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Mullen A, Isobel S, Flanagan K, Harman K. Involving Mental Health Consumers in Nursing Handover: A Qualitative Study of Consumer Perspectives. Issues Ment Health Nurs 2021; 42:730-735. [PMID: 33315485 DOI: 10.1080/01612840.2020.1853288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A number of benefits have been identified for including consumers in nursing handover, such as improved safety and information exchange. In mental health settings these benefits may translate to improved nurse-consumer engagement and working towards the provision of recovery orientated practice. The process of including the consumer, whilst considered best practice, is not well established in mental health settings. Therefore further understanding, in regards to the consumer perspectives about this practice, is needed to inform its adoption and implementation.This qualitative descriptive study explores consumers' perspectives of their possible involvement in the nursing handover process within a mental health inpatient setting. The study took place in two mental health inpatient units in regional New South Wales, Australia. Thirteen semi-structured individual interviews were conducted with consumers, and a conventional content analysis method was used to analyse the data. Findings are presented under two categories: understanding the purpose and process of nursing handover and considering consumer involvement in handover.Findings provide insight into the views of consumers about being involved in nursing handover and further strengthen the rationale for establishing the process as part of routine practice within acute inpatient mental health units. The study also highlights the need to ensure that all processes within these settings accommodate consumer perspectives and involvement.
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Affiliation(s)
- Antony Mullen
- Hunter New England Mental Health, University of Newcastle, Waratah, Australia
| | | | - Karen Flanagan
- Gold Coast Hospital and Health Service, Southport, Australia
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Pollack AH, Mishra SR, Apodaca C, Khelifi M, Haldar S, Pratt W. Different roles with different goals: Designing to support shared situational awareness between patients and clinicians in the hospital. J Am Med Inform Assoc 2021; 28:222-231. [PMID: 33150394 PMCID: PMC7883969 DOI: 10.1093/jamia/ocaa198] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 08/12/2020] [Indexed: 02/06/2023] Open
Abstract
Objective Team situational awareness helps to ensure high-quality care and prevent errors in the complex hospital environment. Although extensive work has examined factors that contribute to breakdowns in situational awareness among clinicians, patients’ and caregivers’ roles have been neglected. To address this gap, we studied team-based situational awareness from the perspective of patients and their caregivers. Materials and Methods We utilized a mixed-methods approach, including card sorting and semi-structured interviews with hospitalized patients and their caregivers at a pediatric hospital and an adult hospital. We analyzed the results utilizing the situational awareness (SA) theoretical framework, which identifies 3 distinct stages: (1) perception of a signal, (2) comprehension of what the signal means, and (3) projection of what will happen as a result of the signal. Results A total of 28 patients and 19 caregivers across the 2 sites participated in the study. Our analysis uncovered how team SA helps patients and caregivers ensure that their values are heard, their autonomy is supported, and their clinical outcomes are the best possible. In addition, our participants described both barriers—such as challenges with communication—and enablers to facilitating shared SA in the hospital. Discussion Patients and caregivers possess critical knowledge, expertise, and values required to ensure successful and accurate team SA. Therefore, hospitals need to incorporate tools that facilitate patients and caregivers as key team members for effective SA. Conclusions Elevating patients and caregivers from passive recipients to equal contributors and members of the healthcare team will improve SA and ensure the best possible outcomes.
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Affiliation(s)
- Ari H Pollack
- Division of Nephrology, Seattle Children's Hospital, Seattle, Washington, USA.,Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Sonali R Mishra
- Information School, University of Washington, Seattle, Washington, USA
| | - Calvin Apodaca
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Maher Khelifi
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Shefali Haldar
- Department of Biomedical Informatics and Medical Education, University of Washington, Seattle, Washington, USA
| | - Wanda Pratt
- Information School, University of Washington, Seattle, Washington, USA
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Mullen A, Harman K, Flanagan K, O'Brien B, Isobel S. Involving mental health consumers in nursing handover: A qualitative study of nursing views of the practice and its implementation. Int J Ment Health Nurs 2020; 29:1157-1167. [PMID: 32677320 DOI: 10.1111/inm.12756] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 04/28/2020] [Accepted: 05/28/2020] [Indexed: 01/05/2023]
Abstract
Nursing handover occurs between shifts and is an important means of communication and information exchange around consumer care. The involvement of consumers in nursing handover, known as 'bedside handover', is well established within general health settings and promotes a patient-centred approach to care. Bedside handover represents an opportunity for mental health settings to consolidate recovery-oriented principles, albeit with some unique challenges in the way that involving consumers in nursing handover is implemented. This qualitative descriptive study explores the views of nursing staff and nursing managers about involving consumers in nursing handover and the process of implementation across five mental health inpatient units in Australia. The study took place in a local health district covering regional and rural areas of New South Wales that had issued a directive to implement bedside handover. The consolidated criteria for reporting qualitative research (COREQ) checklist was applied to this study. Six focus groups were held with nursing staff (n = 22), and eleven individual interviews were undertaken with nursing managers to explore their perceptions of bedside handover and its implications for nursing practice. The data were analysed using thematic analysis. Data from focus groups and interviews were analysed separately and then combined to generate three themes: (i) the mental health context is different; (ii) protecting consumer privacy and confidentiality; and (iii) it might make things worse. The findings provide insights into both the challenges, and the process of involving consumers in nursing handover within mental health settings and provides guidance for future implementation.
