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Transcript of Clinical Handover
Face to Face handover
Which one is the most effective?
Verbal handovers are more commonly used than written handovers.
Nurses also used handwritten notes during handover.
Medical staff were found to prefer verbal conversation handovers.
Only 33% of information was retained after the handover cycle.
Only 2.5% of information was retained after five handover cycles.
Using pre-prepared data sheets resulted in the full maintenance of data.
What you will learn....
Definition of handover
Importance of handover
When handover is given
Types of handover
Most effective handover
What determines a 'good' handover?
-- Angruz1 2012, 5 ISBAR, video recording, Youtube, viewed 20th August 2014.
-- Clinical handover workshop 2- good 2012, audio casette, Sydney.
-- Jones, D., Belfrage, M., Carter, J., Chaoyer, W., Dunne, J., Hatten-Masterson, S., Jorm, C., Manias, E., Newell, S., Pirone, C., Schmiede, A., Wakefield, J. and Yee, K. C. 2010, 'OSSIE guide to clinical handover improvement', Australian Commission on Safety and Quality in Health Care, pp. 1-56, viewed 20th August 2014, <http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/ossie.pdf>.
-- Moemaylee 210, SBAR report, video recording, Youtube, viewed 21st August 2014.
-- Sterling A. 2009, Nurse shift report, video recording, Youtube, viewed 20th August 2014.
-- Tucker, A. and Fox, P. 2014, 'Evaluating nursing handover: the REED model', Nursing Standard, Vol.28, No. 20, pp.44-48, viewed 21st August 2014, <http://rcnpublishing.com/doi/abs/10.7748/ns2014.01.28.20.44.e7992>.
-- Australian Resource Centre for Healthcare Innovations 2013， Ambulance to emergency department handover project, viewed 24th August 2014, <http://www.archi.net.au/resources/safety/clinical/nsw-handover/ambulance-ed-handover>.
"Effective transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another person, or professional group on a temporary or permanent basis"
-- Australian Commission on Safety and Quality in Health Care (2010)
Why is clinical handover important?
- Communication problems are a major contributing factor in 70% of hospital adverse events.
- In 2007, WHO recognised "communication during patient handovers" as a primary element in improving patient safety.
Types of handover
When handover is given?
- Escalation of deteriorating patient.
- Patient transfers to another ward
- Shift to shift changeover
- Patient transfers for a test or appointment
- Patient transfers to another facility
- Improve safety
- Standardised and structured approach
- Continuity of care and patient safety
- Information is clear and concise
- < Adverse events
Elements of ISBAR
On the activity provided is a scenario of a clinical handover transcript. Go through and highlight with different colours the corresponding sections of ISBAR. For example, yellow for Introduction, blue for Situation......etc.
Pros and Cons
What makes a bad handover?
- Information inaccurately given.
- Bad communication e.g. language barriers.
- Not following ISBAR (not thorough enough)
- Bad atmosphere e.g. lack of privacy, noisy
- Not being respectful to the nurse handing
over or the patient.
- Time constraints.
- Lack of cultural understanding.
Initiatives to improve handover
- 'Clinical handover - standard key principles' (NSW Government)
- The Ossie Guide.
- Ambulance to Emergency Department Handover Project'
- Clinical handover in an important tool within a clinical and community setting.
- Face to Face handover is preferred.
- Handover is given at many points within a patient journey
- ISBAR is an important tool for a good handover.
- The government continues to implement mechanisms in order to standardize handover.