Medication Communication During Handovers Involving Nurses in Speciality Hospital Settings

2.50
Hdl Handle:
http://hdl.handle.net/10755/335524
Category:
Abstract
Type:
Presentation
Title:
Medication Communication During Handovers Involving Nurses in Speciality Hospital Settings
Author(s):
Manias, Elizabeth; Liew, Danny; Rixon, Sascha P.; Williams, Allison; Braaf, Sandy C.
Lead Author STTI Affiliation:
Non-member
Author Details:
Elizabeth Manias, RN, MPharm, PhD, emanias@unimelb.edu.au; Danny Liew, MBBS PhD; Sascha P. Rixon, BSc/BA (Hons) PhD; Allison Williams, BNurs, PhD; Sandy C. Braaf, RN BN PhD
Abstract:
Session presented on Saturday, July 26, 2014: Purpose: Handover may be defined as “the exchange between health professionals of information about a patient accompanying either a transfer of control over, or of responsibility for, the patient” (Cohen & Hilligoss, 2010, p. 494). It is an important forum for communicating patient information. Communication breakdowns during handover may have adverse effects on patient safety and quality of healthcare (Department of Health, 2012). Existing research on handovers involving nurses has largely focussed on information provision during shift-to-shift nursing handovers in specific hospital settings (e.g., medical wards). Research to date does not adequately convey the detail and complexity of handover communication. Handovers take place multiple times during a nurse’s working shift, and is an important communication forum for conveying information pertaining to a patient’s medications (e.g., at-home medications, medication treatment, goals and outcomes of medication treatment, and discharge medications). Liu, Manias, and Gerdtz, 2012, Manias, Aitken, and Dunning, 2005) have explored medication communication during nurse-to-nurse handovers in individual settings. However, there is a lack of research on communication about medications during handovers involving nurses (in which health professionals other than nurses may give or receive handover) in a variety of specialty hospital settings. We seek to address this gap in research by examining how medications information is communicated during handovers involving nurses in a variety of speciality hospital settings. Methods: This exploratory qualitative study draws on over 200 hours of audio-recorded participant observation of health care professionals in hospital specialty settings. The study was conducted at a metropolitan Australian public hospital in cardiothoracic care, intensive care, emergency care, and oncology care settings. Communication interactions involving nurses performing handovers to, or receiving handovers from, ambulance officers, doctors or other nurses, were observed. Handover types included health care professionals’ communication for the purposes of shift changeover, moving patients between or within a ward, receiving or sending patients via ambulance services, and leaving or returning to the patient area for tea breaks or other purposes. All audio recorded handovers were de-identified and transcribed verbatim. A comprehensive thematic analysis was performed by three researchers. Results: Factors shaping medication communication during all types of handover included: whether an intravenous infusion was being administered and the type of infusion, medication tasks to be attended to, anticipated time away from the bedside, a receiving nurse’s knowledge of the patient, and potential risk to the patient. Outgoing nurses who left the bedside temporarily, such as for a tea break, infrequently received a handover of information upon return to the patient area. There was a lack of medication communication involving patients and any present family members during handovers, despite these handover interactions often taking place at the bedside. Little time was devoted to conveying medication information. Information conveyed focused on medications prescribed during a patient’s hospital stay. Patient medications taken prior to hospitalisation were seldom mentioned, except in ambulance officer-nurse interactions. Medication names were not always mentioned during handover, with generic medication referents used instead (e.g. antibiotics). Often the names of medications were abbreviated and units of medication doses omitted. In regard to shift-to-shift handovers, the structure of communication varied according to the setting in which it was conducted. In cardiothoracic care and intensive care nurses were observed to use a body systems approach to order their communication, which facilitated the sharing of medication information. In emergency care and oncology care, patient documentation was used to structure communication. Medication communication did not arise consistently with this approach. In all settings, medication administration records were often reviewed at the end of handover interactions. Conclusion: Effective communication between health care professionals during handover enhances patient safety and quality of care. Currently little time is allocated to the communication and discussion of medication information. Greater emphasis on medications during handover, and the involvement of patients and family members, could improve the content, accuracy, timeliness and completeness of medication communication. This may reduce the risk of medication incidents.
Keywords:
Communication; Handover; Medications
Repository Posting Date:
17-Nov-2014
Date of Publication:
17-Nov-2014
Conference Date:
2014
Conference Name:
25th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Hong Kong
Description:
International Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kong
Note:
This is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.

