How Can Nursing Handover Become an Important Part of the Nursing Profession Rather than a Routine Task - Literature review Example

How Can Nursing Handover Become an Important Part of the Nursing Profession Rather than a Routine Task? Name of the Student Institution Course Name of Tutor Date of Submission Table of Contents Table of Contents 2 Introduction 3 Critique of the Literature 4 Findings and Discussions 6 Recommendation for Future Research and Practice 7 References 9 Introduction According to Australian Medical Association (2006), nursing handover can be defined a s process through which one nurse or a team of nurses transfers the responsibility and accountability of care of the patients to another nurse or team if nurses. The handing over exercise is a very important exercise and requires to be conducted in a very seamless manner. According to Manias & Street (2000), it is through the handing over that the day nurse is able to brief the night shift nurse about the progress of the patients and vice versa. The handing over process is a systematic communication of the patients’ information by one nurse to the other which entails the patients’ history and likely future occurrences. The nursing handover originates from the fact that a patient may require medical attention for a long period of time which therefore means that there is need for shared responsibility between nurses from one shift to the other. The shift to shift hand over therefore necessitates that there is a smooth flow of information about the patients to avoid any adverse events. According to Matic et al (2000), up to 98,000 deaths occur annually in the United stated owing to health care errors some of which can be attributed to poor nursing handover. In addition to transmitting useful information about the patient from one nurse to the other, nursing handover exercise plays a number of other important roles among them being the development of cohesion among group members, impacting on knowledge to others through training and teaching, raising situational awareness among the team members as well as orienting new members about the organization and the working culture (Chaboyer, 2011). All this have the overall effect of ensuring that the patient receives quality health care all round the clock from one shift to the other. According Matic et al (2009), communication failures amounting to omission of important details about the patients during the shift to shift handovers have in many occasions resulted in fatal incidences to the patient hence underlying the importance of effective nursing hand over. A number of important measures to enhance an effective nursing handover have been proposed and implemented in various medical institutions. One of such measures includes what is referred to as the bed side nursing hand over. This entails making the patient part and parcel of the hand over process which helps in promoting a patient cantered healthcare (McMurray et al. 2011). The helps the patient in terms of talking charge of their health as well as reminding the handing over nurse of any important information that may have been skipped in the handing over process. Another measure that is important in enhancing the effectiveness of nursing handover is through incorporation of technology. Technology would play an important part in the areas of keeping records and other patients’ information electronically hence enhancing and facilitating a smooth hand over process. According to Bates & Gawande (2003), despite the advancement in technology in the medical field, there is still a notable lack of development to bring about operational and system based solutions in health care provision. Critique of the Literature Nursing handovers are necessitated by the need to offer the patient 24 hour medical care and attention hence the need to break the day into practical shifts that a nurse can handle (Sexton et al 2004). This means that a patient will be handled by at least two nurses in a 24 hour day with each nurse handing over the responsibilities and accountability of the patient to the next nurse. According to Bates & Gawande (2003), the many nursing hand over sessions may give room to rise in a number of problems the common one being medication problems. This arise from instances of miscommunication between the nurses involved in the hand over exercise where important information is not given hence leading to what at times has turned to be grievous mistakes. According to Patterson et al. (2004, the nursing hand over is done as the last assignment of the nurse in charge of the patient and in many instances there is no ample time to conduct the exercises. This time constraint factor compounded by the fact that it is not possible for the nurse to transfer in whole everything that is in the mind including opinions and mental pictures formed throughout the interaction with the patient which may be important to the well being of the patient makes the handing over exercise develop a weak link in the patients health care which may be at times fatal. By pointing out such a weakness inherent to any nursing handover process, the study therefore fails to address the issue of whether the nursing hand over should be done or not. According to McMurray et al. (2011), bed side handover has developed over the years as a way of improving communication as well as timely transfer of the patients’ information from one nurse to the other during shifts hand over. Incorporating the patient into the nursing hand over process has the benefit of ensuring that the patient can point out any important information left out during the hand over as well as asking health related questions about the