Reflective Analysis on Clinical Handover using ISBAR Framework - Importance of Assessment and Communication for Effective Healthcare Delivery

This reflective analysis discusses the importance of assessment and communication in clinical handover using ISBAR framework. It covers the patient's critical condition, assessment from head to toe, evaluation, analysis, conclusion, and action plan for future improvement.

Reflective Analysis

Table of Contents
INTRODUCTION...........................................................................................................................3
MAIN BODY...................................................................................................................................3
Description.............................................................................................................................3
Feelings...................................................................................................................................4
Evaluation...............................................................................................................................5
Analysis..................................................................................................................................6
Conclusion..............................................................................................................................6
Action Plan.............................................................................................................................7
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................9

INTRODUCTION
Pneumonia refers to an infection that is related with lungs where there lungs may be
filled with pus or fluid and cause cough and create difficulty breathing along with fever. ISBAR,
is a framework which provides communication approach which can used in situation. It includes
Introduction, situation, background, assessment and recommendation. Patient was suffering with
lower back pain along with side lower chest pain. Patient was in critical condition and pain was
not tolerable. Patient had the history of asthma and other diseases which create complication
during medication. There is need for proper assessment along with some recommendation for
patient's better health. In this report, there is discussion about patient health condition and
experiences. In this report, there is sharing of information about the patient health and covering
patient assessment from head to toe. There is also discussion about patient current condition
which is related to assessment and medication. This report consists of patient placement which is
due to its critical condition and for better-improved health along with treatment and care
(Moreno-Pérez, (2020)).
MAIN BODY
Summary of clinical handover
As per the Australian nursing standard and professionals code of conduct, there is need to
take consent from patient for their treatment. There is also need to maintain confidentiality,
ISBAR is used during delivering clinical handover. My handover was 51 year's old gentleman
who is suffering form back pain and acute side left chest pain. I have placed in Modbury hospital
as a nursing staff member. I have attended a transfer case of patient who was suffering from
pneumonia and having history of asthma, cholesterol and depression along with type-2 diabetes.
Patient was a smoker, alcohol user along with ethanol containing user.
Reason chosen aspect for reflective analysis
I have worked as a nursing staff and part of ISBAR clinical handover, I forget some
assessment and got stressed during delivering of care and services. This reflection can help to get
encouragement and improvement in services and actions. Therefore, this experience can help me
in future practice.

Description
Patient has been handover from the organization to my Modbury hospital where I have
assigned to provide a healthcare treatment and services. I have performed head to toe assessment
which is highly important to identify patient's problem. It also helps to identify the patient's
medical needs. It includes the physical examination. Head to toe assessment is required to get all
the health related information about the patient which can allow to delivery and evaluate the
consequences for better and effective healthcare services and treatment. Patient was in critical
condition where patient was suffering from various problem with chest pain in left side. Blood
pressure was low and case of hypoxic respiration failure where I have provided treatment and
care to that patient. I was a nursing staff who was working in Modbury hospital where patient
was transferred. I have communicated with patient and got all the information related with
patient. This was the situation where I need it to provide healthcare treatment effectively. This
helped me to provide effective healthcare treatment. Patient was in critical condition and needed
immediate effective healthcare treatment (Rose, (2021)). Patient had a background of various
diseases and due to high consuming alcohol and smoking made his condition worse. He was
suffering from pneumonia and having chest pain in left side. I have a provided immediate
oxygen supply which can help to provide better respiration with immediate effect. I have taken
assessment of the patient from head to toe which can allow getting every small issue. I have
applied various blood test which included coagulation study, magnesium level, phosphate,
complete blood examination, creatine kinase, hemoglobin test, population prothrombin INR,
FBC and APTT.
I have taken all the assessment which was related with blood tests to get the information
that could have impact on the patient condition. This test where highly important to the patient
that can help to provide various information regarding patients was critical. There are various
pharmacological effect of the various drug is provided high impact over patient health which we
deliver better impact on the patient. It also provide a health benefit when medication was
delivered to the patient. I have also studied the past medical history of patient which help me to
focus on medication which should not take any contradiction or side effect on patient health
(Hawse, (2018)).

