Implementation of the Handoff Communication Tool - Assignment Example

? Implementation of the Hand–off Communication Tool Implementation of the Hand–off Communication Tool Introduction Patient safety has been a matter of concern to many healthcare personnel. Handoffs are essential part of clinical practice and play a great role in improving communication between healthcare personnel. Good communication among healthcare personnel results in improved patient safety and quality of care. Handoff is a process by which vital information about a client/patient/resident is passed from one provider of healthcare to another (Reisenberg, Leitzsch, & Cunningham, 2010). They typically occur during shift changes. Inadequate communication has been cited as a major cause of medical errors (Reisenberg, Leitzsch, & Cunningham, 2010). Researchers who were exploring the causes and nature of human error in intensive care settings found out that verbal communication between nurse and physicians contributed to 37% of medical errors (Reisenberg, Leitzsch, & Cunningham, 2010). In an Australian study, more than 14,000 admissions were investigated. The study revealed that approximately 17% of the cases had an adverse event closely associated to it. Among the 17% of the cases, 11 percent were attributed to communication errors (Reisenberg, Leitzsch, & Cunningham, 2010). According to TRICARE (2005), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) requires that institutions of healthcare ought to implement a standardized approach to handoff communications in an effort to meet the ever growing need of patient safety. Current Scenario The current tool in use has been associated with a number of delays. Nurses would file reports indicating that beds were not ready; patients missed their medication, nurses themselves not being ready and the absence of vital patient information. A questionnaire was submitted to healthcare personnel in an effort determine the cause of the delays. Analysis of the data revealed that the reports prepared for use by the receiving nurse were not user friendly. The study also revealed that the health personnel preferred using another tool of handoffs communication. Other reasons for the delay were difficulty in locating medicine, and difficulty in accessing critical patient information. In other clinical nursing scenarios, many errors have been identified that have resulted from communication problems. For instance omission of critical information as a result of poor communication between healthcare personnel, miscommunication that has results in misunderstanding of information, inability of the receiving nurse to contact the ongoing nurse due to communication problems, use of communication tools like reports that often become too routine and result in loss of focus by many healthcare personnel (Ong, &Coiera, 2011). Other problems arising due to absence of standard communication procedure include idle chatting during handoffs that dilutes the importance of handoffs, illegible handwriting in reports, reports with judgmental statements, absence of research on handoffs and data that is in support of best practices, ethnic, cultural and racial barriers which interfere with communication channels, language barriers that frustrate efforts to communicate effectively, and staff who resist change that comes with implementation of new routines (Reisenberg, Leitzsch, & Cunningham, 2010). Implementation I pass the baton is a technique that was designed with a primary purpose of streamlining the handoff process and have a well established and standardized means of communication. The main idea behind the use of this tool is to minimize information loss and more importantly ensure that exchange of information occurs in a timely manner and with a high level of accuracy. The culture and needs of a healthcare institution often dictate how the technique will be utilized. I pass the baton stands for I-introduction, P-patient, A- assessment, S-situation, S-safety concerns, B-background, A-actions, T-timing, O-ownership, N-next. This tool requires that a caregiver identifies himself or herself and their role. The correct patient is then identified in terms of name, age, sex, and location. Then the patient’s assessment is presented and this includes the patient’s chief complaint, the vital signs, symptoms and diagnosis. The current situation of the patient is then delivered. Here the patient’s current status, code status, recent changes, and response to treatment are noted. This is followed by the patient’s safety concerns which include laboratory results and reports, allergies, other socio economic factors and alerts. The background of the patient is also discussed. Essential aspects of the patient’s background include family history, previous history and co-morbidities. The actions taken are then discussed in detail and any other actions to be taken are noted together with a brief rationale for those actions. The timing of the actions to be taken is prioritized so that the receiving nurse is aware of the urgency of any action to be taken. The individuals who are responsible are identified. They may include a doctor, a team of specialists etc. The last step is to give the plan of actions which details what is to happen next (TRICARE, 2005). According to the Emergency Nurses Association, I pass the baton is one of the best communication tools. Another tool often used in communication during handoff is the SBAR. SBAR stands for S-situation, B-background, A-assessment, R-recommendation. This tool, although good, when compared to I pass the baton, it has some shortcomings. SBAR may not elicit or prompt the incoming/emergency nurse to seek all the key elements needed to see a safe transition. The “I pass the baton” checklist, enables both the incoming and of-going nurse to keep in mind all of the pertinent elements required for safe transition. The tool has also been proven to be effective in the geriatric care (Emergency Nurses Association, 2011). Implementation of this tool ensures the continuum of quality patient care and allows the oncoming caregiver to seek clarifications when there is need. By allowing the patient to participate in the process, patient centered care is enhanced and the patient is fully aware of the caregiver in charge of them. Implementation of the tool within the healthcare setting resulted in a decrease in the number of occurrence reports from 28 to 8 over a three month period when the tool had been implemented. The time spent in communication remarkably improved from 754 to below 250 hours. The nurses within the healthcare setting recognized the importance of the tool and considered adopting it in their day to day clinical practice activities. These changes and improvement were realized in a short time span of about three months. There are particular attributes of the tool to improve communication between the healthcare personnel. The implementation of this tool