospitals use more specific tools that will help them improve quality of perioperative nursing care. •Operating room nurses, both from public and private tertiary hospitals, should put importance during handoff communication details about their patient’s condition •A study that focuses on the same variables will be conducted by other researchers in the future with the following modifications: Increasing the number of respondents, increasing the number of research locales, including the ones receiving the handoff and utilizing observation as a complimentary method of data collection to improve quality of data generated. •Perioperative nurse, both from public and private tertiary hospitals, who are assigned in the surgical unit improve process of verification in their handoff communication. •Perioperative nurses from private tertiary hospitals should utilize time management to enhance handoff communication. •Nurse managers are suggested to not change the area of assignment of perioperative nurses inasmuch as the longer they stay in their area of assignment, the more sophisticated their communication strategies become. •Perioperative nurses, both from public and private tertiary hospitals, who are assigned in the surgical unit always practice the strategy of limiting interruptions and distractions •Surgical inpatient nurses, both from public and private tertiary hospitals, should emphasize assessment in their handoff communication Area of Assignment
•Surgical Inpatient Unit – 38%
•Operating Room – 39%
•Post-anesthesia Care Unit – 23% Hospital Classification
•Public – 43%
•Private – 57% Public and Private
-focus on technical and ethical aspects
Public - more efficient --> time management
Private - more assertive --> clarification BSN & MAN units
- ethical considerations
MAN & Doctoral units
- ethics and technicalities Ward & PACU
- time management 2-4 yrs - ethical
5-10 yrs - ethical + time management
10 yrs + - very cautious & circumspect Private - more specific Sophistication increases with their educational attainment
BSN & MAN with units - very basic
MAN - more complicated
Doctoral units - more sophisticated, creative and independent All perioperative areas - ensuring patient safety
OR Nurses - verification process the number of years in the area does not affect the likelihood of nurses in using more sophisticated standardization strategies
10 years and up - verification process public & private
- same in utilizing environmental strategies not affected by Educational attainment Ward - able to do handoff despite interruptions and distractions
OR & PACU - need to limit it number of years spent working in a specific are make nurses use all environmental strategies Surgical inpatient unit nurse
-do not always put emphasis
on assessment Public & Private OR Nurses
- do not always communicate
the details about the patient's
physical condition PACU nurse from private hospital - more thorough in the practice of SBAR Structure Outcome Process the administration of hospitals should provide areas within the nursing stations areas which are conducive to handoff communication for perioperative nurses from one unit to another unit The areas should have limited noise and distractions, and should be private so as not to breach patient confidentiality as nurses normally would exchange vital information about the patients (a) strict restrictions on floating of perioperative nurses to other areas in the hospital as the findings of the study concluded that the nurses’ ability to utilize appropriate strategies for handoff and SBAR techniques are dependent on factors like the length of experience in their respective areas of assignments (b) a stringent policy on continuing education of nurses inasmuch as the findings of the study point that nurses with higher educational qualifications tend to utilize more sophisticated strategies and they tend to be more inclined to manage their time more judiciously (c) a careful and consistent reward system that will motivate nurses who utilize effective strategies of handoff communication (d) a systematic training and development program that will address competency gaps among nurses and will abreast them with the trends and issues pertaining to handoff communication (e) a just and sustained monitoring of the observance of handoff communication techniques as a function of the controlling as a component of nursing management (a) least possible errors in any of the processes in the perioperative unit of the hospital (b) a satisfactory level of satisfaction among patients who received perioperative nursing care (c) complaints emanating from perioperative nurses regarding patient care instructions and conditions are kept at a minimum In a nutshell, the limited list of foreign and local studies on handoff communication point out that communication failure is the leading cause of inadvertent patient harm. Communication failures include issues such as faulty exchanges of existing information, insufficient information, ambiguous and unclear information and lack of timely and effective exchange of pertinent information and result from individual, interpersonal and systemic factors. Increasing recognition of these issues has made improving teamwork and communication a priority for advancing patient safety and quality of care. Effective interaction between team members has been associated with greater efficiency and decreased workloads, reduced adverse drug events, improved clinical outcomes, reduced patient morbidity, improved job satisfaction and retention and improved patient satisfaction. Design Locale Population Instrument Statistical Analysis Data Gathering Procedure Demographic Profile Utilization of Strategies for Effective Handoff Communication Practice of Perioperative SBAR Elements of Handoff Communication
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