Feelings
When patient was transferred to the hospital and handover to me. In this condition i
observed that patient's condition was critical and needed effective treatment with immediate
effect. I was feeling nervous at that situation because it was one-on-one situation and there were
no any nursing staff there to help me out to attempt patient condition effectively. Due to one-on-
one situation and not have longer experience I was not able to get any help or support for
providing medical treatment to minimize the risk of patient health. I was feeling very nervous
and thought weather I could a give my best for saving his life or not. I was nervous at that
situation and feeling to have some support from other nursing staff (Lim, (2021)). But I felt that
if other healthcare professionals would have there I would have felt more nervous. Now I think
that situation has provided me one new experience that how to handle any critical situation alone
and which type of feeling can be there during such type of critical condition of patient. Luckily,
there was no any other nurses to attend patient. Otherwise I could have get more nervous which
could have impacted me in delivering of care and effective on time treatment to the patient. If
there would have other nurses then due to public speaking in such situation could have made me
more discomfort which could have impacted my delivery of healthcare services. While I was
providing treatment to the patient I got many type of though which was I like- am I the right
person to attempt this patient's critical condition, am I the one who is right for his treatment, am I
able to deliver best treatment for his better health, what if I am not able to make treatment
effective. Like this there were many thought were coming in my mind which was during
delivering healthcare treatment and services to the patient (Duret, (2021)).
Evaluation
That experience was good to tackle such critical situation which was also my first
experience. I have communicated with that patient by using communication techniques. I have
used local language to make connect with the patient but patient was not able to get my
communication. Then I used English as the second language which made me to get connect with
the patient. Patient was not able to reply due to worse condition. So, I used the eye contact as the
communication strategy. Due to this communication technique, I was able to get connect with
patient who was answering my question regarding health related with. There was too much
information available but irrelevant to the current scenario which was not helping to take action
regarding that critical situation. Due to not having objective information but subjective

information was available to due to scarcity of time and not having the proper time to go through
those information I was feeling nervous and tries to get the information by communicating
patient for frequent treatment. I have evaluated that during clinical handover, previous hospital
should have provided current information that could helped me to safer care for the patient. I
have tried my best to follow all the Australian nursing standard which can help me to focus on
effective healthcare delivery. This can help to provide competent care to patient for their better
health. I have evaluated that at that time during attending patient, there should have some person
who should have the information of current situation (Tur-Sinai, (2018)). I needed some current
information which could have allowed me to get better and effective situation that can allow to
deliver better and more effective treatment at that time to minimise the health risk of patient. I
have also made some assumption regarding some health issues which was needed for patient
treatment. I have evaluated that there patient was not able to communicate orally and due to
which I have asked some question that patient can reply by using eye contact communication
that was needed to evaluate that current situation. I have made some assumption that helped me
to connect with patient situation for better his better treatment (Saunders, (2018)).
Analysis
I have analysed that I forget to focus on the various blood test which could play an
important role in delivering of effective treatment for doctor. Blood test helps doctors to check
whether patient have certain diseases or condition which can help to delivery treatment and care
accordingly. It also confirms the function of organs also helps in confirming the effective
treatment. Doctor needed more information which is necessary to focus on the type of treatment
which was required to decide. I have analysed that it is important to get all the information
related with patient and his current and previous medical history which can allow doctor to focus
right treatment according to patient health at that time which was serious condition. It was
necessary to communicate about the medication because medication have their own important
role in reduce the critical situation and providing relief form the current health condition. I also
analysed that assessment observation is important to evaluate the situation and seriousness of
health that can provide enough information related with determining the treatment. Due to
having not relevant information and following the hospital policy, it was necessary for the
patient assessment that is needed to get ensure about the test report and help doctor or healthcare
professionals to evaluate the current situation to decide the treatment (Cavicchi, (2017)). I have

