PICOT STATEMENT

The Problem- inadequate patient information transfer from outgoing and incoming nurses during change of shifts. 

Intervention- Bedside rounding 

Don't use plagiarized sources. Get Your Custom Essay on
PICOT STATEMENT
Just from $13/Page
Order Essay

Current Practice- taped or handwritten report 

Outcome- important and critical clinical information is handed over to incoming nurses during shift changeover. 

Time- This study will be complete before the end of this unit. 

Literature Search

Abraham, J., Kannampallil, T. G., & Patel, V. L. (2012). Bridging gaps in handoffs: a continuity of care based approach. Journal of biomedical informatics, 45(2), 240-254.

Handoff among healthcare providers has been recognized as a major source of medical errors. Most prior research has often focused on the communication aspects of handoff, with limited emphasis on the overall handoff process, especially from a clinician workflow perspective. Such a workflow perspective that is based on the continuity of care model provides a framework required to identify and support an interconnected trajectory of care events affecting handoff communication. To this end, we propose a new methodology, referred to as the clinician-centered approach that allows us to investigate and represent the entire clinician workflow prior to, during and, after handoff communication. This representation of clinician activities supports a comprehensive analysis of the interdependencies in the handoff process across the care continuum, as opposed to a single discrete, information sharing activity. The clinician-centered approach is supported by multifaceted methods for data collection such as observations, shadowing of clinicians, audio recording of handoff communication, semi-structured interviews and artifact identification and collection. The analysis followed a two-stage mixed inductive–deductive method. The iterative development of clinician-centered approach was realized using a multi-faceted study conducted in the Medical Intensive Care Unit (MICU) of an academic hospital. Using the clinician-centered approach, we (a) identify the nature, inherent characteristics and the interdependencies between three phases of the handoff process and (b) develop a descriptive framework of handoff communication in critical care that captures the non-linear, recursive and interactive nature of collaboration and decision-making. The results reported in this paper serve as a “proof of concept” of our approach, emphasizing the importance of capturing a coordinated and uninterrupted succession of clinician information management and transfer activities in relation to patient care events.

Abraham, J., Kannampallil, T. G., Almoosa, K. F., Patel, B., & Patel, V. L. (2014). Comparative evaluation of the content and structure of communication using two handoff tools: implications for patient safety. Journal of critical care, 29(2), 311-e1.

Purpose

Handoffs vary in their structure and content, raising concerns regarding standardization. We conducted a comparative evaluation of the nature and patterns of communication on 2 functionally similar but conceptually different handoff tools: Subjective, Objective, Assessment and Plan, based on a patient problem-based format, and Handoff Intervention Tool (HAND-IT), based on a body system-based format.

Method

A nonrandomized pre-post prospective intervention study supported by audio recordings and observations of 82 resident handoffs was conducted in a medical intensive care unit. Qualitative analysis was complemented with exploratory sequential pattern analysis techniques to capture the characteristics and types of communication events (CEs) and breakdowns.

Results

Use of HAND-IT led to fewer communication breakdowns (F1,80 = 45.66: P < .0001), greater number of CEs (t40 = 4.56; P < .001), with more ideal CEs than Subjective, Objective, Assessment and Plan (t40 = 9.27; P < .001). In addition, the use of HAND-IT was characterized by more request-response CE transitions.

Conclusion

The HAND-IT’s body system-based structure afforded physicians the ability to better organize and comprehend patient information and led to an interactive and streamlined communication, with limited external input. Our results also emphasize the importance of information organization using a medical knowledge hierarchical format for fostering effective communication.

Chaboyer, W., McMurray, A., & Wallis, M. (2010). Bedside nursing handover: a case study. International journal of nursing practice, 16(1), 27-34.

A case study of six wards in two hospitals was undertaken to describe the structures, processes and perceptions of outcomes of bedside handover in nursing. A total of 532 bedside handovers were observed and 34 interviews with nurses were conducted. Important structural elements related to the staff, patients, the handover sheet and the bedside chart. A number of processes before, during and after the handover were implemented. They included processes for managing patients and their visitors, sensitive information, and the flow of communication for variable shift starting times. Other key processes identified were the implementation of a safety scan and medication check. The situation, background, assessment and recommendations approach was used only in specific circumstances. Perceived outcomes were categorized as improving accuracy and service delivery, and promoting patient‐centred care. Although the move to bedside handover is not the norm, it reflects a patient‐centred approach.

Manias, E., & Watson, B. (2014). Moving from rhetoric to reality: patient and family involvement in bedside handover. International journal of nursing studies, 51(12), 1539-1541.

Patient and family involvement in bedside handover enables patients and families to interact with health professionals. Active participation only occurs through reciprocal relationships of dialogue and shared decision-making (Bolster and Manias, 2010). Rather than being an information-giving exercise or just a chance to exchange greetings, patient and family involvement is an opportunity to make an important contribution to patient care (Thompson, 2007). While much has been written about the need to include patients and families in bedside handover, it is not clear whether in actual practice their views are considered at all, or indeed, whether health professionals really want them to be involved in the first place.

Riesenberg, L. A., Leisch, J., & Cunningham, J. M. (2010). Nursing handoffs: a systematic review of the literature. AJN The American Journal of Nursing, 110(4), 24-34.

