Authors (including presenting author) :
Wong KN(1), Wong SY(1), Wong YK (1)
Affiliation :
(1) Department of Paediatric and Adolescent Medicine, Princess Margaret Hospital
Introduction :
Effective clinical handover is vital to protect patient safety which is an important nursing responsibility. Clear and accurate communication of relevant clinical information across shift changes or between teams is essential to reduce communication error and ensure continuity of safe patient care. In order to ensure the critical information can be articulated and transferred accurately, a quality improvement project was initiated in PMH Paediatric Intensive Care Unit (PICU) to enhance effective communication in nursing clinical handover.
Objectives :
1) To identify areas of improvement in communication of clinical handover, including shift to shift handover, shift relief handover and patient condition change, 2) To develop structured and standardized tools to aid effective communication in clinical handover, 3) To strengthen nurses’ competence on executing articulate communication in clinical handover, 4) To evaluate nurses’ compliance on performing effective communication in clinical handover.
Methodology :
Interventions were developed and implemented as follow: 1) Set up ground rules and nursing roles on clinical handover, 2) Formulate quick reference guide for using SBAR (Situation-Background-Assessment-Recommendation), 3) Create SBAR cue card, 4) Conduct lectures with incident sharing and scenario-based training for all nurses on effective clinical handover, 5) Design poster to promote articulate communication. Outcome measures: 1) Compare the results of satisfaction survey of nurses before and after the project, 2) Assess nurses’ compliance on effective communication in the clinical handover after the training by direct observation and convenience sampling, 3) Compare the time spending on clinical handover before and after project implementation.
Result & Outcome :
The mean scores in post-survey had significant improvement. Nurses agreed that the training and handover tools were useful and their communication skills, knowledge and time management of clinical handover were enhanced. The results of compliance assessments were satisfactory. 90% and 94% of the samples achieved 100% compliance on the ground rules of shift to shift handover and communication of patient condition change respectively. The overall time spent on handover was diminished from 20-30 minutes to 10-20 minutes. In conclusion, the project achieved the objectives and gained positive outcomes. Supervision with regular training and monitoring of clinical handover were recommended. Although the problem of lengthy handover was improved, the handover quality should not be compromised.
