The 10 Tips
Here are ten tips to assist nurses to communicate effectively at handover, ensuring brief yet accurate information is shared to encourage safe continuity of patient care:
- Use a structured format to organise your reporting – e.g. the care plan or other system
- Review the patient’s chart just prior to the end of your shift
- Talk with other care providers who saw the patient that day. Get a mini-report from them with their views and observations
- Make dot-point notes throughout your shift and compare these with the information recorded on the patient’s record
- The off-going and oncoming nurses should share a verbal report about each patient
- Consider a bedside report between the off-going and oncoming nurse
- Design a patient safety checklist suitable for use on your unit that can be reviewed by both nurses at change of shift
- Always include allergies, code status, and other relevant involved care providers (the patient’s doctor, etc.) in your handover report
- Provide a brief report of the patient’s care plan (home tomorrow, surgery)
- Don’t rush. That extra minute or two speaking with the on-coming nurses will make little difference in the time you return home, but will make huge differences in the quality of patient care.
Handover, or change of shift, is a critical time for patients, as the accuracy of the information communicated between nurses at shift change could result in a change in patient care – for better or worse.
What the Research Says
Research has shown that poor or missed communication has led to events that affect the quality of patient care. In 2003, the Joint Commission on Accreditation of Healthcare Organisations (Alvarado et al. 2006) reported almost 70% of sentinel events are caused by a breakdown in communication. For example, missing identification armbands or misidentified intravenous solutions could cause serious problems. In fast-paced areas like the emergency room or neonatal ICU, proper and accurate communication at handover could mean the difference between life and death.
Pass it On
When handover is inadequate it can also be detrimental to the nurse’s state of mental health. How often have you arrived home only to worry or wonder if you had forgotten to pass on something to the oncoming nurse? It can make for a very restless night’s sleep, or stretch of days off.
- Alvarado, K, Lee, R, Christoffersen, E, Fram, N, Boblin, S, Poole, N, Lucas, J & Forsyth, S 2006, ‘Transfer of Accountability: Transforming Shift Handover to Enhance Patient Safety’, Healthcare Quarterly, vol. 9, pp. 75-9, viewed 26 October 2016, http://www.longwoods.com/content/18464