Authors (including presenting author) :
CHAU LS(1),CHEANG SK(1),CHOI TH(1); NG K(1)(2),WONG CY(1), WONG SC(1), WONG SF(1)
Affiliation :
(1)Department of Psychiatry,Shatin Hospital,(2)Department of Psychiatry, Prince of Wales Hospital
Introduction :
Nowadays, supporting staff takes more responsibility and assignments in their daily inpatient service than 2 decades ago. However, the workflow of clinical handover and communication between nursing staff and supportive staff almost remain status quo of the traditional practice.
Effective clinical governance on supporting staff yields positive effect on reducing nurses’ workloads, enhancing team spirits and patient outcomes. Clinical handover is a structured activity to ensure patient’s information passing down between shifts. It facilitates the continuity of patient care. Any faults or delay on clinical handover may result in catastrophic consequence. In 2018, a review on this clinical supervision was conducted in the department of psychiatry in Shatin Hospital. It revealed that the clinical communication between supporting staff were suboptimal. They jotted the events in a small notebook for clinical handover. This practice hindered the communication process as staff found it difficult to comprehend the nature of events owing to its over-simplified design and illegible handwriting. Thus, a tailor made diary was invented after consulting nurse supervisors and supporting staff. Staff can easily identify daily routines, important instructions and updated information from the designated sections of this diary. Both nurses and supporting staff are astonished by this small change which could bring a breakthrough to enhance clinical supervision. Nurse had taken a more active stance in participating in the clinical handover between supporting staff.
Objectives :
To enhance the continuity of patient care;
To implement continuous supervision on documentation of supporting staff;
To enhance staff alertness on shift handover, communication and daily routine of patients;
To facilitate the newly recruited supporting staff to adapt to the daily routine work;
To provide a systematic format of clear information in shift handover.
Methodology :
A two-month pilot run for the new diary took place in two male psychiatric in-patient wards in November 2018 to January 2019. All nurses and supporting staff were briefed on the use and features of the new diary before commencement. The diary was modified based on the feedbacks collected from the pilot run and formally invented in January 2019. In July 2019, a satisfactory survey was designed to assess the attitudes of nurses and supporting staff toward the effectiveness of the new diary. A total of 32 nurses and 19 supporting staff completed the satisfaction survey (Response rate = 100%).
Result & Outcome :
Most of nurses (90%) and supporting staff (89%) agreed that the new dairy enhanced staff’s alertness in shift handover communication and daily routine of patient who has special care needs. Amongst nurses, all of them agreed that the new dairy can enhance the continuity of patient care and provided a systematic format of clear information in shift handover. For the survey of supporting staff. Over 94.7% staff agreed that the new diary facilitate them to know the patient’s recent condition and improve their communication among the ward issue. They felt became more confident in provide patient safety.
Overall, there were positive feedbacks from nurses and supporting staff. The results supported that the new diary not only enhanced clinical supervision of supporting staff on documentation, but also improved their communication during shift handover. The active participation from the frontline staff in redesigning the diary is crucial to its successful implementation.
In the future, we hope that it will be applicable to all in-patient setting in SH. Ultimately we hope that a more precise and concise documentation can lead to a more effective and better patient management.