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Affiliation(s)
- Antony Mullen
- Hunter New England Mental Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Katryna Harman
- Hunter New England Mental Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Karen Flanagan
- Gold Coast Hospital and Health Service, SouthPort, Queensland, Australia
| | - Beth O'Brien
- Hunter New England Mental Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Sophie Isobel
- Faculty of Medicine and Health, School of Nursing and Midwifery, The University of Sydney, Sydney, New South Wales, Australia
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Abstract
This literature review looks at articles on bedside shift report initiatives and offers strategies that may lead to sustained practice.
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Reprint of: Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2019; 97:63-77. [PMID: 31181413 DOI: 10.1016/j.ijnurstu.2019.05.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 11/23/2022]
Abstract
BACKGROUND Numerous reviews of nursing handover have been undertaken, but none have focused on the patient's role. OBJECTIVES To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN Systematic mixed- methods review. DATA SOURCES Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. REVIEW METHODS Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. RESULTS Segregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barriers to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' discomfort encouraging patient participation and worries for sharing confidential and sensitive information. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and increasing the interpersonal approach during handover. CONCLUSIONS Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses to achieve this and prepare patients to do this. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Kullberg A, Sharp L, Johansson H, Brandberg Y, Bergenmar M. Improved patient satisfaction 2 years after introducing person-centred handover in an oncological inpatient care setting. J Clin Nurs 2019; 28:3262-3270. [PMID: 31066144 DOI: 10.1111/jocn.14903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/18/2019] [Accepted: 05/02/2019] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To investigate patients' satisfaction with care, 2 years after the introduction of person-centred handover (PCH) in an oncological inpatient setting, and to describe patients' perceptions of individualised care. BACKGROUND To obtain higher levels of patient satisfaction, bedside nursing handovers have been evaluated with positive results. One such model is PCH, which blends aspects of person-centred care with the bedside report and provides the opportunity for nursing staff and patients to perform the handover together. DESIGN A survey-based design was used with one data collection period. Patient satisfaction scores were compared with baseline data from a previous study that has been conducted in the same wards. METHOD Patient satisfaction was measured with the EORTC IN-PATSAT32 questionnaire, and individualised care was assessed with the Individualized Care Scale. A total of 120 adult patients with cancer were invited to participate from August 2017-March 2018. Of these, 90 chose to participate. The STROBE checklist for cross-sectional studies was used when preparing the paper. RESULTS Compared to the previous study, statistically significant improvements in patient satisfaction were observed in the subscales "Exchange of information between caregivers" and "Nurses' information provision" postimplementation of PCH. Regarding patients' perceptions of individualised care, the highest scores were in the ICS-A subscale "Clinical situation" and ICS-B "Decisional control," while "Personal life situation" scored the lowest overall. CONCLUSIONS Person-centred handover seems to have sustainable positive effects on important outcomes regarding patient satisfaction. A novel finding is the positive impact on nurses' information provision, indicating that PCH can facilitate effective information exchange between patients and nurses. RELEVANCE TO CLINICAL PRACTICE Person-centred handover seems to improve patients' satisfaction with nurses' provision and exchange of information. Nurses and managers should carefully consider the implementation process of PCH and evaluate its long-term effects. PCH can be recommended in the oncology inpatient setting.
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Affiliation(s)
- Anna Kullberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lena Sharp
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Bressan V, Cadorin L, Pellegrinet D, Bulfone G, Stevanin S, Palese A. Bedside shift handover implementation quantitative evidence: Findings from a scoping review. J Nurs Manag 2019; 27:815-832. [DOI: 10.1111/jonm.12746] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 01/03/2019] [Indexed: 11/25/2022]
Affiliation(s)
| | - Lucia Cadorin
- Continuing Education Centre, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS Aviano Italy
| | | | | | | | - Alvisa Palese
- Department of Medical SciencesUniversity of Udine Udine Italy
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Usher R, Cronin SN, York NL. Evaluating the Influence of a Standardized Bedside Handoff Process in a Medical-Surgical Unit. J Contin Educ Nurs 2019; 49:157-163. [PMID: 29596702 DOI: 10.3928/00220124-20180320-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 12/20/2017] [Indexed: 11/20/2022]
Abstract
BACKGROUND Patient safety is a national and global concern. In the United States, medical errors result in more than 50,000 unnecessary patient deaths annually and contribute to billions of dollars in health care costs. The purpose of this project was to evaluate a standardized bedside handoff process and its influence in a medical-surgical unit. METHOD A quality improvement project was performed in a medical-surgical unit and consisted of development, implementation, and evaluation of a standardized bedside handoff. The project included surveying nurses, a web-based educational program, and observations using the SBAR (T) competency checklist tool. Data were analyzed for trends. RESULTS Results identified an improved perception of communication among the nurses as it relates to shift report and a reduction in length of handoff time after the education intervention. CONCLUSION Continual nurse education and audits by nurse leaders are vital to the sustainment of positive outcomes. J Contin Educ Nurs. 2018;49(4):157-163.
