Developing a Bedside Handoff Process for Postpartum Patients
Developing a Bedside Handoff Process for Postpartum Patients Kelli Benson, BSN, RNC-MNN Ferris State University Plan Project goals: • To improve the handoff process between the labor and delivery (L&D), postpartum, and antepartum departments. • To improve patient involvement in handoff report. Problems addressed: • No patient involvement in handoff • No face to face handoff • Needed use of Situation, Background, Assessment, Recommendation structure (SBAR) for handoff Support: • Bedside handoff has been shown to improve: • Patient outcomes, engagement, and satisfaction • Staff communication, accountability, and satisfaction Root Cause Analysis: • Environment: different models of care • Management: different managers, styles, and experience levels • Equipment: unreliable phone system, not using electronic medical record for handoff • Process: phone handoff, transfer time inconsistent • People: patient and family not involved, patient transferred by nursing assistant, lack of understanding of each other’s roles Do Staff Involvement: • Requesting volunteers from all departments • Utilized to help develop the handoff tool and staff survey questions in order to increase success of the new procedure Standardized Tool: • Developed to provide handoff that provided the information needed by all departments • Ensure the patient would be appropriately updated Patient Survey: • Determine patient perspective of involvement • Before and after the change in practice Staff Survey: • Elicit staff opinions related to handoff • Before and after the change Study Standardized Handoff Tool • Developed by staff • Initiated in labor and delivery • Used at bedside • SBAR format New Handoff Process • Labor and delivery calls receiving unit to give 15 minute “heads up” to transfer • Receiving nurse available at bedside • Handoff occurs at bedside • Patient and family included Act • • Repeat staff survey Repeat patient survey Bedside handoff audits Bedside staff volunteers • Ongoing feedback • Revisions of standardized handoff tool • Revisions of bedside handoff process References Groves, P. S. , Manges, K. A. , & Scott-Cawiezell, J. (2016). Handing off safety at the bedside. Clinical Nursing Research, 25(5), 473 -493. doi: 10. 1177/1054773816630535 Holden, A. C. (2012). Commitment to putting new mothers first: Implementing bedside report in a family birthing center. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(1), s 60 -s 61. doi: 10. 1111/j. 1552 -6909. 2012. 01361. x Jeffs, L. , Acott, A. , Simpson, E. , Campbell, H. , Irwin, T. , Lo, J. , …Cardoso, R. (2013). The value of bedside shift reporting: Enhancing nurse surveillance, accountability, and patient safety. Journal of Nursing Care Quality, 28(3), 226 -232. doi: 10. 1097/NCQ. 0 b 013 e 3182852 f 46 Mardis, T. , Mardis, M. , Davis, J. , Justice, E. M. , Riley Holdinsky, S. , Konnelly, J. , …Riesenberg, L. A. (2016). Bedside shift-toshift handoffs. Journal of Nursing Care Quality, 31(1), 54 -60. doi: 10. 1097/NCQ. 0000000142 Maxson, P. M. , Derby, K. M. , Wrobleski, D. M. , & Foss, D. , M. (2012). Bedside nurse-to-nurse handoff promotes patient safety. Med. Surg Nursing, 21(3), 140. Retrieved from http: //www. medsurgnursing. net/cgibin/Web. Objects/MSNJournal. woa Olson-Sitki, K, Weitzel, T. , & Glisson, D. (2013). Freezing the process: Implementing bedside report. Nursing Management, 44(7), 25 -28. doi: 10. 1097/01. NUMA. 0000431431. 39008. af Olvera, L. & Campbell Bliss, M. (2010). Perfecting the patient handoff: Improving the process for patients and nurses. Nursing for Women’s Health, 14(6), 496 -504. Retrieved from http: //onlinelibrary. wiley. com/journal/10. 1111/(ISSN)1751486 X Spinks, J. , Chaboyer, W. , Bucknall, T. , Tobiano, G. , & Whitty, J. A. (2015). Patient and nurse preferences for nurse handoverusing preferences to inform policy: a discrete choice experiment protocol. British Medical Journal, online. doi: 10. 1136/bmjopen-2015 -008941 Vines, M. M. , Dupler, A. E. , Van Son, C. R. , & Guido, G. W. (2014). Improving client and nurse satisfaction through the utilization of beside report. Journal for Nurses in Professional Development, 30(4), 166 -173. doi: 10. 1097/NND. 000000057 Acknowledgements The author acknowledges Emily Jackson, MSN, CNM who provided extensive support, guidance, and expertise during this project.
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