Authors (including presenting author) :
Chan YTS(1), Chan YW(1), Ng PC(1), Li SFD(1), Ho WL(1), Lee LH(1), Leung C(1)
Affiliation :
(1) Department of Clinical Oncology, Queen Elizabeth Hospital
Introduction :
Effective communication during handover is essential for ensuring patient safety and continuity of care. However, patient safety literature has repeatedly been pointed out that a lack of formal training and systems for clinical handover impede the good practice to maintain high standards of clinical care. Also, according to annual report on sentinel and serious untoward event of 2018, communication breakdown is one of the contributing factors which caused by unclear instructions between the nurses. Therefore, this project aims to improve communication through establishing standardised handover system for nurses.
Objectives :
(1) To strengthen nursing skill on clinical handover; (2) To facilitate the standardised nursing handover structure; (3)To enhance patient safety by bedside handover processes; (4) To ensure the consistency and completeness of the handover content; and (5) To promote speak up culture and encourage clarification on clinical handover.
Methodology :
The standardised handover system consisted of the following: (1) sharing session; (2) standardised activity planning sheet; (3) bedside handover flow chart (4) handover content tips; and (5) speak up culture poster. Handover audits and nurse satisfaction survey (before-intervention and after-intervention) were evaluated. Before-intervention survey explored nurse’s perception of the existing handover regarding to handover skill, structure, process, content, clarification and overall satisfaction. After-intervention survey explored nurses’ perceptions of the standardised handover system, and how interventions improve each corresponding item. Patient safety outcomes in the form of decreased frequency of patient adverse events such as falls, pressure injuries and medication incidents are reported.
Result & Outcome :
A total of 60 random audits were completed within the audit period (n=30 before-intervention; n=30 after-intervention). The audit results show that compliance rate had improved. All standard criteria achieved 90% compliance or above in after-intervention audit. Also, 14 nurses who met the inclusion criteria, 100% participated and returned before-intervention and after-intervention satisfaction surveys. The mean score percentages for each item in after-intervention survey increased between 22% to 35%. Nurse showed positive feedbacks and satisfied with all interventions. Besides, reduction in the number of patient adverse events were noted: 50% decrease in the number of falls, no medication errors and pressure injuries were reported. The results indicate that standardised handover system had a positive impact on handover audit, nurse’s satisfaction and patient safety outcomes. Nurses’ awareness was raised to ensure patient safety and continuity of care. Thus, communication has improved.
