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Nursing handover from ICU to cardiac ward: standardised tools to reduce safety risks

Graan, Sher Michael, Botti, Mari, Wood, Beverley and Redley, Bernice 2016, Nursing handover from ICU to cardiac ward: standardised tools to reduce safety risks, Australian critical care, vol. 29, no. 3, pp. 165-171, doi: 10.1016/j.aucc.2015.09.002.

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Title Nursing handover from ICU to cardiac ward: standardised tools to reduce safety risks
Author(s) Graan, Sher Michael
Botti, MariORCID iD for Botti, Mari orcid.org/0000-0002-2782-0987
Wood, Beverley
Redley, BerniceORCID iD for Redley, Bernice orcid.org/0000-0002-2376-3989
Journal name Australian critical care
Volume number 29
Issue number 3
Start page 165
End page 171
Total pages 7
Publisher Elsevier
Place of publication Amsterdam, The Netherlands
Publication date 2016-08
ISSN 1036-7314
Keyword(s) checklist
clinical handover
intensive care unit
patient safety and quality
standardised framework
Summary BACKGROUND: Standardising handover processes and content, and using context-specific checklists are proposed as solutions to mitigate risks for preventable errors and patient harm associated with clinical handovers. OBJECTIVES: Adapt existing tools to standardise nursing handover from the intensive care unit (ICU) to the cardiac ward and assess patient safety risks before and after pilot implementation. METHODS: A three-stage, pre-post interrupted time-series design was used. Data were collected using naturalistic observations and audio-recording of 40 handovers and focus groups with 11 nurses. In Stage 1, examination of existing practice using observation of 20 handovers and a focus group interview provided baseline data. In Stage 2, existing tools for high-risk handovers were adapted to create tools specific to ICU-to-ward handovers. The adapted tools were introduced to staff using principles from evidence-based frameworks for practice change. In Stage 3, observation of 20 handovers and a focus group with five nurses were used to verify the design of tools to standardise handover by ICU nurses transferring care of cardiac surgical patients to ward nurses. RESULTS: Stage 1 data revealed variable and unsafe ICU-to-ward handover practices: incomplete ward preparation; failure to check patient identity; handover located away from patients; and information gaps. Analyses informed adaptation of process, content and checklist tools to standardise handover in Stage 2. Compared with baseline data, Stage 3 observations revealed nurses used the tools consistently, ward readiness to receive patients (10% vs 95%), checking patient identity (0% vs 100%), delivery of handover at the bedside (25% vs 100%) and communication of complete information (40% vs 100%) improved. CONCLUSION: Clinician adoption of tools to standardise ICU-to-ward handover of cardiac surgical patients reduced handover variability and patient safety risks. The study outcomes provide context-specific tools to guide handover processes and delivery of verbal content, a safety checklist, and a risk recognition matrix.
Language eng
DOI 10.1016/j.aucc.2015.09.002
Field of Research 111099 Nursing not elsewhere classified
1110 Nursing
Socio Economic Objective 920210 Nursing
HERDC Research category C1 Refereed article in a scholarly journal
Copyright notice ©2015, Australian College of Critical Care Nurses
Persistent URL http://hdl.handle.net/10536/DRO/DU:30080185

Document type: Journal Article
Collection: School of Nursing and Midwifery
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Created: Thu, 10 Dec 2015, 10:09:12 EST

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