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Aviv U, Beylin D, Biros E, Levi Y, Kornhaber R, Cleary M, Shoham Y, Haik J, Harats M. Efficacy of transfer form implementation for adult burn patients between institutions to the Israeli National Burn Center. Burns 2024; 50:1138-1144. [PMID: 38448317 DOI: 10.1016/j.burns.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/15/2024] [Accepted: 02/06/2024] [Indexed: 03/08/2024]
Abstract
Burns are serious injuries associated with significant morbidity and mortality. In Israel, burn patients are often transferred between facilities. However, unstructured and non-standardized transfer processes can compromise the quality of patient care and outcomes. In this retrospective study, we assessed the impact of implementing a transfer form for burn management, comparing two populations: those transferred before and after the transfer form implementation. This study included 47 adult patients; 21 were transferred before and 26 after implementing the transfer form. We observed a statistically significant improvement in reporting rates of crucial information obtained by Emergency Room clinicians and inpatient management indicators. Introducing a standardized transfer form for burn patients resulted in improved communication and enhanced primary management, transfer processes, and emergency room preparation. The burns transfer form facilitated accurate and comprehensive information exchange between clinicians, potentially improving patient outcomes. These findings highlight the importance of structured transfer processes in burn patient care and emphasize the benefits of implementing a transfer form to streamline communication and optimize burn management during transfers to specialized burn centers.
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Affiliation(s)
- Uri Aviv
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Dmitry Beylin
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Clalit Health Services Management, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel
| | - Erik Biros
- College of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia; Townsville University Hospital, Townsville, QLD, Australia
| | - Yossef Levi
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
| | - Rachel Kornhaber
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt, Bathurst, NSW 2795, Australia
| | - Michelle Cleary
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Sydney, NSW 2000, Australia
| | - Yaron Shoham
- Plastic Surgery Department, Burn Unit, Soroka University Medical Center, Israel; Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba 84105, Israel
| | - Josef Haik
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; Talpiot Leadership Program, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Institute for Health Research, University of Notre Dame, Fremantle, WA 6160, Australia
| | - Moti Harats
- Department of Plastic and Reconstructive Surgery, National Burns Center, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Faculty of Medicine, Tel-Aviv University, Tel-Aviv 69978, Israel; Talpiot Leadership Program, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel; Institute for Health Research, University of Notre Dame, Fremantle, WA 6160, Australia.
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O'Neill K, Powell M, Lovell T, Brown D, Walsham J, Calleja P, Nielsen S, Mitchell M. Improving the handover of complex trauma patients by implementing a standardised process. Aust Crit Care 2023; 36:799-805. [PMID: 36621344 DOI: 10.1016/j.aucc.2022.10.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 10/25/2022] [Accepted: 10/31/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND Patient handover continues to be an international health priority in the prevention of patient harm. Transitioning patients from the intensive care unit (ICU) to the ward is complex, particularly for trauma patients, due to the multifaceted aspects of their care requirements as a result of multiple injuries and different speciality teams. OBJECTIVES/AIM To design, implement, and evaluate the efficacy of a standardised handover process and tool for the transfer of ICU trauma patients. METHODS A multimethod before/after study design was used. This included observations before and after an implemented transfer process and semistructured interviews with ICU and ward nurses caring for trauma patients. Comparisons were made of data before and after the intervention. RESULTS Eleven patient handovers were observed, and 21 nurses (11 from the ICU and 10 from the ward) were interviewed. Patients and family members were included during the handover following the intervention (n = 0/10 [0%] vs n = 4/11 [36%]) and the ward nurses were asked if they had any concerns (n = 5/10 [50%] vs n = 10/11 [91%]). Improvements in patient observations handed over were reported following the intervention. However, omissions remained in some key areas including patient introduction, patient identity, fluid balance, and allergies/alerts. Thematic analysis of interviews revealed that the new handover process was perceived advantageous by both ICU and ward nurses because of its structured and comprehensive approach. Identified future improvements included the need for hospital service managers to ensure integration of ICU and ward electronic health record systems. CONCLUSION Precise, accurate, and complete handover remains a patient safety concern. Improvements were achieved using a standardised process and handover tool for the transfer of complex trauma patients. Further improvements are required to reduce the failure to hand over essential patient information.
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Affiliation(s)
- Kylie O'Neill
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia.
| | - Madeleine Powell
- School of Population Health, University of New South Wales, Sydney, Australia; National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Tania Lovell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Duncan Brown
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - James Walsham
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Medicine, University of Queensland, Brisbane, Queensland, Australia
| | - Pauline Calleja
- School of Nursing, Midwifery & Social Sciences, Central Queensland University, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia
| | - Sue Nielsen
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia
| | - Marion Mitchell
- Intensive Care Unit, Princess Alexandra Hospital, Metro South Hospital Health Service, Queensland, Australia; School of Nursing & Midwifery, Griffith University, Queensland, Australia; Patient Centred Health Services, Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland, Australia
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