Authors (including presenting author) :
Yuen WM, SIN MY, CHAN TS, CHAN BH, CHAN YK, MAK Flora, KNG Carolyn
Affiliation :
Department of Medicine & Geriatrics, Ruttonjee and Tang Shiu Kin Hospital
Introduction :
A systematic review recommended that face-to-face communication and structured documentation were essential for leading the clinical handover (Smeulers, Lucas & Vermeulen, 2014). This study aimed to improve the clinical handover efficacy by developing a structure clinical handover note (CHN), to improve communication among nursing staff, to show appreciation to staff and to enhance patient safety.
Objectives :
CHN captured important patient information and provided guidance in clinical handover. Subsequent interventions included a ward-based staff voting for handover champion, training sessions to introduce the CHN and share the handover best practice. Outcomes were evaluated by direct on-site observation, compliance audit on nursing documentation and staff questionnaire.
Methodology :
Eight direct on-site observations were done and pre-post results were compared. The average time reduction in clinical handover was significant from 62 minutes decreased to 45.88 minutes after using CHN. Twenty six cases met the inclusion criteria and were recruited into the compliance audit conducted by advanced practice nurse. Overall compliance rate reached 96.79%. Nurses had fully adhered to the practice in affixing correct patient label, documentation of main problems and patient’s background and had made accurate entry of all information. Non-fully compliant items scored 92.3%-96.2%. We believed the compliant rate will be further improved when the staffs became more familiar in using CHN. All nurses respond and gave comments at the anonymous staff questionnaire. They all agreed that CHN was clear and understandable and it could be a quick reference for them to understand their patients after a period of day off. CHN matched to local needs as majority of clients were “long stay” at subacute setting. It was accepted to be a quick tool for nurses at handover and it improved efficacy as reflected by handover time reduction and the satisfactory result in documentation compliance audit. Future focus could be eexploring the possibility of implementation of electronic handover system.
Result & Outcome :
I DISAGREE to send the abstract to Continuous Quality Improvement Initiatives System (CQIs) for sharing after HA Convention.
