Nursing Handover – Where can we improve? (Part 1)

One of the most important times at the start and end of every shift is the nursing handover to your colleagues at which time we are communicating information that will be used to deliver more individualised care in response to the care previously administered, the needs of the patient during the past 12 hours and future actions/tasks.

At handover we receive a paper sheet(s) with an amount of information which at best is written correctly but the majority of the time has a lot of information which if reviewed properly does not actually have much relevance to the current diagnosis/procedure/treatment which then becomes noise that can cloud the actual information which is of upmost importance.

Some of the information which may be relevant during the patients stay or at a particular time when discharge planning comes into play but in my view has no relevance on a nursing handover. Some examples are:

  • Lives with Family
  • Knee Pain
  • Poor Mobility
  • Previous wrist fracture
  • Brain Surgery
  • Obesity

All of this information is relevant to some aspect of patients care but depending on when, what and where it becomes irrelevant to the present situation. These examples were all irrelevant to the current treatment to the patients I was looking after and served no purpose on the handover.

Information is normally split into diagnosis/relevant past history, current presentation – what has changed recently, future – what needs to be done.

This information is generally presented in different sections on the handover with different headings depending on the ward/unit. Surely if this information was standardised then this would reduce the risk of miscommunication of information and ensure clinicians know what information is displayed where on the document.

Other factors to take into account are abbreviations, use of upper/lower case, bold vs standard text amongst others.

The importance of displaying relevant information is crucial to the continued care of patients in a format that allows for easy access at the point of care. The technologies available to us today allows for clinicians to be able to create clinical views that can be accessed at the touch of a button displaying the right information which should reflect the continuation of patient care throughout their stay with little or no effort required in the update of a structured handover with the correct tools in place.

The need to reduce the amount of paper we carry as clinicians becomes more apparent when taking this into account especially when paper can be so easily lost or misplaced which then makes the potential for unsafe handovers more common.

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