probable future happenings that would be important in guiding the nurse taking charge of the new shift. This is in addition to the benefit of allowing patients to be partners in their health care which leads to higher patients’ satisfaction. Despite these benefits of bed side hand over, the study raises some issues that arises from the bed side hand over which are counterproductive to the patients health. One such issue is the fact that the handing over nurses may be using some complex medical terms that may leave the patient in confusion or more disturbed owing to their inaccurate personal interpretation of the terms. Another drawback of the bed side nursing hand over that the study raises is the element of time. Being among the last assignments that a nurse handles before the end of the shift, there is normally not so much time to spend on the nursing handover. When the patient is therefore brought on board on the handing over process, they may end up asking or raising a lot more questions and issues than the handing over nurse hand time for hence distracting the handing over process. This may at the end result in a poorly done handing over process that may result in fatal incidences to the detriment of the patients’ health. McMurray et al. (2011) also points out on the issue of breaching the patient’s confidentiality. Ordinarily there are certain issues that doctors or nurses may not discuss in the presence of the patient. Some of the issues require prior counselling of the patient before disclosure or some issues may even need to be discussed with the patients relative to safeguard the well being of the patient. This therefore obviously poses a significant challenge on the idea of bed side hand over as a way of enhancing an effective nursing hand over exercise. Maticet al (2009) emphasis on the need to develop a standard way of nursing handover and reporting to ensure that the various nurses in the health institutions give a specified minimum amount of information to their peers when handing over. This study claims that this would make the handover to meet a certain threshold hence ensuring that vital patient’s information is not left out. Advancing this concept further is the fact that the study advocates for the use of technology in facilitating the standardization of the handing over process. According to the study, a computerized handover system would enhance communication by setting a common standard of reporting through the requirement of a minimum data set. The computerization of the process has also the ability of minimizing the time spent in the handing over process. However, notable weakness in this proposal is the failure to appreciate that different patients have different health issues requiring different attention and hence a difficulty in standardizing the handing over process. A patient suffering from one ailment may require a different attention from another patient with a different one and therefore there is some important information that the nurse will require to relay to the colleague that may not be necessary for another patient. Owing to the severity of a patient, even though they may be suffering from the same medical condition, one patient may require some specialized attention and consequently a different way of communication from the other hence making standardization in handover difficult (Catchpole 2007). Computerization may also not address the challenge of communication during handing over since the technology cannot exist and work independent of the handing over nurses. The success of the system therefore depends much on the competence of the person using it and also their qualification. An incompetent or negligent nurse is likely to give inaccurate or omit important information therefore rendering the whole process of standardization and computerization meaningless (Fenton 2006). According to Friesen et al (2009) nursing handover also referred to as handoffs should be devoid of interruptions as much as possible. This according to the study is to ensure that the off going nurse has ample time to update the incoming nurse as much as possible. This would therefore mean that in case a patient has an issue that would require the attention of the nurses, the patients would have to wait until the nurses are through with the handing over. While this is a prudent proposal especially in instances where the nurses involved in the handing over are not concentrating because of numerous and at times unnecessary interruptions, it fails to appreciate the fact that even during the nursing hand over period, the patients requires attention and in some instances where the patient requires urgent attention, the patient must be given precedence over the handing over session. Findings and Discussions The essence of nursing handover is to pass over accurate information about the patient in relation to the ongoing treatment and medication, the current condition of the patient and any foreseeable change that may take place in the patients’ health. According to Sexton et al (2004), communication is a crucial component of the nursing handover of the process. The outgoing nurse must relay clear information to the incoming nurse ensuring that important health issues of the patients are given. Friesen et al (2009) concurs about the need for good communication during handover by advocating for use of clear language as well as the need to avoid the use of abbreviations. The use of abbreviations during oral and written handover reports may be misinterpreted by the incoming nurse leading to wrong actions that may result to fatal situations on the part of the patient. Maticet al (2009) concludes that use of technology