Full metadata record

DC FieldValue Language
dc.language.isoen_USen_GB
dc.type.categoryAbstracten_GB
dc.typePresentationen_GB
dc.titleMedication Communication During Handovers Involving Nurses in Speciality Hospital Settingsen_GB
dc.contributor.authorManias, Elizabethen_GB
dc.contributor.authorLiew, Dannyen_GB
dc.contributor.authorRixon, Sascha P.en_GB
dc.contributor.authorWilliams, Allisonen_GB
dc.contributor.authorBraaf, Sandy C.en_GB
dc.contributor.departmentNon-memberen_GB
dc.author.detailsElizabeth Manias, RN, MPharm, PhD, emanias@unimelb.edu.au; Danny Liew, MBBS PhD; Sascha P. Rixon, BSc/BA (Hons) PhD; Allison Williams, BNurs, PhD; Sandy C. Braaf, RN BN PhDen_GB
dc.identifier.urihttp://hdl.handle.net/10755/335524-
dc.description.abstractSession presented on Saturday, July 26, 2014: Purpose: Handover may be defined as “the exchange between health professionals of information about a patient accompanying either a transfer of control over, or of responsibility for, the patient” (Cohen & Hilligoss, 2010, p. 494). It is an important forum for communicating patient information. Communication breakdowns during handover may have adverse effects on patient safety and quality of healthcare (Department of Health, 2012). Existing research on handovers involving nurses has largely focussed on information provision during shift-to-shift nursing handovers in specific hospital settings (e.g., medical wards). Research to date does not adequately convey the detail and complexity of handover communication. Handovers take place multiple times during a nurse’s working shift, and is an important communication forum for conveying information pertaining to a patient’s medications (e.g., at-home medications, medication treatment, goals and outcomes of medication treatment, and discharge medications). Liu, Manias, and Gerdtz, 2012, Manias, Aitken, and Dunning, 2005) have explored medication communication during nurse-to-nurse handovers in individual settings. However, there is a lack of research on communication about medications during handovers involving nurses (in which health professionals other than nurses may give or receive handover) in a variety of specialty hospital settings. We seek to address this gap in research by examining how medications information is communicated during handovers involving nurses in a variety of speciality hospital settings. Methods: This exploratory qualitative study draws on over 200 hours of audio-recorded participant observation of health care professionals in hospital specialty settings. The study was conducted at a metropolitan Australian public hospital in cardiothoracic care, intensive care, emergency care, and oncology care settings. Communication interactions involving nurses performing handovers to, or receiving handovers from, ambulance officers, doctors or other nurses, were observed. Handover types included health care professionals’ communication for the purposes of shift changeover, moving patients between or within a ward, receiving or sending patients via ambulance services, and leaving or returning to the patient area for tea breaks or other purposes. All audio recorded handovers were de-identified and transcribed verbatim. A comprehensive thematic analysis was performed by three researchers. Results: Factors shaping medication communication during all types of handover included: whether an intravenous infusion was being administered and the type of infusion, medication tasks to be attended to, anticipated time away from the bedside, a receiving nurse’s knowledge of the patient, and potential risk to the patient. Outgoing nurses who left the bedside temporarily, such as for a tea break, infrequently received a handover of information upon return to the patient area. There was a lack of medication communication involving patients and any present family members during handovers, despite these handover interactions often taking place at the bedside. Little time was devoted to conveying medication information. Information conveyed focused on medications prescribed during a patient’s hospital stay. Patient medications taken prior to hospitalisation were seldom mentioned, except in ambulance officer-nurse interactions. Medication names were not always mentioned during handover, with generic medication referents used instead (e.g. antibiotics). Often the names of medications were abbreviated and units of medication doses omitted. In regard to shift-to-shift handovers, the structure of communication varied according to the setting in which it was conducted. In cardiothoracic care and intensive care nurses were observed to use a body systems approach to order their communication, which facilitated the sharing of medication information. In emergency care and oncology care, patient documentation was used to structure communication. Medication communication did not arise consistently with this approach. In all settings, medication administration records were often reviewed at the end of handover interactions. Conclusion: Effective communication between health care professionals during handover enhances patient safety and quality of care. Currently little time is allocated to the communication and discussion of medication information. Greater emphasis on medications during handover, and the involvement of patients and family members, could improve the content, accuracy, timeliness and completeness of medication communication. This may reduce the risk of medication incidents.en_GB
dc.subjectCommunicationen_GB
dc.subjectHandoveren_GB
dc.subjectMedicationsen_GB
dc.date.available2014-11-17T13:54:20Z-
dc.date.issued2014-11-17-
dc.date.accessioned2014-11-17T13:54:20Z-
dc.conference.date2014en_GB
dc.conference.name25th International Nursing Research Congressen_GB
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen_GB
dc.conference.locationHong Kongen_GB
dc.descriptionInternational Nursing Research Congress, 2014 Theme: Engaging Colleagues: Improving Global Health Outcomes. Held at the Hong Kong Convention and Exhibition Centre, Wanchai, Hong Kongen_GB
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item related to this abstract, you may find it by browsing the repository by author. If author contact information is availabe in this abstract, please feel free to contact him or her with your queries regarding this submission.en_GB
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