Nursing Leadership and Management Experience
Standardizing Handoff Communication
The main goal of any healthcare organization is to ensure medication is provided to patient. Resources and team worked combined together are the “raw materials” that drive a healthcare organization. The resources might include, but not limited to, level of skills among the workers, commitment and dedication of workers, drugs, motivation of workers, patient safeguarding, handling of patient reports etc. Upon evaluation of the current healthcare organization where I work, the organization has dedicated itself to ensure that patients who visit the organization enjoy the services offered. However, there is one major problem that affects the healthcare organization thereby lowering the quality of the services offered. The organization has a problem when it comes to standardizing handoff communication during shift handover.
Handoff assists in reducing the errors that might be cause by sleep but also increases the risk of communication break down and major medical errors. Medical errors can be avoided b ensuring a modern and standardized communication among nurses. The problem of handoff communication requires practical change not only among trainees but also nurses in various fields and levels of training. Practical change is required in order to ensure that the number of patients dying due to communication errors is reduced. Report says that practical change through implementation of a standard handoff processing the field of study and work place can reduce medical errors by 30%. Formulas and mnemonics need to be drafted to help nurses remember major parts of the handoff communication. Proper utilization of available technological and communication tools can improve handoff communication. Practical change is more efficient since nurses are reminded on what to do regardless of whether they are at their training level or working environment. A literature review of more than 45 articles shows that mnemonics have been proved to keep nurses alert by having more than 90% of their brains at work. Studies shows that nurses who have more than 5 years of experience in the nursing profession provide higher satisfaction level than those without much experience.
The problem of handoff communication also require innovations that can guide nurses on how to safeguard and keep tract of their patients’ information. A research was conducted to account on this phenomena where 15 nurses were presented with tablets that had been printed with standard handoff, SBAR as a guide. Researchers found the method to be more reliable and promotes better nursing documentation (Danis, Klinkner, Malec, & Rees, 2017, ).
Standardizing handoff communication in the health organization has failed to be achieved because of various reasons. First there is much interactions between nurses leading to confusion in handling of patient information. In rare occasions, you will find nurses interacting with specific personnel in the healthcare. They have to move up and down in various departments to take instructions, prescriptions and consultations. Secondly, the area designed for occurrence of handoffs is not specified. Nurses don’t know where to meet with their fellow for exchange of duty and information. There is no proper communication channel to lead them where to report before signing in r signing out. This makes handoff hectic and nurses end up sharing information in a way that is not recommended. Some might meet up late and do the hand off in a hurry. They need to design a quiet place without interaction where handoff takes place. Thirdly, the organization has not yet identified templates to help nurses in their sign out. Templates need to be placed in work places so that nurses can remind themselves on what to do, during sign out, nurses will be able to keep time and exchange information as required before sign out. In addition to that the organization has not set specific time for handoffs, time management is a key factor for better services in a health organization. If the organization had set specific time when handoff need to be done, it could act as an alarm to guide nurses. Lastly, the organization does not empower those who give information and those who receive information. Empowering of the giver and receiver can help raise attention leading to relaying and receiving of vital information.
The project under development aims at standardizing communication during handoff and it is vital to let the stakeholders know about the project. Stakeholders are major investors in any given organization and make more of the decisions that help the organization grow. In the organization, the major stake holders identified ranges from administration to volunteers within and outside the organization. The first stake holder is the general manager of the organization, he owns the organization and finances the organization at large. More than 30% of the organization’s liquidity is owned by the general manager. The second shareholder is the manager, she acts as the linkage between the general manager and everyone in the health organization. Most of the decisions she makes comes from the general manager, she has capital shares of 5% in the health organization. Another stake holder is a senior nurse who has worked in the organization for more than 20 years with a share capital of 5%. Another retired nurse who is the head of all associates of the organization and old members of the health organization, she has a share capital of 4%. Well-wishers and supporters of the organizations have a share capital of 40% combined. World health organization (WHO) have shares accounting to 15% of the total capital of the organization. WHO are represented by one support staff who works in the department of quality Assurance. The American Pediatric Committee has a share capital of 25%.
The organization’s general manager is interested in the project since it can improve the health of patients visiting the organization. The project aims at reducing the number of deaths reported due to mixture of patient reports. Since the project does not involve face to face patient contact, it requires resources and the general manager can help finance it. Most of the decisions are made by the general manager, he can easily convince other stake holders to finance the projects. The general manager is said to have worked in the Technology industry before retiring and can help link the project with the company.
The manager of the organization is ever dreaming of making the organization a better place where patients meet their satisfaction level. Most of the time she works under the authority of the general manager and can easily accept to finance the project. She has been working on leaving a legacy in the organization and live to be a heroine. The project can help boost her dreams by solving a big problem that has existed in the organization. More so, her salary is directly proportional to the success of the health organization that means the project can make her good cash and she has no reasons to decline the approval. She has the power to finance the project through contribution and advising her colleagues to support it.
