...Evidence Based Practice Task 1 Western Governors University Evidence Based Practice and Applied Nursing Research The nursing topic of interest is bedside handover, which is the concept of conducting shift handover at the patient’s bed instead of doing it at the front desk. Part A The article being analysed is: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal of Clinical Nursing, 22, 192-200. The analysis of the primary research report is done in the form of a graph (figure 1). Each of the four analysis areas is rated within a scale of 1-10; 1 denotes extremely weak while 10 denotes very strong. Table 1 then gives justifications for the rating by explaining why each area of analysis was rated that way in the analysis chart. [pic] Figure 1 Table 1 |A1 Article: Tobiano, G., Chaboyer, W. & Murray, A. (2012). Family Members’ Perceptions of the Nursing Bedside Handover. Journal | |of Clinical Nursing, 22, 192-200. | |A2 Background or introduction |The researchers provided an in depth introduction of the research topic outlining | | |important issues, previous research on the topic and their findings. The introduction | | ...
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...EBT1 Task 1 Critique of a Nursing Research Article A1. Article Ford, Y. , Heyman, A., Chapman, Y. (2014). Patients’ perceptions of bedside handoff; the need for a culture of always. Journal of Nursing Care Quality, 29(4), 371-378. A2. Graphic Background Information | The purpose of this article was to identify patient perceptions of bedside handover through directly asking patients about their care. The study was done on a two in-patient medical-surgical departments at Borgess Medical Center in Michigan. They had implemented bedside handoff at shift change 18 months prior to this study. Then a sample of patient participants was chosen from the two nursing departments for the study. They had to meet certain criteria to be a participant and they had to experience three handoffs. Then they were given a survey to fill out after the beside handovers. Participants were positive about the RN bedside handoff process. The overall mean from the survey was 3.32 on a scale of 1 (strongly disagree) to a 4 (highly agree). | Review of Literature | There were multiple references that provided statistics and facts during this study. Most of these studies have focused on implementing bedside handoffs and nurse perceptions of the handoff. Published studies that focused on patients’ perceptions of beside handoff have been mainly qualitative. Recently, researchers have published...
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...CHAPTER 1 INTRODUCTION 1.0 INTRODUCTION A handover is defined as “the act of moving power or responsibility from one person or group to another (Oxford Advanced Learner’s Dictionary of Current English 2005)”. In healthcare and clinical context, the term “handover” applies to the transferring of a patient’s information between two health care providers, when the patient receives care in a different location, or when another healthcare provider is responsible of the patient (ACSQHC 2005). The American word “handoff” also signifies the same meaning. Nursing handovers are often being described as a ritual, which stemmed from the medical concept preliminarily in the 1880s, whereby the nursing sister would direct the nurses on duty after hearing reports from the night shift nurses and the doctors’ rounds (Walsh and Ford 1989). The repetitive characteristic of the traditional handover does not encourage nurses to think critically or share different views, therefore depicted as a “ritual” (Kerr et al 2011). 1.1 BACKGROUND OFTHE STUDY The aim of a nursing shift handover is to precisely inform the patient’s general condition, care plan, treatment and expectations in a timely manner (Runy 2008). The process, if made without a systematic standardized method, would lead to errors and jeopardizes patient’s safety (ACSQHC 2010). Reported adverse events from handovers include unnecessary procedure and investigations, delayed diagnosis or treatments, prolonged hospitalization...
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...rates among older adults living in the community?) | 1) Chaboyer W, McMurray A, Wallis M. Bedside nursing handover: A case study, International Journal of Nursing Practice 2010: 16:27-34 | Level I: Evidence from a systematic review or meta-analysis of all relevant randomized controlled trials (RCTs) or evidence-based clinical practice. | This research aimed to better understand the structures, processes and perceived outcomes of bedside nursing handover as a beginning step to facilitate its implementation. | Randomized control trial, clinical trial. | 532 bedside handovers, 34 interviews with nurses. Six wards in two hospitals in Austrailia. 3 medical, 1 surgical, 1 medsurge, 1 rehabilitation ward. Semistructured observation and interviews. | SBAR was used in 45-65% of handovers in 3 situations when: patients were new or condition changed, patients were unfamiliar to staff such as when staff had been off for a few days, or casual/agency staff were part of the team. On average each bedside handover took just over a minute. | Before handover patient handover was completed and handover sheet updated. Just before handover pts were informed that handover would shortly take place and were asked if they required any assistance in order to limit disruptions during handover, visitors were excused. Information was prompted by pts presence. Safety scan and medication review was done. Kept handover short and simple and to the point. Information found might be used as the basis for standard...
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...3.3 CHARACTERISTICS OF HANDOVER Laxmisan et al (2007) conducted an ethnographic study involving analysis of emergency department handover in a US hospital. The study found that interruptions within the emergency department were prevalent and diverse in nature and that there were gaps in information flow due to multi-tasking and shift changes. The communication process is complex and cognitively taxing during and after team handover, that can compromise patient safety. The study also discusses the need to tailor generic electronic tools to support adaptive processes like multi-tasking and handoffs in time constrained environments. Arora et al (2005) conducted interviews using the critical incident technique to handover failures between inpatient physicians in a US hospital. The study interviewed 26 interns and found 25 discrete incidents. The 21 worst events are described. Omitted contents and failure prone communication processes were identified as a major category of failure in communication. These may result in inefficient or sub-optimal care, leading to patient harm....