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Family Caregivers' Experiences of Within-Hospital Handoffs for Older Adults in Acute Care. J Nurs Care Qual 2018; 33:368-374. [PMID: 29227336 DOI: 10.1097/ncq.0000000000000306] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Family caregivers' experiences during within-hospital handoffs between acute care units are not well understood. Qualitative description methodology was employed to describe family caregivers' experiences during their loved ones' handoffs. Semistructured interviews were conducted with 10 caregivers of hospitalized older adults. Three themes emerged: Lack of care coordination, Muddling through handoffs alone, and Wariness toward the care delivery system. Findings can help clinicians shape their interactions with caregivers to maximize their involvement in post-hospital care.
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Kullberg A, Sharp L, Dahl O, Brandberg Y, Bergenmar M. Nurse perceptions of person-centered handovers in the oncological inpatient setting: A qualitative study. Int J Nurs Stud 2018; 86:44-51. [DOI: 10.1016/j.ijnurstu.2018.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Revised: 04/20/2018] [Accepted: 06/02/2018] [Indexed: 11/26/2022]
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Slade D, Murray KA, Pun JKH, Eggins S. Nurses’ perceptions of mandatory bedside clinical handovers: An Australian hospital study. J Nurs Manag 2018; 27:161-171. [DOI: 10.1111/jonm.12661] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2018] [Revised: 04/18/2018] [Accepted: 05/16/2018] [Indexed: 01/08/2023]
Affiliation(s)
- Diana Slade
- School of Literature, Language and Linguistics, ANU College of Arts and Social Sciences; Australian National University; Canberra ACT Australia
| | - Kristen A. Murray
- Department of English; The Hong Kong Polytechnic University; Hong Kong SAR China
| | - Jack K. H. Pun
- Department of English; City University of Hong Kong; Hong Kong SAR China
| | - Suzanne Eggins
- School of Literature, Language and Linguistics, ANU College of Arts and Social Sciences; Australian National University; Canberra ACT Australia
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Callaway C, Cunningham C, Grover S, Steele KR, McGlynn A, Sribanditmongkol V. Patient Handoff Processes: Implementation and Effects of Bedside Handoffs, the Teach-Back Method, and Discharge Bundles on an Inpatient Oncology Unit. Clin J Oncol Nurs 2018; 22:421-428. [PMID: 30035777 DOI: 10.1188/18.cjon.421-428] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Bedside handoffs, the teach-back method, and discharge bundles have been shown to contribute to empowering patients to actively engage in their treatment. OBJECTIVES The objectives were to identify patient activation scores, patient readmission rates, and nursing staff satisfaction before and after implementing bedside handoffs, the teach-back method, and discharge bundles on an inpatient oncology unit at a large military treatment facility. METHODS A series of three cycles using the Plan-Do-Study-Act framework guided implementation of the multifaceted approach. Patient activation scores, readmission rates, staff satisfaction, and anecdotal feedback from patients and nursing staff were collected prior to and following implementation. FINDINGS The sample of patients with cancer had high patient activation scores. After implementation of the multifaceted approach, readmission rates decreased from 32% to 25%, and staff satisfaction improved.
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Affiliation(s)
| | | | - Shawna Grover
- Uniformed Services University of the Health Sciences
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Assessing the implementation of a bedside service handoff on an academic hospitalist service. Healthcare (Basel) 2018; 6:117-121. [DOI: 10.1016/j.hjdsi.2017.06.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 05/09/2017] [Accepted: 06/17/2017] [Indexed: 11/22/2022] Open
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Faloon DN, Hampe H, Cline T. Effects of Multimethod Intervention on Bedside Report Compliance and Patient Satisfaction. Crit Care Nurs Q 2018; 41:129-141. [DOI: 10.1097/cnq.0000000000000191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2017; 77:243-258. [PMID: 29149634 DOI: 10.1016/j.ijnurstu.2017.10.014] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 08/30/2017] [Accepted: 10/22/2017] [Indexed: 11/19/2022]
Abstract
BACKGROUND Numerous reviews of nursing handover have been undertaken, but none have focused on the patients' role. OBJECTIVES To explore how patient participation in nursing shift-to-shift bedside handover can be enacted. DESIGN Systematic mixed- methods review. DATA SOURCES Three search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects. REVIEW METHODS Screening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table. RESULTS Segregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barrier to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' concerns for the consequences of encouraging patient participation, worries for sharing confidential and sensitive information and feeling hesitant in changing their handover methods. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and involving both patients and nurses throughout the change process. CONCLUSIONS Using research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses and patient views. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.