also analysed that I forgot the blood related assessment which was necessary and highly needed
to doctor for getting ensure about the condition and its reason which was with the patient health.
I have also analysed that there are many of assessment which I needed to perform has been made
by me. But some assessment that are also having their specification has not evaluated by me. I
also analysed that I was not able to evaluated the pharmacological impact of drugs that have
administering and administered to patient for health improvement during treatment.
Conclusion
I have learned that I need more training and experience to handle such type of critical
situation which are there in some cases. Patient was needed immediate treatment and care for
better and effective health. I have performed all the standard procedure but forget some
assessment which was also needed. I could have entertain the patient with better effect and could
have analysed all the report of previous hospital (Ahmed, (2018)). I could also have get all the
necessary information at right time for implement care and service at initial stage. I could have
also focus on performing all the assessment including blood test. I could have also deliver my
services more effectively that could have allow me to administer medication with immediate
effect. But due to not having the pathophysiology information according to patient scenario, I
was not able to provide medication for patients improved health. Pathophysiology study is
important because it provides the information about the act of diseases on the body system. This
can lead to cause functional changes and health consequences. I could also have some frequent
information about the side effect of medication which could have allow me to investigate about
administered medication at previous hospital before clinical handover. I could have focus on my
service delivery quality and not getting nervous during attending patient. I could have also made
myself calm to follow all the basic and necessary assessment procedure and other follow up
procedure. I also need to get feedback about the job role at that time which can help me to take
future action and make improvement in my act to delivery care services. Feedback can help me
to focus on my fault and required improvement and needed delivery my services effectively
(Drach-Zahavy, (2017)).
Action Plan
If such type of scenario or case comes again, I will be prepared for this condition. To
handle such type of case I need to improve my skills and to focus on my practices and work on
not to get nervous during handling such condition and cases. This can help me change my

practice by attending many case. When I attend such cases on regular basis I will get addict of
such situation and will not get nervous and will perform all my task and assessment procedure
effectively. I need to make sure that I can act effectively in such condition. This can help me to
improve my services and allow to work effectively (Ding, (2020)).
This Gibbs cycle allows to express all the condition and scenario which can help
individual to evaluate the situation on self basis. This is the reflection cycle which allow to
improve the action which has been attended previously and to focus on quality of delivery. By
using all the element, it helps to make reflection concise and short for better and effective
reflection.
CONCLUSION
From above discussion, it can be conclude that in case of clinical handover, situation of
patient is generally critical and needed immediate action towards saving life of patient. There is
need to focus on effective delivery of care and treatment to patient for their improved health. In
this report, there is discussion about the description of the case scenario which was there due to
clinical handover. There is discussion about all the assessment requirement and condition which
allow to focus on self evaluation. There is discussion about the feeling which has arises during
handling situation and after that. There is also discussion about the evaluation, analysis,
conclusion and action plan which allow to share brief experience regarding care of patient along
with treatment.

REFERENCES
Books and Journals
Ahmed, (2018). Improving the quality of medical handover on a paediatric ward. British Journal
of Hospital Medicine, 79(10), 584-585.
Cavicchi, (2017). Healthcare sustainability and the role of intellectual capital: evidence from an
Italian regional health service. Journal of Intellectual Capital.
Ding, (2020). Chest CT findings of COVID-19 pneumonia by duration of symptoms. European
journal of radiology, 127, 109009.
Drach-Zahavy, (2017). Similarity and accuracy of mental models formed during nursing
handovers: A concept mapping approach. International journal of nursing studies, 74,
24-33.
Duret, (2021). Identifying the Barriers to Incorporating Reflective Practice into a Veterinary
Curriculum. Journal of Veterinary Medical Education, e20200040.
Hawse, (2018). Fostering wise judgement: professional decisions in development programmes
for early career engineers. Journal of Vocational Education & Training, 70(2), 297-312.
Lim, (2021). Use of surveillance technology to enhance exposure management for healthcare
workers during the COVID-19 pandemic. The Journal of Hospital Infection, 107, 101.
Moreno-Pérez, (2020). Experience with tocilizumab in severe COVID-19 pneumonia after 80
days of follow-up: A retrospective cohort study. Journal of autoimmunity, 114, 102523.
Rose, (2021). Timing of delivery with coronavirus disease 2019 pneumonia requiring intensive
care unit admission. American Journal of Obstetrics & Gynecology MFM, 3(4), 100373.
Saunders, (2018). Key considerations for selecting instruments when evaluating healthcare
professionals’ evidence‐based practice competencies: A discussion paper. Journal of
advanced nursing, 74(10), 2301-2311.
Tur-Sinai, (2018). Assessing the determinants of healthcare expenditures in single-person
households. Israel journal of health policy research, 7(1), 1-10.