Clinical Handover

Rona RinosaClinical Support and

Development The Alfred Hospital

Overview•The importance of clinical handover

•Problems encountered with handover•The components on what make a good clinical handover•ISBAR•What next? What can we do to improve our practice?

World Health Organization

“..the process of passing patient-specific information from one

caregiver to another, from one team of caregivers to the next, or from

caregiver to the patient and family for the purpose of ensuring patient care

continuity and safety.”

Modes of Handover

•Face to face: at the patient’s bedside, nursing station or staff meeting room•Taped•Written•Over the phone

How often do we handover?

Without Clinical Handover

•It can lead to incorrect patient diagnosis•The patient not receiving the appropriate treatment that they require•Errors in medical and nursing interventions •Deterioration in patients condition•Increase risk of adverse effects

The importance of clinical handover

•Patient involvement

•Promotes a teaching-learning environment

Identifiable risks in Handover

•Breakdown in communication•Frequency of interruptions•Lack of space•Time constraints•Handover during the weekend

Identifiable risks in Handover•Incomplete or omitted information•Irrelevant information and repetition•Speculation•Non- compliance

Components that make a good Handover

• Communication“...Communication is linked to the safety of the patient and the continuity of his/her care.” (Guevara, Maryory & Ligia, 2015, p421.)

• Clear• In a timely fashion• Involve the Patient in the Handover process

Components that make a good Handover

Taken from WHO (2007) Communication during patient handovers

Benefits of Bedside Handover

• Patients were better informed• It gives patients the opportunity to be involved in their care• Increases patient satisfaction

• Minimise errors• Improving nurse-patient relationship

ISBAR

IdentitySituation

Background

Assessment

Recommendations

https://www.youtube.com/watch?v=K6Ah8ojVPiQ

The Future, what next?

“Like a bicycle, a healthcare system is dynamically stable only when receiving

constant inputs and feedback from practitioners” (Hill & Nice, 2010, p47).

The Future, what next?

• Paper free •Tablets• WiFi• OpenKIMS

The Alfred

Safe handover = Safe patients

Take Home Message:

References:1. Greaves, C. (1999). Patients’ perceptions of bedside handover. Nursing Standard, 14(12), 32-35.2. Hill, W. & Nyce, J. (2010). Human factors in clinical shift handover communication: Review of reliability and

resilience principles applied to changes of shift report. Canadian Journal of Respiratory Therapy, 46(1), 44-51.3. Amil Kusain, T. (2015). Emphasizing caring component in Nurse-Patient-Nurse bedside reporting. International

Journal of Caring Sciences, 8(1), 188-193.4. Priestly, D.S. (2006). A reflective evaluation of patient handover practices. Nursing Standard, 20(21), 49-52.5. Barnes, S.L., Campbell, D.A., Stockman, K.A. & Wunderlink, D. (2011). From theory to practice of electronic

handover. Australain Health Review, 35, 389-391.6. Guevera, L., Maryory, A.M., & Ligia, P. (2015). The handover: A central concept in nursing care. Enfermia Global, 37,

419-434. 7. Koberich, S. (2014). Nursing bedside handover does not influence cardiovascular surgery patients’ participation in

nursing care decision making process: Results three months after implementation. International Journal of Caring Sciences, 7(3), 823-833.

8. Eggins, S. & Slade, D. (2012). Clinical handover as an interactive event: Informational and interactional communication strategies in effective shift-change handovers. Equinox Online, 9(3), 215-227.

9. Adams, J.M. & Osborne-McKenzie, T. (2012). Advancing the evidence base for a standardized provider handover structure: Using staff nurse descriptions of information needed to deliver competent care. The Journal of Continuing Education in Nursing, 43(6), 261-266.

10. Scovel, S. (2010). Role of the nurse-to-nurse handover in patient care. Nursing Standard, 24(20), 35. 11. Australian Medical Association (2006). Clinical handover guide: Safe handover safe patients. Sydney: Australian

Medical Association. Retrieved 19th of May, 2015 from https://ama.com.au/sites/default/files/documents/Clinical_Handover_0.pdf

12. World Health Organisation (2007). Communication during patient handovers. World Health Organization Collaboration Centre for Patient Safety Solutions, 1(3). Retrieved 19th of May, 2015 from http://www.who.int/patientsafety/solutions/patientsafety/PS-Solution3.pdf

13. Safe handover safe patients: Guidance on clinical handover for clinicians and managers (n.d.) British Medical association retrieved 19th of May, 2015 from https://www.google.com.au/url?sa=t&rct=j&q=&esrc=s&source=web&cd=2&cad=rja&uact=8&ved=0CCMQFjAB&url=http%3A%2F%2Fbma.org.uk%2F-%2Fmedia%2FFiles%2FPDFs%2FPractical%2520advice%2520at%2520work%2FContracts%2Fsafe%2520handover%2520safe%2520patients.pdf&ei=P9VaVfHTFouf8QXatoHYAg&usg=AFQjCNE2E-1GZj6zLSuALZlwBE7vXDIcMQ&sig2=RHfBQw508dICa0ycnpJHRA

14. Allen, S. (2012). Accrediting Agencies Surveyor Workshop, Australian Commission on Safety and Quality in Health Care. Standard 6: Clinical Handover. National Safety and Quality Health Service Standards retrieved 20th of July, 2015 from http://www.safetyandquality.gov.au/our-work/accreditation-and-the-nsqhs-standards/resources-to-implement-the-nsqhs-standards/

15. Australian Commission on Safety and Quality in Health Care. Safety and Quality Improvement Guide Standard 6: Clinical Handover (October 2012). Sydney. ACSQHC, 2012.

16. Alfred Health (2015). Clinical Handover Guideline. Retrieved June 16th, 2015 from Alfred Health intranet.

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