Patient Awareness In Patient Care

958 Words4 Pages
A Case Study6
Nurse caring for a patient at a disadvantage by not having information that may be necessary to make critical decisions for safe patient care. Patterson et al (2004) examined hand off in settings with high consequences for failure, such as, NASA, the Johnson Space Center in Texas, Nuclear Power generation plants in Canada, a railroad dispatch center in the United States and an ambulance dispatch center in Toronto. Patterson found that hand offs in these settings were interactive, verbal, face-to-face interactions between incoming and outgoing personnel. This allowed for questioning and checking for accuracy of information. Validation of information was found to be an important factor in maintaining the plan for care or daily
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Likewise in healthcare, oncoming staff generally does initiate not patient care delivery until a hand off process occurs. “Communication failures are increasingly being implicated as important latent factors influencing patient safety in hospitals.”(Sutcliffe, 2004, p. 187) Parker (1996) reports, “the nurses handing over had direct knowledge of the patient and were able to convey idiosyncratic and personal knowledge of the patient. This is a crucial element in professional nursing practice. The nurse can report on clinical judgments and can be held accountable for the judgments made” (Parker, 1996, p. 25) Critical evaluation of nursing actions can be evaluated and considered to be either continued or discontinued based on the rationales for the action and the patient outcome. In 2005, the Australian Council for Safety and Quality in Healthcare published a literature review of clinical handover and patient safety. This report was compiled in an effort to appraise the evidence available and the research completed regarding nursing handover. Healthcare hand off processes, tools and guidelines for hand off were examined (Safety Council, 2005) the council identified three major domain areas related to…show more content…
The findings can be used as a basis for the development of standard operating protocols for its implementation, something only beginning to be documented in the literature. It was interesting that, despite being intended as a patient-centered approach, patients actively participated in less than half of observed handovers, a finding also confirmed in a survey. While our interview participants explained legitimate reasons for this low participation rate, it appears that nurses must work to actively involve patients. Only one hospital adopted SBAR 27, 28 in their handovers. SBAR formalizes handover content, which may create trust within the healthcare team, as all team members are provided with objective information in a standardized format.31 Alternatively, such rigid structures may actually have unintended consequences.32 Patterson 32 suggests that instead of using a very structured approach during handovers, transferring information according to priority, with the ‘most important first,’ may help oncoming staff get ‘the story’ more quickly. The suggestion for ‘most important first’ was not identified in our study. This study has shown that one important difference between bedside and other forms of handover is that nurses receive report on only their assigned patients, and not the other
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