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Affiliation(s)
- Georgia Tobiano
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Tracey Bucknall
- Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University and Alfred Health, 221 Burwood Hwy, Burwood, Victoria 3125, Australia; Alfred Health, The Alfred, 55 Commercial Rd, Melbourne, VIC 3004 Australia.
| | - Ishtar Sladdin
- Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia.
| | - Jennifer A Whitty
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich NR4 7TJ, United Kingdom.
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Gold Coast Campus, Parklands Drive, Southport, QLD 4222 Australia.
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Tobiano G, Whitty JA, Bucknall T, Chaboyer W. Nurses’ Perceived Barriers to Bedside Handover and Their Implication for Clinical Practice. Worldviews Evid Based Nurs 2017; 14:343-349. [DOI: 10.1111/wvn.12241] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/28/2017] [Indexed: 12/15/2022]
Affiliation(s)
- Georgia Tobiano
- Menzies Health Institute Queensland Griffith University Southport QLD Australia
| | - Jennifer A. Whitty
- Professor, Norwich Medical School, University of East Anglia, Norwich, UK; School of Pharmacy, Faculty of Health and Behavioural Sciences The University of Queensland Woolloongabba QLD Australia
| | - Tracey Bucknall
- Professor and Foundational Chair in Nursing, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health Deakin University and Alfred Health Burwood VIC Australia
| | - Wendy Chaboyer
- Director, National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland Griffith University, Southport QLD Australia
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Using Kotter's Change Framework to Implement and Sustain Multiple Complementary ICU Initiatives. J Nurs Care Qual 2017; 33:38-45. [PMID: 28658182 DOI: 10.1097/ncq.0000000000000263] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
This article describes the planning, implementation, and outcomes of 2 complementary quality initiatives, bedside handoff and nurse-initiated interdisciplinary bedside rounds, in a 24-bed medical/surgical intensive care unit. Systematic approaches such as Kotter's change model and unit-based champions were used to redesign care processes and standardize daily communication and workflows. Active partnership with the patient and the family during these changes promoted a strong intensive care unit culture of patient- and family-centered care.
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Abstract
This study explored parents' perspectives regarding their involvement in safety for their hospitalized children. We employed qualitative description and semistructured interviews of parents of children in an urban tertiary hospital ward. Content analysis revealed 4 parent themes: risks to child safety and comfort, hospital role as a protector, participation in safety varies by individual and organizational factors, and balancing safety with "speaking up" interpersonal risks. We suggest key concepts to incorporate into staff education and family engagement/safety programs to develop effective partnerships between clinicians and parents.
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Affiliation(s)
- Deborah C Small
- Deborah C. Small is the CNO and vice president of Patient Care Services at Cleveland (Ohio) Clinic Fairview Hospital. Joyce J. Fitzpatrick is the Elizabeth Brooks Ford Professor of Nursing at Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, Ohio
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Cardio-thoracic surgical patients’ experience on bedside nursing handovers: Findings from a qualitative study. Intensive Crit Care Nurs 2016; 35:28-37. [DOI: 10.1016/j.iccn.2015.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2015] [Revised: 11/18/2015] [Accepted: 12/03/2015] [Indexed: 11/24/2022]
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Clinical communication: is patient involvement warranted? J Nurs Care Qual 2016; 30:104-5. [PMID: 25679353 DOI: 10.1097/ncq.0000000000000101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
The study purpose was to describe how bedside nurses can use nursing bedside shift report (NBSR) to keep patients safe. NBSR has been recommended as a means of increasing patient safety, but little is known about how or whether it does so. Grounded theory methods were used. Data were collected from 2014 to 2015 with bedside nurses in a pediatric unit with an established NBSR process. The primary process by which bedside nurses use NBSR to keep patients safe is reducing risk of harm through conveying the patient story from shift to shift. Having a perspective from the bedside is a key antecedent to reducing risk of harm, as it supports the nurses' ability to subsequently identify and address risks. Although often seen as a routine exchange of information, how nursing shift report is conducted can impact patient safety. The study reinforces the value of targeting nursing communication to improve patient safety.
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Affiliation(s)
| | - Kirstin A Manges
- The University of Iowa, Iowa City, USA Iowa City VA Healthcare System, IA, USA
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