Clinical Handover: Evidence, Actions, and Nurse Communication

This report provides a comprehensive overview of bedside handover practices in healthcare settings. It begins by examining the contemporary evidence supporting bedside handover, emphasizing its importance in ensuring patient safety and continuity of care. The report then delves into the key actions outlined in Action 6.7 of the Communicating for Safety NSQHS Standard, detailing the essential elements of a bedside handover, such as patient identification, current diagnosis, and care plans. The rationale behind each action is explained, highlighting how these practices contribute to effective communication and minimize potential errors. Finally, the report addresses how to approach a Registered Nurse in a handover situation, emphasizing effective communication skills and a proactive approach to ensure information is conveyed accurately and completely. The report references several academic sources to support the findings and recommendations, providing a well-rounded understanding of bedside handover best practices.

Case scenarios
Contents
1. What is the contemporary evidence to support bedside handover?.............................................3
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2. Referring to the Action 6.7 in Communicating for Safety NSQHS Standard - what key actions
should happen in the bedside handover and why?...........................................................................4
3. Briefly explain how you will approach the RN in this situation?................................................5
REFERENCES................................................................................................................................6
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1. What is the contemporary evidence to support bedside handover?
In the health care facility, the responsibility for patient's care is transferred among care
providers on daily basis. It happens in active as well as interruptive environments which are
typical of those in health care currently. Communicating the information of patient to the next
provider of care can be referred as handover or handoff or end of shift report or report. There are
three primary things which are transferred at the time of handover including responsibility,
authority and information (Martin, Jones, & Wolfe, (2017). Effective information transfer is very
important it has been depicting that communication breakdown between the care providers is the
key contributing element in sentinel events. It has been found in a review that around 3000
sentinel events depicted that a breakdown in communication happened 65 - 70 % of the time
(Bressan, Cadorin, Stevanin, & Palese, (2019). The poor communication handovers have
outcomes into adverse events, redundancies and delays in treatment which impact effectiveness
and efficiencies, low satisfaction of patient and health care providers and more admission.
As per the Australian council for safety and quality in healthcare's clinical handover report,
clinical handover of patients is the transfer of professional accountability and responsibility for
some or all care aspects for patient to another individual on temporary or permanent basis. As
per the provided scenario, the hand over takes place at nursing station to a graduate nurse on
surgical ward and the handover is given for patients in the area. There are four patients among
which I know one of the patient and the remaining 3 are new to me. A comprehensive handover
has received by me of all the pertinent medical as well as nursing information. The handover is
provided properly with adequate amount of information, accountability and responsibility which
will impact positively on the patients (Flanigan, (2016). This help me in providing the diagnosis,
treatment and care in an appropriate way. An evidence based handover communication will
support improving the safety of patient by execution of care delivery systems which are
effectively structure the communication of handover. The nursing handover practices is highly
variable which lead to inconsistencies in accuracy and content of handover information.
However, transferring the responsibility for care of patient to another care provider maximize the
probabilities of an error happening, particularly if important information is not communicated
properly. Any incomplete, unclear, or inaccurate transfer of information upsurges the risks of
possibly severe errors while patient care (Jensen, (2020).
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2. Referring to the Action 6.7 in Communicating for Safety NSQHS Standard
- what key actions should happen in the bedside handover and why?
The National Safety and Quality Health Service Standards were developed to deliver
consistent level of high quality and safe care across Australian national health services. The
standards were designed to derive the execution of safety as well as quality systems and
enhancement to health care quality. It gives a mechanism to allow systematic review of the
systems which are complex and a way of tracking alterations in quality and safety of patient care.
As per the action 6.7 in communicating for safety NSQHS standard, it states that the minimum
information content to be convey at clinical handover must be based on best practice guidelines.
The intent of this action is that relevant as well as accurate information regarding the care of
patient is transferred and communicated at each clinical handover to make sure high quality and
safe patient care (Communication at clinical handover, 2019). The key actions that must happen
in bedside handover includes identify the patient, team and self; administer current working
diagnosis, concerns, specific clinical issues and critical laboratory outcomes; observations to
update, check and discuss the recent signs; update as well as discuss the background history of
patient including relevant support and medical information; outline the plan for proper
assessment, treatment as well as discharge; and confirm shared understanding by responsibility
and risk management.
Apart from this, the processes must not minimise the set guidelines or communication which
interfere with what workforce deems to be critical information. A standardized approach which
is flexible will administer the structure of handover and enable the flexibility to fit work
practices and service context. The information which is necessary to be communicated includes
patient identification, diagnosis, risk of harm, medical history, emerging information, agreed care
plan, infectious state, transfusion history and The Identity of the clinician responsible and
accountable for the care of patient (Action 6.7, Clinical Handover, 2019). the main aim of
clinical handover is to make sure that accurate, relevant and current information regarding the
care of patient is transferred to right individual, action is taken as well as the continuity of patient
is maintained. All these key actions must happen in bedside handover so that appropriate care
and support will be provided to the patients involved in clinical handover. Handovers at bed side
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promotes face to face communication among nurses and patients as well as encourage patient to
engage verbally, therefore putting them at centre of the process of information exchange.
3. Briefly explain how you will approach the RN in this situation?
In this situation, I will approach the registered nurse by communicating the nurse about all
the information of patient along with interventions that required to be altered on the basis of new
information from patient. The handover is highly relying on interpersonal skills of
communication of care provider along with the experience and knowledge level of care provider
(Ford, & Heyman, (2017). It is necessary to communicate with registered nurse effectively and
emphasize on big picture. Apart from this, while communicating with the registered nurse, it is
important to use such a technique which seeks to bridge the gap between distinct channels of
communication of nurse in the situation. In order to promoting the patient safety while handover,
facilitating communication is very important. A poor shift report may result into adverse
outcomes for patient (Bressan, & et. al., (2019). Apart from this, by using proactive approach, I
will approach to registered nurse. I communicate with the registered nurse by using appropriate
communication skills along with other skills so that all the information regarding the health
condition of patient can be communicated properly and appropriate decisions can be taken in
order to gain better health outcomes for patient. This will help in improving the practice and
providing high quality care services to patients.
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REFERENCES
Books and Journals
Martin, C., Jones, D., & Wolfe, R. (2017). State-wide reduction in in-hospital cardiac
complications in association with the introduction of a national standard for recognising
deteriorating patients. Resuscitation, 121, 172-178.
Flanigan, K. (2016). NSQHS standard-patient identification. ACORN: The Journal of
Perioperative Nursing in Australia, 29(1), 23.
Jensen, F. (2020). Partnering with consumers through NSQHS standards. Journal of Health
Information and Libraries Australasia, 1(1), 18-19.
Bressan, V., & et. al., (2019). Bedside shift handover implementation quantitative evidence:
Findings from a scoping review. Journal of nursing management, 27(4), 815-832.
Ford, Y., & Heyman, A. (2017). Patients' perceptions of bedside handoff: further evidence to
support a culture of always. Journal of nursing care quality, 32(1), 15-24.
Bressan, V., Cadorin, L., Stevanin, S., & Palese, A. (2019). Patients experiences of bedside
handover: findings from a meta‐synthesis. Scandinavian journal of caring
sciences, 33(3), 556-568.
Online
Communication at clinical handover, 2019. [Online]. Available through:
<https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-
standard/communication-clinical-handover>
Action 6.7, Clinical Handover, 2019. [Online]. Available through:
<https://www.safetyandquality.gov.au/standards/nsqhs-standards/communicating-safety-
standard/communication-clinical-handover/action-67>
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