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...The New Trend of Bedside Reporting Versus Traditional Taped Report Methods Community Health Nursing Lewis Clark State College The change from taped report to a bedside report is essential to increasing patient safety and satisfaction, nursing satisfaction, physician satisfaction, and a savings to the health-care facility. The Joint Commission found that the breakdown in communication during the shift report is a leading cause of sentinel events in the United States (Laws & Amato, 2010). We will explore benefits to the patient, nurse, facility and physician. The patient and family benefit by becoming a part of their own treatment. They will participate in decisions and know at all times the plan for their care. This autonomy helps the patient to have a confidence in the health-care facility and staff. They provide essential information that is not available otherwise to assist in providing the best care possible for the patient. With the family and patient being informed about the plan of care, they are less anxious. This promotes more compliance with care and willingness to start treatments earlier. These patients have a higher level of satisfaction and are less likely to litigate (Anderson & Mangino, 2006). In a study at Sharp Grossmont Hospital in San Diego County, a 481-bed community hospital, the patient benefits included a reduction of unanswered call lights and a reduction in patient falls. With the bedside report, patients are able...
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...and interruptions are barriers to the effective handoff and can be a detriment to successful implementation of an effective communication strategy. The inquiry for this investigation is attempting to reveal that implementation of a systematic tool for communication as well as performing the handoff at the bedside are considered best practices in decreasing adverse patient events. It is necessary to perform an investigative research using quantitative and qualitative studies to help describe a problem that is an important clinical issue in health care. Defining the elements to a process change through a systematic research study will help to find solutions for best practice. Implementing successful communication strategies will help to reach out to the patient community who seeks out best care practices and who know more from technological advances. The problem faced by health care personnel is the lack of a standardized tool for communication. When nurses attempt to give report to another nurse without a systematic way of providing the information, elements in patient care information are omitted leaving room for errors. Handoffs that do not occur at the patient’s bedside are faced with inefficiencies due to noisy environments, and communication exchange in this type of setting includes interruptions. Report will occur that may not necessarily paint a complete...
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...Bedside reporting is a process of communication between the nurses. At the end of the shift, the off going nurse is responsible to give a detail report on the patient to the incoming nurse who will be caring for the patient, so that they are up-to-date on the patient treatment needed for the shift. Change of shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The hand over process of communication between nurses to nurses with the intention of transferring essential information for safe, and holistic care of patients. Traditionally, this shift report has been done away from the patient’s bedside, at the nurse’s station, or other place like staff’s room. In addition,...
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...of transfer of care is inadequately undertaken risks to the patient are increased and may subsequently lead to harm (BMA, 2005; Joint Commission, 2007). The Network organised a series of patient safety road shows which were specifically designed to build consensus and concentrate activities on the key topic of transfer of care, to facilitate networking between members of the Network’s regional groups and a range of colleagues working across all care sectors, and to identify the actions required to improve the patients’ experience of transfer of care across all health and social settings. 1.1 Literature Review “A good…handover process is a crucial part of providing quality…care…The conservation of patient data during the handover process is vital to ensure good continuity of care and safe practice. Any errors or omissions made during the handover process may have dangerous consequences…” (Pothier, et al., 2005) Delays in transferring or discharging patients can result in a range of problems for both patients and organisations (Bryan, et al., 2005). For patients these problems include: increased dependency; depression; loss of choice, control and confidence; and being placed at risk of exposure to hospital acquired infection. For organisations delays in the transfer or discharge of patients may result in bed blocking, leading to the possibility of greater waiting times for patients needing hospital care and treatment. In addition,...
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...Bedside Report: Improving hand-off Shift Report in Hospital Settings Eastern International College Evelyn Terreros & Meron Gebrezgi April 26, 2013 End of shift reports between nurses has been an important process in clinical nursing practice. Allowing nurses to exchange vital patient information to ensure continuity of care and patient safety. Therefore, the chance of potential communication gaps causing an error is high. According to the Joint Commission, communication is the primary cause of medical errors, with handoffs accounting for 80% of these errors [ (Zhani, 2012) ]. The most commonly practiced model of report takes place in the staff room, at the nurses’ station, or other locations away from the patient’s bedside. However, more institutions are implementing the Bedside Report hand-off model to communicate patient care information. Research articles has identified the benefits of bedside report in conjunction with structured reporting tool (e.g. SBAR) as: (1) improvements in patient-centered care and nursing services, (2) less chance of medical errors, (3) decreasing the length of stay in patients [ (Chaboyer W, 2009) ]. Upon observing the shift to shift report in SMMC, it was evident that some nurses failed to provide effective communication and did not utilized the SBAR format tool as stated in the hospital’s guidelines. Hand-off reports were being done in the nurse’s station and along the unit’s hallways. Fatigue and...
