2.50
Hdl Handle:
http://hdl.handle.net/10755/162692
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:2008
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
Purpose: The Joint Commission has targeted the improvement of communications between caregivers as one of the National Patient Safety Goals for 2006 and 2007. The purpose of this project was to develop and implement a standardized approach to patient handoffs between caregivers in the ED.

Design: Quality improvement project.

Setting: Urban Level-I Trauma Center with 96,000 patient visits in 2006.

Participants: 160 ED RN's, LPN's, and ED technicians, all who were currently employed in our ED as patient caregivers.

Methods: Prior to beginning this effort, shift report, or "handoff" was conducted in a haphazard fashion, with both oncoming and departing shifts huddled around a computerized tracking screen at the nurses' stations. In an attempt to bring a more formalized structure to the process, a literature search was conducted to determine the best practice for patient handoff. Based on this review, the "bedside handoff" method was selected for implementation, primarily due to its 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 promotes the exchange of vital information and involves the patient in his or her own care. An educational module was developed and presented to 160 staff members at mandatory staff meetings and small group meetings on the unit, and an implementation date was set. Two Unit Managers and the shift charge nurse monitored the handoff 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. Managers addressed staff concerns via weekly email updates. Three months after implementation, staff was surveyed to determine their level of satisfaction with the use of bedside handoffs. Issues addressed by the survey included asking staff to rate the overall process on a 5-point scale, with open-ended questions regarding barriers encountered as well as positive experiences. Additionally, random telephone surveys of patients who were in the ED during a shift change were conducted see how well they believed they were informed about their care and ED treatment.

Results: 57% of the ED staff responded to the 3- month survey. 78% viewed the process positively, rating it as either 4 or 5 on the 5-point scale. Advantages cited included being better informed about their patients and prevention of "near-misses" of medication and treatment orders. Concerns included violating the privacy of patients bedded in hallways and curtained areas, and lingering resistance to change on the part of some staff members. 51 patients were surveyed after implementation. 76% (39/51) responded that they believed they were kept up to date with their care plan, and 88% (45/51) believed that the nursing staff answered all of their questions.

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. Further monitoring of staff and patient satisfaction is planned.
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/10755/162692-
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">2008</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</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-email"><td class="label">Email:</td><td class="value">dfabert@clarian.org</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The Joint Commission has targeted the improvement of communications between caregivers as one of the National Patient Safety Goals for 2006 and 2007. The purpose of this project was to develop and implement a standardized approach to patient handoffs between caregivers in the ED. <br/><br/>Design: Quality improvement project.<br/><br/>Setting: Urban Level-I Trauma Center with 96,000 patient visits in 2006.<br/><br/>Participants: 160 ED RN's, LPN's, and ED technicians, all who were currently employed in our ED as patient caregivers. <br/><br/>Methods: Prior to beginning this effort, shift report, or &quot;handoff&quot; was conducted in a haphazard fashion, with both oncoming and departing shifts huddled around a computerized tracking screen at the nurses' stations. In an attempt to bring a more formalized structure to the process, a literature search was conducted to determine the best practice for patient handoff. Based on this review, the &quot;bedside handoff&quot; method was selected for implementation, primarily due to its 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 promotes the exchange of vital information and involves the patient in his or her own care. An educational module was developed and presented to 160 staff members at mandatory staff meetings and small group meetings on the unit, and an implementation date was set. Two Unit Managers and the shift charge nurse monitored the handoff 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. Managers addressed staff concerns via weekly email updates. Three months after implementation, staff was surveyed to determine their level of satisfaction with the use of bedside handoffs. Issues addressed by the survey included asking staff to rate the overall process on a 5-point scale, with open-ended questions regarding barriers encountered as well as positive experiences. Additionally, random telephone surveys of patients who were in the ED during a shift change were conducted see how well they believed they were informed about their care and ED treatment. <br/><br/>Results: 57% of the ED staff responded to the 3- month survey. 78% viewed the process positively, rating it as either 4 or 5 on the 5-point scale. Advantages cited included being better informed about their patients and prevention of &quot;near-misses&quot; of medication and treatment orders. Concerns included violating the privacy of patients bedded in hallways and curtained areas, and lingering resistance to change on the part of some staff members. 51 patients were surveyed after implementation. 76% (39/51) responded that they believed they were kept up to date with their care plan, and 88% (45/51) believed that the nursing staff answered all of their questions. <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. Further monitoring of staff and patient satisfaction is planned.</td></tr></table>en_GB
dc.date.available2011-10-27T10:32:32Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:32:32Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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