encouraged effective communication between the healthcare providers by encouraging a two way communication between one caregiver and another. The tool overtly outlined the transfer of responsibility from one caregiver to another and therefore eliminating confusion and errors. Learning Experience Through the implementation of the “I pass the baton” tool, I have learnt how to communicate with fellow colleague (healthcare personnel), patients and close family members. The tool encourages meaningful and effective communication among concerned parties. As a result, I have been able to develop and sustain holistic and caring relationships with patients who emanate from diverse ethnic, cultural and racial backgrounds within the clinical setting. Through effective communication brought about by implementation of the handoff tool, I have acquired knowledge that enables me to exercise the science and art of nursing in determining critical interventions and decision making in a clinical setting. I have also learnt how to apply the nursing theory into the science and art of nursing. Through implementation of the handoff tool I have participated in many nursing clinical scenarios that were challenging enough and required research efforts in order to be able to develop the best care plan. I have learnt how to orchestrate scientific evidence from research into the science and art of nursing. I have gained more insight on this particular handoff communication tool. I have learnt how it can be tailored to fit the various clinical settings that often arise within the day to day activities of the practicing nurse. Through implementation of the tool, I have participated in case scenarios where the tool has been used in facilitating decision making within the clinical set up. I have learnt how the tool can be used in the making of critical decisions especially where care is being offered by a team as is the case in coordinated palliative care plans. Practical experience and development of nursing career The practical experience that I gained has greatly enhanced my knowledge and skills and in effect contributing towards my professional growth and development. According to a Delphi study, the roles of a registered nurse include community care provider, family health manager, and health and hygiene planner. The study further revealed that the role of the nurse must be extended to community health oriented role from the traditional case oriented role. The study revealed that stakeholders of the nursing profession (government, nurses, and academic institutions) believe there is need to increase the scope and depth of the nursing profession. The study further revealed that nurses ought to have abundant knowledge, practical experience and skills in order to execute their mandate effectively (Lee, Shieh, & Chiou, 2001). In another article, the authors have discussed professional development of nurses and discussed it in three stages. The first stage (acquiring nursing education in institution of higher learning) is marked by confusion as an individual is exposed to nursing profession. In the second stage maturation of an individual occurs in the career ladder. The individual practices gains more pertinent skills and knowledge. In the third phase, are clinical advancement programs. By engaging in a real nursing environment and getting first hand experience on the challenges presented, I gained abilities and special skill sets that would see me transition between the three phases of development with much ease (Donley, & Flaherty, 2008). In line with the above roles of a registered nurse, the practical experience acquired contributed towards developing an ability to meet the roles and duties satisfactorily. While at the healthcare institution, I was able to interact with patients and caregivers in the course of executing my duties and in the process gained experience on how to provide care to patients while observing set guidelines, ethical standards and focusing on outcome optimization. Through participating in a team of healthcare personnel handling a specific patient, I was able to provide key knowledge to the client which contributed to enhancing the client to comply with the therapeutic plan. I also gained skills necessary to work within a team and focus on achieving the overall goal of the team effort. The practical session enabled me to gain experience in providing intellectual, emotional and psychological support to the patients. I developed skills that enable me to guide advice and counsel patients on the correct choices to be made in order to optimize their quality of life and longevity. While at the hospital, I was able to participate in researching problems that proved to be a challenge to the team of caregivers. I participated in scientific investigation in the process gaining knowledge and skills necessary for conducting a scientific research. I gained knowledge on the research process the language of research and sensitive issues that relate to protection of rights of patients. Conclusion Communication plays a central role in the execution of roles and duties of nurses. A lapse in the communication channel results in the many medical errors which could cost the precious life of patients. Implementation of the “I pass the baton” handoff communication tool is a critical step towards minimizing errors that are closely associated with communication problem. The tool is capable of minimizing errors committed within the clinical setting by healthcare personnel. It also helps improve on better patient outcomes due to minimized errors and better communication of relevant information. Working within a nursing environment contributed towards achieving my student learning outcomes and professional growth. I gained fundamental knowledge and skills necessary for executing the duties and responsibilities of nurses and in the process achieve professional growth. References Donley, R., Flaherty, M.J. (2008). Promoting professional development: Three phases of articulation in nursing education and practice. The online Journal of issues in Nursing, 13(3). Hohenhaus, S.M. (2011 June). I pass the baton for safer handoffs in pediatric emergency care. ENA Connection, 35(6), 8-9. Lee, S.T., Shieh, W.L., & Chiou, C.J. (2010). Role and function of registered professional nurses station: A Delphi study. Hi Li Yan Jiu, 9(3), 269-78. Ong, M., & Coiera, E. (2011). A systematic review of failures in handoff communication during intrahospital transfers. Joint Commission Journal on quality and Patient Safety, 37(6), 274-284. Reisenberg, L.A., Leitzsch, J., Cunningham, J.M. (2010). Nursing handoffs: A systematic review of literature. American Journal of Nursing, 110(4), 24-34. TRICARE (2005). Strategies and tools to improve healthcare handoffs and transitions. Retrieved from: http://www.unmc.edu/rural/patient-safety/tool-time/TT2-053006-DOD-SBAR- SafetyBriefings/DOD%20Handoff%20-%20I%20Pass%20the%20Baton.pdf Read More