NURSING

COMMUNICATION DURING
A PATIENT HANDOVER
Olga Bljashkina
North-Estonia Medical Center
(PERH)

Mentors: Milvi Moks PhD, Ene

Kotkas
17.05.2010
 The aim of the research is to describe
nurses' communication during a patient
handover from one department to
another.
 This research is a qualitative one,
which is based on the literature
review.
 68 literature sources were used in
this research.
 Information retrieval was
accomplished
› in EBSCOhost and OVID databases
and sources of literature in Tallinn
Health Care College and Satakunta
Central Hospital libraries were used.
 Handover
 Handover is ‘the transfer of
professional responsibility and
accountability for some or all
aspects of care for a patient, or
group of patients, to another person
or professional group on a temporary
or permanent basis.’
Australian Medical Association in their ‘Safe Handover: Safe
Patients’ guideline (AMA, 2006) and United Kingdom
National Patient Safety Agency (2004)
Patient handover process I
 A significant part of patient handover
process concerns the exchange of
information between healthcare
professionals.
 Traditionally, handovers are focused
on what nurses have already done
rather than being patient-centered
and meeting the needs of patient.
 Handover process II
 Has many functions:
- nurses use the handover to
demonstrate their knowledge,
expertise and protect their role in
patient care,
- may facilitate nurses in performing
certain nursing procedures.
 Nurses` communication
during a patient handover I
 The aim of communication during the
handover is to give high-quality and
appropriate clinical information from
one healthcare professional to another.
 Information exchange between nurses is
essential to achieve the continuity of
effective, individualized and safe patient
care.
 It helps to avoid errors and gives an
opportunity to ask questions and ensure
that after handover all members of the
team will have the same understanding
and set of priorities.
 Nurses`s communication
during a patient handover
II
 Poor communication might lead to
inaccurate sharing information about
patient details and some important
aspects may be missed.
 Staff communication should be more
developed and facilitated in healthcare
organizations.
 Improving communication between
nurses can be an important factor in
creating patient safety.
 Barriers to effective
communication
 Factors  Human factors
influencing verbal - human failure,
communication
- human mistakes.
- environment
(interruptions,
noise),
- handoverer as a
speaker,
- receiver as a
listener.
 Communication methods
 Verbal
 Written
 Electronic
 Combination of
them
 Verbal communication
methods I
 Verbal report:
- the oldest handover format;
- is usually given in a setting away from
patients and is supported by nursing
documentation;
- provides more opportunity to clarify
information.
 Verbal communication
methods II
 Bedside handover:
- individualized and patient- centered
care;
- based on a patient involvement and
participation in handover process;
- promotes a mutual respect between
patients and caregivers.
 Written documents
 The medical record
- written account of a person`s condition
and response to the treatment and
care;
- permanent and legal document.
 SBAR method
 S – situation (discussion of the current
patient condition).
 B – background ( discussion of the
background and patient history).
 A – assessment .
 R – recommendations (and orders that
need to be completed).
This method allows to report
information in a systematic way and
decrease confusion
 Electronic information
handover
 Electronic patient record (EPR)
- quick, easy access to the patient
record by multiple caregivers in
multiple places;
- takes time for nurses to become
enough experienced;
- reduce duplication;
- gives opportunity for automating and
structuring.
 Tape- recorded handover
 Audiotapes provide fast means of
communication and detailed
assessment.
 The record can be reviewed many times.
 Excludes the social and emotional
aspects and opportunity to ask and
answer questions.
 Difficult to understand if those who
made the tape are not present.
 Nursing report and
information sharing
 For a report to be
meaningful the
information to the receiver
has to be given in an
effective way.
 Nursing handover using
accurate and documented
information promotes
effective time
management.
 Information handover
 The information needs to be provided
in a prioritized, clear, concise and
chronological manner.
 Information should contain patient
care plan, treatment, current
condition and any recent or
anticipated changes.
 Standardized guidelines
 The handovers often lack formal
structure and this can be explained by a
lack of guidelines for nurses.
 Formal direction for handover would
ensure an adequate level of the process
consistency and provide support to the
nurse delivering handover. Thus, the
formal direction increases the quality of
the report given.
 Feedback from staff is important to
monitor effectiveness of handover.
 Training/education
 Introductory briefing.
 Written materials
 like educational booklets, posters.
 Conclusion I
 Nurses` communication is an important
part of a patient handover process from
one department to another.
 The aim of nurses`communication is to
give and receive accurate patient
information in a way, which enables
nurses to continue high-quality care
and reduces errors.
 Conclusion II
 Nurses can use
 different communication methods (like
verbal, written, electronic or
combination of them) to achieve more
effective outcomes.
 Conclusion III
 Requirements for effective nurses`
communication and work productivity
improvement are:
- Consideration with barriers.
- Reducing or minimazing their negative
impact.
- Acknowledgement of human factors
(how human beings make errors).
- Creating appropriate work
environment.
 Conclusion IV
Nurses` communication optimization
opportunities:
 Choice of an appropriate
communication method.
 Presence of appropriate documentation.
 Attentive listening.
 Standardized guidelines acceptation and
implementation.
 Research suggestions I
 Investigate current policies and
guidelines related to sharing
information during patient handover.
 Investigate verbal, written and
electronic-based practices of
communication at handover.
 Examine nurses' beliefs and
perceptions regarding their role during
patient handover.
 Research suggestions II
 Pay attention to nursing time
management and provide appropriate
environment.
 Training programs compilation and
implementation in the hospital.
Thank you for your
attention