Objective: Handoffs of patient care from one nurse to another are an integral part of nursing practice; but there is abundant evidence that poor communication and variable procedures result in inadequate handoffs. We sought to conduct a systematic review of articles that focused on nursing handoffs, conduct a qualitative review of barriers to and strategies for effective handoffs, and identify features of structured handoffs that have been effective.

Methods: We conducted a systematic review of English-language articles, published between January 1, 1987, and August 4, 2008, that focused on nursing handoffs in the United States. The search strategy yielded 2,649 articles. After title review, 460 of these were obtained for further review by trained abstractors.

Results: Ninety-five articles met the inclusion criteria; of these, 55 (58%) were published between January 1, 2006 and August 4, 2008. Content analysis yielded identification of barriers to effective handoffs in eight major categories and strategies for effective handoffs in seven major categories. Twenty articles involved research on nursing handoffs. Quality assessment scores for the research studies ranged from 2 to 12 (possible range, 1 to 16). The majority of the research studies on nursing handoffs (17 studies; 85%) received quality scores at or below 8 and only three achieved scores above 10. Ten (50%) of the studies included measures of handoff effectiveness.

Conclusion: Despite the well-known negative consequences of inadequate nursing handoffs, very little research has been done to identify best practices. There is remarkable consistency in the anecdotally suggested strategies; but there is a paucity of evidence to support them. We call for high-quality studies of handoff outcomes that focus on systems factors, human performance, and the effectiveness of structured protocols and interventions.

Pothier, D., Monteiro, P., Mooktiar, M., & Shaw, A. (2005). Pilot study to show the loss of important data in nursing handover. British Journal of Nursing, 14(20), 1090-1093.

A good nursing handover process is a crucial part of providing quality nursing care in a modern healthcare environment. The conservation of patient data during the handover process is vital to ensure good continuity of care and safe practice. Any errors or omissions made during the handover process may have dangerous consequences. The authors observed the handover of 12 simulated patients over five consecutive handover cycles between nurses. Three handover styles were used and the amount of data loss was recorded for each style. A purely verbal handover style resulted in the loss of all data after three cycles. A note-taking style (the traditional style used in most hospital wards) resulted in only 31% of data being transferred correctly after five cycles. When a typed sheet was included with the verbal handover, data loss was minimal. Current handover methods may result in significant loss of important data that may impact on patient care. The authors recommend that prior to handover, a formal handover sheet be constructed that can be transferred as part of the handover process.

References

Abraham, J., Kannampallil, T. G., & Patel, V. L. (2012). Bridging gaps in handoffs: a continuity of care based approach. Journal of biomedical informatics, 45(2), 240-254.

Abraham, J., Kannampallil, T. G., Almoosa, K. F., Patel, B., & Patel, V. L. (2014). Comparative evaluation of the content and structure of communication using two handoff tools: implications for patient safety. Journal of critical care, 29(2), 311-e1.

Chaboyer, W., McMurray, A., & Wallis, M. (2010). Bedside nursing handover: a case study. International journal of nursing practice, 16(1), 27-34.

Manias, E., & Watson, B. (2014). Moving from rhetoric to reality: patient and family involvement in bedside handover. International journal of nursing studies, 51(12), 1539-1541.

Riesenberg, L. A., Leisch, J., & Cunningham, J. M. (2010). Nursing handoffs: a systematic review of the literature. AJN The American Journal of Nursing, 110(4), 24-34.Pothier, D., Monteiro, P., Mooktiar, M., & Shaw, A. (2005). Pilot study to show the loss of important data in nursing handover. British Journal of Nursing, 14(20), 1090-1093.

Place your order
(550 words)

Approximate price: $22

Calculate the price of your order

550 words
We'll send you the first draft for approval by September 11, 2018 at 10:52 AM
Total price:
$26
The price is based on these factors:
Academic level
Number of pages
Urgency
Basic features
  • Free title page and bibliography
  • Unlimited revisions
  • Plagiarism-free guarantee
  • Money-back guarantee
  • 24/7 support
On-demand options
  • Writer’s samples
  • Part-by-part delivery
  • Overnight delivery
  • Copies of used sources
  • Expert Proofreading
Paper format
  • 275 words per page
  • 12 pt Arial/Times New Roman
  • Double line spacing
  • Any citation style (APA, MLA, Chicago/Turabian, Harvard)

Our guarantees

Delivering a high-quality product at a reasonable price is not enough anymore.
That’s why we have developed 5 beneficial guarantees that will make your experience with our service enjoyable, easy, and safe.

Money-back guarantee

You have to be 100% sure of the quality of your product to give a money-back guarantee. This describes us perfectly. Make sure that this guarantee is totally transparent.

Read more

Zero-plagiarism guarantee

Each paper is composed from scratch, according to your instructions. It is then checked by our plagiarism-detection software. There is no gap where plagiarism could squeeze in.

Read more

Free-revision policy

Thanks to our free revisions, there is no way for you to be unsatisfied. We will work on your paper until you are completely happy with the result.

Read more

Privacy policy

Your email is safe, as we store it according to international data protection rules. Your bank details are secure, as we use only reliable payment systems.

Read more

Fair-cooperation guarantee

By sending us your money, you buy the service we provide. Check out our terms and conditions if you prefer business talks to be laid out in official language.

Read more
Live Chat+1(978) 822-0999EmailWhatsApp

Order your essay today and save 20% with the discount code LEMONADE