Clinical Handover in Health Care - Personal Statement Example

Hand over processes have also been referred to as hand off, patient transfer and it may involve Nursing and midwifery shift to shift transfer, junior to senior clinicians, inter-facility transfer, between medical teams, and may be a transfer to the medical teams. It is the process that sees through the transfer of accountability and professional responsibility for some or all that concerns the care of that particular patient or a group of patients to another professional group. In addition, it should be a very effective process with already determined clinical success factors and limitation of the successful hand over strategies. Moreover, a good practice should carry an aspect of being transferable and sustainable. And above all, it should be able to bridge the gaps in the evidenced base hand over process. All this can be achieved through the constant sourcing for new pieces of information which are available from the peer reviewed journals and other articles of relevance to the area of expertise. As a nursing student, I have always developed the passion to do more and achieve the academic, professional and the statutory requirements. My understanding of hand over includes a ritual practice of analysing case loads at the start of every shift. ‘This is a very essential practice as it involves a regular analysis of patients hand over case studies’ (Jeffcott et al, 2007). As a matter of fact, the case loads are divided into several groups of people who work in teams. ‘Teamwork is a pertinent thing in hand over especially the nursing scenario where we might be required to work in shifts’ ((Bianco, 2008). I was allocated a team which was my colleague and I; I was to look at the case study hand over laboratory one and them hand over to my colleague who was to hand it over back to me. My lab one analysis was a little bit more confusing; I had a theoretical understanding of all the details that are involved in a hand over. It Includes information of the leadership, time, place which could be either face to face or at the bed site, the history of the patient, the current status of the patients, the preferred intervention to be conducted. Lab one HND had the bed no, the details of the patient, admission; History, the recommended diet for the patient, mobility and the comments. According to me, this was a shallow hand over report. The second report was good, I was now enlightened and I had improved my speed in handling and coordination which took me less time because I had decided to use a different technique, IOSBAR tool. It improved my timing in analysing what I needed to do with almost 35%. It was over the bed site handover which informs the patient and allows informed consent of the patient. Face to face will not provide you much of the information as might be required while the taped handover is the worst kind of hand over because somebody will feed you with the theories he or she wants to believe, there are no questions and clarification and kills the team factor. This was a difficult scenario to handle because the information I have in the report does not bear any resemblance with the current status of the patients. For instance, it does not tell you what type of treatment have already been done and what will be the next type of regime to be administered. To a greater extend this was the information that was more or less required by the administration than the nursing attendants. The information provided did not have any significance for my role as a care giver; it was retrospective in relation to the clinical care. I did not intentionally inform her of the wide gaps that are in the paper. When she later handed over to me, she was so angry of what I had done to her; she too was unable to handle the transferred patient’s details. She felt betrayed by her own colleague which I did intentionally to confirm the inadequacy of the report. This was the first challenge I had to face. I decided to find out the information by following a communication tool kit that is practised in the nursing practice. This was necessary in order to find out information about the patient so that I can get the information that will enable me handover to the next colleague of mine. It was time to take a different approach in analysing the case scenario. It is extremely difficult to determine the next motion of action except to adopt one of the three handover tool kits. ‘Handover can take place through several ways, the SBAR system which stand for the Situation, background, assessment, recommendation criteria’(Australian commission on safety and quality in healthcare, 2009). This had been advanced to take care of the wide gaps between the SBAR, which was a localised tool system. It stands for; Identify your patient, observe, situation, background, Assessment, and recommendation which has been referred to as read back to represent initiate the aspect of accountability and transfer of information already presented in the handover sheet. The ISBAR system is the other final option for this case study. Considering that we don’t meet but only find the information on the handover sheets which we are to read and continue with the exercise I decided to use the IOSBAR system, it has widely been used elsewhere and it is the best especially for shift hand over like we do, it has also found application in the emergency departments and the theatre to ward transfers. ‘It requires proper leadership and involvement and the advantage of fitting into the local situations’ (Tollefson, 2010). It gives everyone the power of ownership of the whole process and reduces the chances of having your working being duplicated which really interfere with the integrity of the patients and the profession of nursing. What we target to achieve in the hand over is to reduce the chances of affecting the patient’s safety and quality of the health care provided. ‘It gives room for the proper communication which is a systemic and standardised approach’ (Davies & Priestly, 2006). This had to be done because the patient life is at the core of any practise but any system that meets the assurance and safety of the patients. It also enabled me to collect information from my colleague who most f the time she is away and still be able to meet time lines of attending to the patients. ‘It also has room for taking responsibility for misconduct which is done through the appending of the signature at the end of the exercise’ (Sexton, 2004). This protects the patient from malpractices which can be done either accidentally or intentionally by malicious individuals. ‘It provides legal abilities for someone to take legal responsibilities for the actions done and if possible be charged accordingly’ (Australian commission on safety and Quality in healthcare, 2001). It will also enable me to be perfect by going through the work and confirming the practice before implementing it to the patient. It gives the name of the leader and who was in charge at that particular time and it will mitigate some of the problems of the staff to issue blame to staff members. The only alternative action was to use the SBAR system which is a comprehensive method for which I could also have made my decision. ‘It does provide information about the situation which gives information about the patient status, changes in the plan, procedures and the protocol’ (Schroeder, 2007). It even goes ahead and handles the environmental and the organizational issues. Moreover, it provides the background information about the history of the patient as concerns the sickness. It even goes further to provide good assessment for the client and targets the personal level changes, the environmental changes and even the activity participation or functional changes. ‘It all culminates in a conclusive and comprehensive recommendation which that handles all the aspect that relates to the patients information’ (Groah, 2006). It ends the process through the signing of the patient to admit informed consent that he or she had been adequately informed before any step was taken. It is that binding to the patient, the institution and the staff leaders responsible for the hand over. All this choices had a good ground for argument against the lab reports we had been provided for and that is why they are best to be used. In addition, they all work on a face to face hand over which incorporates the patients at the bed side. This is the best place for the transaction to take place. ‘It gives the patients room in the decision making and to confirm that every detail provided is true as it has taken place or presented’ ( John, 2009). The others were open forms filled by the doctor and were only applicable at the locality of the hospital environment. ‘It is a very risky way of handling patients and indicates very wide gaps in patient’s safety and quality of service’ (Horn et al, 2004). This was a good learning experience, it challenged my passion for service especially when I graduate, it gave me room to find information and had to read most of the peer reviewed journals and other information. It also gave me the typical individualised set up that surrounds the hand over process. The Johns reflective model gave me the deepest insight into the best practice of the hand over process which I would always want to apply in my nursing profession. In conclusion, John’s model can effectively provide the best reflection in a hand over process. It needs to be done in a careful, accurate and with a well documented with information that has timely aspect in order to achieve effective time management. Communication between the nurses also helps to build resilience and team building as it enhances proper discussion of issue and eventually solution finding which can be able to reinforce the proper procedure the professional practice. This will to a great extend ensure uniformity in the practice and in modern professional practice in line with the health care provision as ruled by the Nursing council. Read More