Minimizing Communication Errors During Patient Hand-Offs: Implementation of Nursing Sterile Cockpit

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Hdl Handle:
http://hdl.handle.net/10755/157059
Category:
Abstract
Type:
Presentation
Title:
Minimizing Communication Errors During Patient Hand-Offs: Implementation of Nursing Sterile Cockpit
Author(s):
Uhl, Tammy L.
Author Details:
Tammy L. Uhl, RN,MS,MSN,CCRN,CCNS, Duke Children's Hospital, Durham, North Carolina, USA, email: tammy.uhl@duke.edu
Abstract:
PURPOSE: The Joint Commission has identified qualities of effective hand-offs, including limited interruptions. In the pediatric ICU at Duke Children's Hospital, minimizing interruptions was achieved during rounds with implementation of the "sterile cockpit." Transition to nursing hand-offs had not occurred. The purpose of this quality improvement initiative was to implement a sterile cockpit environment during nursing hand-off to improve the nurse-to-nurse patient hand-off process and nursing satisfaction. DESCRIPTION: Communication quality and unit environment during change of shift report were assessed via observation and questionnaire. Observations revealed several factors associated with the potential for miscommunication: multitasking by bedside nurses, dual conversations occurring during exchange of patient information, and environmental distractions (phones, radios, televisions). Nurses were frequently interrupted by a variety of disciplines (physicians, PNPs, fellows, residents) and ancillary services (laboratory, radiology) during both morning and evening sign out. Additionally, it was not uncommon in the morning for rounds to begin before nursing completing the patient hand-off. After completion of observations and with administrative approval, staff was requested to complete an online survey specific to the unit environment during shift report. The majority of questions were multiple choice; 2 open-ended questions asked for suggestions for improvement. Variables inconsistent with a sterile cockpit environment were identified and analyzed. Variables that could be controlled for were negotiated with the medical staff. Strategies for implementation were then developed to improve the hand-off environment. EVALUATION/OUTCOMES:Implementation of a nursing sterile cockpit during nursing patient hand-off has demonstrated a statistically significant decrease in interruptions. Trends toward improvements in length of change of shift report, time stayed past change of shift, and frequency of bedside rounds starting before end of report were noted. Physicians now ask the bedside nurse if he/she is ready to begin rounds; if not, the team moves on to another patient. Nursing states satisfaction with the sterile cockpit. Resident interruptions continue to be the greatest challenge. Implementation of the nursing sterile cockpit is a first step in meeting one Joint Commission recommendation for effective patient hand-offss
Repository Posting Date:
26-Oct-2011
Date of Publication:
26-Oct-2011
Citation:
2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866
Conference Date:
2010
Conference Name:
National Teaching Institute and Critical Care Exposition
Conference Host:
American Association of Critical-Care Nurses
Conference Location:
Washington, D.C., USA
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleMinimizing Communication Errors During Patient Hand-Offs: Implementation of Nursing Sterile Cockpiten_GB
dc.contributor.authorUhl, Tammy L.en_GB
dc.author.detailsTammy L. Uhl, RN,MS,MSN,CCRN,CCNS, Duke Children's Hospital, Durham, North Carolina, USA, email: tammy.uhl@duke.eduen_GB
dc.identifier.urihttp://hdl.handle.net/10755/157059-
dc.description.abstractPURPOSE: The Joint Commission has identified qualities of effective hand-offs, including limited interruptions. In the pediatric ICU at Duke Children's Hospital, minimizing interruptions was achieved during rounds with implementation of the "sterile cockpit." Transition to nursing hand-offs had not occurred. The purpose of this quality improvement initiative was to implement a sterile cockpit environment during nursing hand-off to improve the nurse-to-nurse patient hand-off process and nursing satisfaction. DESCRIPTION: Communication quality and unit environment during change of shift report were assessed via observation and questionnaire. Observations revealed several factors associated with the potential for miscommunication: multitasking by bedside nurses, dual conversations occurring during exchange of patient information, and environmental distractions (phones, radios, televisions). Nurses were frequently interrupted by a variety of disciplines (physicians, PNPs, fellows, residents) and ancillary services (laboratory, radiology) during both morning and evening sign out. Additionally, it was not uncommon in the morning for rounds to begin before nursing completing the patient hand-off. After completion of observations and with administrative approval, staff was requested to complete an online survey specific to the unit environment during shift report. The majority of questions were multiple choice; 2 open-ended questions asked for suggestions for improvement. Variables inconsistent with a sterile cockpit environment were identified and analyzed. Variables that could be controlled for were negotiated with the medical staff. Strategies for implementation were then developed to improve the hand-off environment. EVALUATION/OUTCOMES:Implementation of a nursing sterile cockpit during nursing patient hand-off has demonstrated a statistically significant decrease in interruptions. Trends toward improvements in length of change of shift report, time stayed past change of shift, and frequency of bedside rounds starting before end of report were noted. Physicians now ask the bedside nurse if he/she is ready to begin rounds; if not, the team moves on to another patient. Nursing states satisfaction with the sterile cockpit. Resident interruptions continue to be the greatest challenge. Implementation of the nursing sterile cockpit is a first step in meeting one Joint Commission recommendation for effective patient hand-offssen_GB
dc.date.available2011-10-26T19:23:07Z-
dc.date.issued2011-10-26en_GB
dc.date.accessioned2011-10-26T19:23:07Z-
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.conference.date2010en_GB
dc.conference.nameNational Teaching Institute and Critical Care Expositionen_GB
dc.conference.hostAmerican Association of Critical-Care Nursesen_GB
dc.conference.locationWashington, D.C., USAen_GB
dc.identifier.citation2010 National Teaching Institute Research Abstracts. American Journal of Critical Care, 19(3), e15-e28. doi:10.4037/ajcc2010866en_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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