NURSING COMMUNICATION DURING A PATIENT HANDOVER Olga Bljashkina

NURSING COMMUNICATION DURING A PATIENT HANDOVER Olga Bljashkina North-Estonia Medical Center (PERH) Mentors: Milvi Moks Ph. D, Ene Kotkas 17. 05. 2010

The aim of the research is to describe nurses' communication during a patient handover from one department to another.

This research is a qualitative one, which is based on the literature review. � 68 literature sources were used in this research. � Information retrieval was accomplished › in EBSCOhost and OVID databases and sources of literature in Tallinn Health Care College and Satakunta Central Hospital libraries were used.

Handover is ‘the 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 Medical Association in their ‘Safe Handover: Safe Patients’ guideline (AMA, 2006) and United Kingdom National Patient Safety Agency (2004)

Patient handover process I A significant part of patient handover process concerns the exchange of information between healthcare professionals. Traditionally, handovers are focused on what nurses have already done rather than being patient-centered and meeting the needs of patient.

Handover process II Has many functions: - nurses use the handover to demonstrate their knowledge, expertise and protect their role in patient care, - may facilitate nurses in performing certain nursing procedures.

Nurses` communication during a patient handover I The aim of communication during the handover is to give high-quality and appropriate clinical information from one healthcare professional to another. Information exchange between nurses is essential to achieve the continuity of effective, individualized and safe patient care. It helps to avoid errors and gives an opportunity to ask questions and ensure that after handover all members of the team will have the same understanding and set of priorities.

Nurses`s communication during a patient handover II Poor communication might lead to inaccurate sharing information about patient details and some important aspects may be missed. Staff communication should be more developed and facilitated in healthcare organizations. Improving communication between nurses can be an important factor in creating patient safety.

Barriers to effective communication Factors influencing Human factors verbal communication - human failure, - environment - human mistakes. (interruptions, noise), - handoverer as a speaker, - receiver as a listener.

Communication methods Verbal Written Electronic Combination of them

Verbal communication methods I � Verbal report: - the oldest handover format; - is usually given in a setting away from patients and is supported by nursing documentation; - provides more opportunity to clarify information.

Verbal communication methods II � Bedside handover: - individualized and patient- centered care; - based on a patient involvement and participation in handover process; - promotes a mutual respect between patients and caregivers.

Written documents � The medical record - written account of a person`s condition and response to the treatment and care; - permanent and legal document.

SBAR method S – situation (discussion of the current patient condition). B – background ( discussion of the background and patient history). A – assessment. R – recommendations (and orders that need to be completed). This method allows to report information in a systematic way and decrease confusion

Electronic information handover � 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.

Tape- recorded handover Audiotapes provide fast means of communication and detailed assessment. The record can be reviewed many times. Excludes the social and emotional aspects and opportunity to ask and answer questions. Difficult to understand if those who made the tape are not present.

Nursing report and information sharing For a report to be meaningful the information to the receiver has to be given in an effective way. Nursing handover using accurate and documented information promotes effective time management.

Information handover The information needs to be provided in a prioritized, clear, concise and chronological manner. Information should contain patient care plan, treatment, current condition and any recent or anticipated changes.

Standardized guidelines The handovers often lack formal structure and this can be explained by a lack of guidelines for nurses. Formal direction for handover would ensure an adequate level of the process consistency and provide support to the nurse delivering handover. Thus, the formal direction increases the quality of the report given. Feedback from staff is important to monitor effectiveness of handover.

Training/education Introductory briefing. Written materials like educational booklets, posters.

Conclusion I Nurses` communication is an important part of a patient handover process from one department to another. The aim of nurses`communication is to give and receive accurate patient information in a way, which enables nurses to continue high-quality care and reduces errors.

Conclusion II Nurses can use different communication methods (like verbal, written, electronic or combination of them) to achieve more effective outcomes.

Conclusion III � Requirements for effective nurses` communication and work productivity improvement are: - Consideration with barriers. - Reducing or minimazing their negative impact. - Acknowledgement of human factors (how human beings make errors). - Creating appropriate work environment.

Conclusion IV Nurses` communication optimization opportunities: Choice of an appropriate communication method. Presence of appropriate documentation. Attentive listening. Standardized guidelines acceptation and implementation.

Research suggestions I Investigate current policies and guidelines related to sharing information during patient handover. Investigate verbal, written and electronicbased practices of communication at handover. Examine nurses' beliefs and perceptions regarding their role during patient handover.

Research suggestions II Pay attention to nursing time management and provide appropriate environment. Training programs compilation and implementation in the hospital.

Thank you for your attention