13.00
Hdl Handle:
http://hdl.handle.net/10755/162654
Type:
Presentation
Title:
Implementing Bedside Handoffs in the Emergency Department
Abstract:
Implementing Bedside Handoffs in the Emergency Department
Conference Sponsor:Emergency Nurses Association
Conference Year:2007
Author:Fabert, Debra L., RN, BSN
P.I. Institution Name:Clarian Health Partners, Methodist Hospital
Title:Emergency Department Clinical Manager
Contact Address:1701 North Senate Blvd., Indianapolis, IN, 46202, USA
Contact Telephone:(317) 962-0856
[Clinical Paper Presentation] Clinical Topic: The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) has targeted the improvement of caregiver communication as one of the National Patient Safety Goals (NPSGs) for 2006 and 2007. This organization's response was a mandate that all units would evaluate their method for patient handoff and make improvements. At the time, ED shift reports usually took place at the nursing station of each patient care area, with the departing nurses huddled around the computerized tracking board giving information verbally to the oncoming shift. The purpose of this project was to develop and implement a standardized approach to patient handoffs between caregivers in the emergency department.

Implementation: The initial attempt at improving the handoff process was to use a brief written report. Within days, nurses soundly rejected the use of a written report, citing reasons that included impracticality due to high patient turnover and increase in workload. After an extensive literature review, the "bedside handoff" method was selected for implementation. This method was chosen primarily due to the reported benefits of increased patient and nurse satisfaction. Bedside handoff occurs at the patient's bedside, with both oncoming and departing caregivers exchanging information. Handoff at the bedside not only promotes exchange of vital information, it also involves and engages the patient in his or her own care. To increase staff awareness of evidence-based best practice and enlist their support, an educational module was developed and presented to 160 staff members at mandatory staff meetings and small group meetings on the unit. Implementation date was set for September 2006. Two unit managers and the shift charge nurse monitored the process at each shift change for the first two weeks and intermittently thereafter. Two weeks after the process change, written feedback was solicited from all ED staff, and ongoing feedback was encouraged. Although it is the responsibility of the ED registered nurse to hand off their patients safely, licensed practical nurses and technicians were also surveyed. Concerns were addressed via weekly emails with updates on bedside handoff. Three months after implementation, staff was again surveyed to determine their level of satisfaction with and perception of the bedside handoff process.

Outcomes: Feedback from the 2-week survey revealed staff concerns about patient privacy issues, the amount of time needed to complete a bedside report on several patients, and concern that a complete report might not be appropriate at the bedside in all circumstances. 50% of the ED staff responded to the 3-month survey. 80% gave a favorable review of bedside handoffs. Advantages cited included being better informed about their patients and prevention of "near-misses" of medication and treatment orders. Concerns that remained include violating the privacy of patients bedded in hallways and curtained areas, and lingering resistance to change on the part of some staff members.

Recommendations: Bedside handoff improves patient safety by promoting accountability between shifts and individual caregivers. It allows nurses to immediately prioritize tasks and improves teamwork through face-to-face communication. Bedside handoff provides patients the opportunity to become more involved in their care and reinforces to them that the staff is aware of them and their needs. Continued evaluation of staff and patient satisfaction with the process is warranted.
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementing Bedside Handoffs in the Emergency Departmenten_GB
dc.identifier.urihttp://hdl.handle.net/10755/162654-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementing Bedside Handoffs in the Emergency Department</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Fabert, Debra L., RN, BSN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Clarian Health Partners, Methodist Hospital <br/></td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Emergency Department Clinical Manager</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">1701 North Senate Blvd., Indianapolis, IN, 46202, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(317) 962-0856</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">dfabert@clarian.org</td></tr><tr><td colspan="2" class="item-abstract">[Clinical Paper Presentation] Clinical Topic: The Joint Commission for Accreditation of Healthcare Organizations (JCAHO) has targeted the improvement of caregiver communication as one of the National Patient Safety Goals (NPSGs) for 2006 and 2007. This organization's response was a mandate that all units would evaluate their method for patient handoff and make improvements. At the time, ED shift reports usually took place at the nursing station of each patient care area, with the departing nurses huddled around the computerized tracking board giving information verbally to the oncoming shift. The purpose of this project was to develop and implement a standardized approach to patient handoffs between caregivers in the emergency department. <br/><br/>Implementation: The initial attempt at improving the handoff process was to use a brief written report. Within days, nurses soundly rejected the use of a written report, citing reasons that included impracticality due to high patient turnover and increase in workload. After an extensive literature review, the &quot;bedside handoff&quot; method was selected for implementation. This method was chosen primarily due to the reported benefits of increased patient and nurse satisfaction. Bedside handoff occurs at the patient's bedside, with both oncoming and departing caregivers exchanging information. Handoff at the bedside not only promotes exchange of vital information, it also involves and engages the patient in his or her own care. To increase staff awareness of evidence-based best practice and enlist their support, an educational module was developed and presented to 160 staff members at mandatory staff meetings and small group meetings on the unit. Implementation date was set for September 2006. Two unit managers and the shift charge nurse monitored the process at each shift change for the first two weeks and intermittently thereafter. Two weeks after the process change, written feedback was solicited from all ED staff, and ongoing feedback was encouraged. Although it is the responsibility of the ED registered nurse to hand off their patients safely, licensed practical nurses and technicians were also surveyed. Concerns were addressed via weekly emails with updates on bedside handoff. Three months after implementation, staff was again surveyed to determine their level of satisfaction with and perception of the bedside handoff process. <br/><br/>Outcomes: Feedback from the 2-week survey revealed staff concerns about patient privacy issues, the amount of time needed to complete a bedside report on several patients, and concern that a complete report might not be appropriate at the bedside in all circumstances. 50% of the ED staff responded to the 3-month survey. 80% gave a favorable review of bedside handoffs. Advantages cited included being better informed about their patients and prevention of &quot;near-misses&quot; of medication and treatment orders. Concerns that remained include violating the privacy of patients bedded in hallways and curtained areas, and lingering resistance to change on the part of some staff members.<br/><br/>Recommendations: Bedside handoff improves patient safety by promoting accountability between shifts and individual caregivers. It allows nurses to immediately prioritize tasks and improves teamwork through face-to-face communication. Bedside handoff provides patients the opportunity to become more involved in their care and reinforces to them that the staff is aware of them and their needs. Continued evaluation of staff and patient satisfaction with the process is warranted.</td></tr></table>en_GB
dc.date.available2011-10-27T10:31:52Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:31:52Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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