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...first year student midwife in hospital. The clinical aspect I will examine will be the handover of care. The reflective model I will be using is Stephenson’s, 1993 cited in Benbow et al (2013). Stephenson’s model of reflection will enable me to use a framework specifically targeted at health professionals; this will enable me to link theory to practice and given up to date evidenced based care. The purpose of reflection is to explore the science and art of Midwifery, it is essential for decision making (Raynor, 2010). The essay will examine the psychosocial and communication surrounding handover. Midwives are faced with handover of care on every working day. Handover is a summary of details regarding the woman’s physical condition, personality, relationship, capability and overall judgement from one midwife to another midwife (Wickham, 2008). Midwives are placed to be with woman supporting, informing and educating at a vulnerable time of their lives which can result in emotional instability; midwives need to be effective at taking care of woman’s emotional needs as well as their physical ones (Raynor, 2010.) The sociology aspect of handover has been affected by the government as there are less midwives working, the birth rate is rising and there is a shortage of beds so it is in the agenda to discharge women when it is possible to (Deery et al, 2015). In accordance with the NMC (Nursing and Midwifery Council) Code of Professional Conduct, confidentiality (2015) has been...
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...to communication failures is essential for the long-term evaluation of patient outcomes. The use of standardized SBAR in nursing practice for shift shifts on the bedside will improve communication between nurses and thereby ensure patient safety. S = Situation (a concise statement of the problem) Patient's Name: Ms. Skelt Diagnosis of the patient Stroke and right hemiplegia. B = Background (pertinent and brief information related to the situation) Patient of 75 years, admitted for rehabilitation, by CVA with right Hemiplegia. A = Evaluation (analysis and consideration of options - what found / thinks) Rehabilitation, prevent falls and infections, good hygiene, avoid pain. R = Recommendation (action requested / recommended - what you want) Prevent pressure ulcer, Mobilize the patient, avoid pain with adequate postures, avoid...
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...replication study. Nursing Ethics, 18(1), 54-63. doi: 10.1177/0969733010386162 The authors of this article were one Shelia Catlett of Western Kentucky University and Fairview Community Clinic, USA and one Sherry R Lovan also from Western Kentucky University, USA. Both authors conducted a qualitative research study, which was also a replication of a study published in 2002, investigating the qualities of a good nurse and the role ethics plays in decision making. Ethics refers to the moral code for nursing and is based on obligation to service and respect for human life. Ethical Knowledge occurs as moral dilemmas arise in situations of ambiguity and uncertainty, and when consequences are difficult to predict (McEwen Wills, 2011). Ethics in nursing is used to guide and direct nurses conduct and practices. It requires experiential of social values and ethical reasoning. Its main focus is on matters of obligation, what ought to be done, what is right, wrong and responsible. The study implemented modification related to the research questions, sample selection, data collection and Atlas.ti software for qualitative data for the purpose of providing ease of coding, viewing, mapping and storing the data for retrieval analysis. The main focus of this replication study was to understand what it means to be a good nurse and do the right thing. This research provided current and allied literature to the relationship between ethics and good nursing practice. They study was carried...
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...b) The Registered Nurse should try and guess what do to. A Registered Nurse is asked by another staff member within the interdisciplinary heath care team to carry out a task. However, the Registered Nurse is not certified to carry this task out, what should the Registered Nurse do: a) The Registered Nurse agrees to do the task and does not let the other staff member know they are not qualified. b) The Registered Nurse understands their own responsibilities and accountabilities (Registered nurse competency standards, p.4). Because of this they explain to the staff member that due to the fact they are not certified to do the task, they are unable to do it as they do not have the qualifications Nursing is a profession which requires establishing a collaborative practice with other health care professionals and nurses need to understand their contribution to an interdisciplinary heath care team (Registered nurse competency standards, p.2). a) True b)...
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...Barbara Norris Case Analysis Synopsis Barbara month into a management position of a unit that is ‘Troubled’ she has had no experience in managing a large units which included managing, scheduling and budgeting. The unit is short staffed, stressed and there is a high turnover with a poor culture. Indicated by the 29 onetoone that were requested page 2 & top of 3. Worst performing unit John Frappewell (Nursing Director) needs her to ‘turn this unit around and do it fast’ could be used as a vote of confidence and a leverage point? Management have enacted a hiring freeze and stopped all overtime across the EMU Barbara has the benefit of knowing what good management looks likes with Betty Nolan her old mentor people / leadership skills (2nd last para page 2) and procedural performance reviews (top of page 3) Summary Notes Problems: The GSU has a history of less than effective management in the past (page 3 para2) Culturally poor collaboration and teamwork (page4) Performance review system is a “mystery” (page4) No clear communication (page4) Delegation process is unclear (page4) Over aching all this is the presence of the hospital budget cuts which makes a monetary solution difficult to enact. 29 one on ones requested on the first day does some up the feeling of resentment and negativity. Solutions Barbara clearly has an excellent grasp on what the issues are but the question is what to tackle first and where is the most benefit going to be. Her solutions...
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