has the ability to reduce the time taken when carrying out the handing over exercise. Computerized system would also help in ensuring that important details and information is not left out. Chaboyer, (2011) puts more weight on the need for use of technology as a way of standardizing the handing over process. A standardize process has the advantage of ensuring that the handing over report and the information relayed by one nurse to the other incoming nurses meets a certain minimum threshold as well as ensuring uniformity of the process. This also has the advantage of acclimatizing the nurses to a certain way of handing over therefore ensuring that one can ask question in case there are omissions in the standard report. According to McMurray et al. (2011), a good way of improving on the infectiveness of nursing handover is through the introduction of bedside handing over. This is whereby the nurses that are involved in the handing over process incorporate the patient in the process by allowing the patient to give important contributions and input into the process. This has the advantage of allowing the patient to take charge and responsibility of their health and general well being. The importance of bedside handover is further corroborated in the study by Chaboyer, (2011) where the study suggest that bedside handover reduces immensely the chances of the nurses leaving out important information about the patients since the patients as the patient has the chance to point out on the issues in their knowledge. Recommendation for Future Research and Practice The nursing handover is very important part of a nurse professional work. This is because a poorly carried out handover has the potential of putting the patients’ lives at a risk. It also ensures that there is continuity in the treatment of the patient round the clock at the same time giving the nurses time to take a take a relax (Pothier et al 2005). It is therefore critical that more research into more and better ways of enhancing the quality of nursing handover is carried out. One recommendation into the improvement of the nursing hand over process is the development of universal standards of nursing hand over. In most of the studies discussed above, it is clear that there is little standardization of the handing over process hence leading to a lack of clear guideline as to what a comprehensive hand over process entails. A universal standard on nursing handover would make the nurses take the handing over process as a key component of their daily work and not mere exercises carried out to allow them leave their work for the day. Another recommendation is the need to document the handing over process any time one nurse is handing over to the other. This would help in making the nurses take the process more seriously as well as make them take more responsibility since it would be possible for a senior medical officer to go through the records and detect any errors of omissions and commissions by the handing over nurse. This documentation may be in the form of written submissions as well as video recordings to ensure that any verbal information relayed is as well captured and available for future reference. The final recommendation is on the need for a research in to how much the incoming nurse relies on the information gathered from the previous nurse. The handing over process is a time consuming exercise and at times can be expensive where technology is to be implemented. It is therefore important to gain an understanding as to whether the time spent in handing over and the resources spent in implementing the system are well spent in terms of whether the incoming nurse rely relies and refers to the previous nurse’s handing over notes and reports. References Australian Medical Association 2006, Safe handover: Safe patients; guidelines on clinical handover for clinicians and managers. http://www.ama.com.au/web.nsf/doc/WEEN-6XFDKN/pdf Bates, D & Gawande, A 2003, Improving safety with information technology. New England Journal of Medicine, Vol.348, Pp.2526–2534 Chaboyer, W 2011, Clinical handover, NHMRC Centre of Research Excellence in Nursing care for Hospitalised patientshttp://www.health.qld.gov.au/psq/handover/docs/ch_presentation2.pdf Friesen, M, White, S, & Byers, J 2009, Handoffs: Implications for Nurses. Centez for American Nurses Board of Directors, Vol.2, Is.3.Pp.1-28 McMurray, A, Chaboyer, W, Wallis, M, Johnson, J & Gehrke, T 2011, Patients’ perspectives of bedside nursing handover. Collegian: Journal of the Royal College of Nursing Australia, Vol.18, Is.1, Pp.19-26. Patterson, E, Roth, E, Woods, D et al. 2004, Handoff strategies in settings with high consequences for failure: Lessons for health care operations. International Journal of quality Health Care, Vol.16, Is.2, Pp.125-132. Pothier, D, Monteiro, P, Mooktiar, M & Shaw, A 2005, Pilot study to show the loss of important data in nursing handover. British Journal of Nursing, Vol.14, Is20, Pp.1090-1093. Sexton, A, Chan, C, Elliott, M, Stuart, J, Jayasuriya, R & Crookes, P 2004, Nursing handovers: do we really need them? Journal of nursing management, Vol.12, Is.1, Pp.37-42. Manias, E & Street, A 2000, The handover: uncovering the hidden practices of nurses. Intensive and Critical Care Nursing, Vol.16, Is.6, Pp.373-383. Fenton, W. (2006). Developing a guide to improve the quality of nurses' handover. Nursing older people, 18(11), 32-6. Catchpole, K, De Leval, M, Mcewan, A, Pigott, N, Elliott, M, Mcquillan, A & Goldman, A 2007, Patient handover from surgery to intensive care: using Formula 1 pit‐stop and aviation models to improve safety and quality. Pediatric Anesthesia, Vol.17, Is.5, Pp.470-478. Read More