Nurse-SitterHandoff

Claudette JohnsonManager of Nursing

Support Services

WHAT IS HANDOFF?

transfer of information (along with authority and responsibility) during transition in care for the

purpose of ensuring the continuity and safety of the patient care.

RESEARCH SUPPORTING HANDOFF

Institute of medicine reports Cost associated with medical errors is $8-29 billion annually

Joint Commission data on sentinel events from 1995-2005 reports Communication issues as the

leading cause of sentinel event

REASON FOR CHANGE

SITTERS

Lack of staff satisfaction

Lack of respect for

sittersNot part of

Team

No breaks or last choice on

breaks

48% of sitters responded

BENEFITS OF SITTER HANDOFF

Promote safetyImprove

communications

Improve staff relationship

Improve staff satisfaction

WHY DO SITTER HANDOFF?

RespectStaff Satisfactio

n

Improve communicatio

n

HANDOFFSTAKEHOLDE

RS

Wrong treatmentDelay in DiagnosisAdverse eventsPatient dissatisfactionIncrease hospital costIncrease length of stay

I N E F F E C T I V E HANDOFFS

Leadership

Patient

Staff

BARRIERS TO HANDOFF COMMUNICATION

COMMON HANDOFF ISSUESCAUSES OF

FA ILURE

Ineffective Methods

Time constraints

Change

Lack of focused research on healthcare and handoff

Lack of Efficiency

Lack of commitment

CAUSES OF SUCCESS

Open to change

Understand purpose of Change.

Preparedness and education

Commitment to making a difference

Management Support

Up-to-date information on the following:

Diagnosis, Care, Condition and ChangesLimited interruptionsSufficient time allocatedProcess for verification- repeat

back read back

IMPLEMENTATION

NURSE-SITTER TOOLto improve safety as well as

patient and staff satisfaction. Purpose

Patient: Room # _____ Date ____Shift______Hand off information for any sitter will include:What is wrong with patient? ____________________________Why do they need a sitter? _____________________________Diet/ fluid restrictions: _________________________________Activity- independent or with assist ______________________Specifics about their care ______________________________Time for their meal breaks, what time they are expected back - SPECIFIC TIME _______________________________________Who will relieve them for their break? ____________________Phone number: Charge: Break Relief: ____________

OA/PCT Signature:________________ Date:____________

SITTER HANDOFF GUIDELINESHand off information for any sitter staff will include:

1) What is wrong with patient? Why is a sitter needed? (Hip replacement but is sun downing tries to get out of bed after 7 pm)2) Diet/ fluid restrictions (NPO, 1 cup of water every shift)3) Activity- independent or not (can get up by himself, can get up safely with walker)4) Specifics about their care (examples: quick with hands must watch IV or Foley, bolts out of bed, confused, watch for visitors)5) Time for their meal breaks, what time expected back -MUST be a SPECIFIC TIME (not 1 hour from now but instead 0445)6) Who will relieve sitter for their break (Julie, PCT and her phone # is____) - OA for suicides have to watch the patient at all times and should not be standing by the door looking for help.

OA ROLE

O A S C A N

Ambulate steady gait patients

Set up trays

Unplug IMEDS only if directed by Nurse

Talk and calm patient down

O A S C A N N O T

Ambulate unsteady patients

Feed patients

Touch IMEDS without nurses' direction

Hold a patients arm down (staff should use mitts or medicate patient)Know that PCTs who are sitting can provide PCT care.

The nurse will need to update sitter for any changes.

Sitters will be passing information to each other

WHAT IS ASSERTIVENESSI T IS NOT…

Aggressive

Hostile

Confrontational

Ambiguous

Ridiculing

PILOT STUDY

Begins February 08 to March 08,

2011Forms available in the Float Pool

roomSend completed sheets to

Claudette JohnsonQuestions: call Claudette at

x.7959

Survey to assess the success of the PILOT STUDY

Survey

For:

all OAs random RN/ PCT

Deadline:

October 1, 2011

Return to:

Claudette Johnson

3W

ChangeFor

SafetyAnd more

importantly, change for

YOU

REFERENCES

Agency for Healthcare Research and Quality (2005). 30 safe practices for better health care: Fact sheet. Retrieved March 19, 2011, from

http://www.ahrq.gov/qual/30safe.htm

Institute of Medicine. Committee on Quality Health Care in America. (2000). Errors in health

care: A leading cause of death and injury. In L. Kohn, J. Corrigan, & M. Donalsdson (Eds.) To Err Is Human: Building a Safer Health

System. Washington, D.C: National Academy Press.

Joint Commission on Accreditation of Healthcare Organizations. (2008). 2009 national patient

safety goals [electronic version]. Joint Commission Perspectives, 28(7), 12. Retrieved March 19, 2011, from

http://www.jcrinc.com/common/PDFs/fpdfs/pubs/pdfs/JCReqs/JCP-07-08-S1.pdf

Northwest Community Hospital (NCH), (2011). Nurse- Sitter handoff tool.

Nothwest Community Hospital. (2011). Pre-assessment of sitter needs survey.