A senior nurse has been in the organization for more than twenty years and he probably understands the problem more than anyone else in the organization. Three years ago, documents indicates that he tried to come up with programs that can standardize handoff communication during bedside shift report but it was all in vain. He had not done a good research regarding the same, he did not get support from the entire staff and also had not included the technology party. This can be the best person to help uplift the project since he understands the problem more. He has power to do more research regarding the project and can help finance the project. He can easily elaborate it better to other stakeholders since they are people of his rank.
Well-wishers of the organization who are also part of the major stakeholders need to have a look at the project and approve or decline it. (WHO) and The American Pediatric committee are the major threat to the project. World Health organization representative works in the department of quality assurance which does not have much influence on nurses. The American Pediatric Committee have also their representative who works in the finance department and is ever after minimizing the use of resources. The two shareholders have the power to approve to finance the project but cannot easily approve it unless influence b other stakeholders. However, that does not worry so much since most of the shareholders have an upper hand in approving the project. Proper convincing can win them and gain their support. They have the power to bring in more people who can finance the project at any given stage.
The main purpose of the project is standardization of inpatient handoff report. Standardization of handoff report highly depends on the needs and responsibilities of nurses in the health organization. Therefore, handoff content shows a discrepancy calling for a customized handoff by specific nurses as there is no one size that can fit all the process. Communication will improve in the organization if the groups agrees of standardizing handoffs. The project focuses on creating attention on the content of handoff because it enables the sender and the receiver give out give and receive crucial data. The project focuses more on improvising technology in the hand off communication which will act as a means of standardizing the pleased information. Variability of patient information is common and can only be reduced by the web based application that need to be developed.
Studies have been examined and found out that there are many errors made while people communicate face to face without referring from a note book or any media (Johnson, McCarty, & Mikos, 2017). Most organized organizations have eradicated the errors after implementing the content of this project. Much errors were reduced than it was imagined, such as, missing of patient’s documents and administering of wrong medical dosage. Medical study have proofed that electronics medical records linked to handoff tools can facilitate complete handoff.
Similar support of a digitalized handoff were found in Asian study (Da, n.d, 274) whereby web based applications that acted as handoff tools were evaluated. It was found out that more accurate data was send off because the technology had most of their work done. The sender only needed to fill in information as per the application guidelines and transmit the information electronically to the receiver. This is because, the information provided will be more specific without bias and with no human errors. Research suggests that in order to reduce errors made in handoff, technology should be developed in a way that increases confidence and dependence on the level of information transmitted. More so, the web based application need to give the receiver time to ask questions and clarification. The most important part with the project is that it gives the sender and receiver freedom to interact anywhere.
The capstone project is so demanding and require the efforts of every stake holder to ensure that there is maximum possible results. More of focus will be developing the plan of the project by applying the knowledge in the technology field. The project has no much of explanation but it involves planning and action. Personally, creating a database and lines of code for the web based application is necessary. However more of personnel with skills in Information and Technology will be required to assist. The content of the project has been fished in the “EPITONE OF TECHNOLOGY” by John Patel. All the steps to be followed for one to come up with an efficient web based application have been elaborated. Depending on the need of the organization, the whole process of handoff might be done be done in a digitalize manner. The project requires all patient information noted including age, gender, and geographical location. Once the information has been recorded it is send to the main server of the department where it can be accessed easily. The nurses will receive information from the main server with all descriptions provided by doctors. This will be done by login in the portal of the patient, all information regarding medication and the condition of the patient will be provided by the nurse and send back to the main server for integration. While signing in, another nurse will be provided with the integrated information and will be linked with the sign out nurse at a strategic place for elaboration of information. Never the less any update required by the incoming nurse ca be provided by the outgoing nurse regardless of the location since the web based applications are linked to their phones.
Recourses required in the project are few compared to personal commitment and administration support. Finance is required to host the web based application and hiring of more personnel to help in developing them. The main office of the server will be required and should be supplied with electricity and a good network system.
There are few barriers to the implementation of the project basing on the disadvantages associated with the project. The project will require additional staff team in the organization thereby calling for more resources. Timely update of the web based application is required and without update, they can give wrong information making it more badly than before. The project is time consuming and will need the attention of more workers thus lowering the services they offer. Lastly, the web based applications are linked with personal phones and that might encourage laziness while working.
1. Da, S. (n.d.). Standardizing Terminology and Developing a Data Dictionary for a Tribology Database. Standardizing Terminology for Better Communication: Practice, Applied Theory, and Results, 270-270-6. doi:10.1520/stp18012s
2. andNA; (2014). Effective handoff communication. OR Nurse, 8(1), 26-27. doi:10.1097/01.orn.0000442005.50438.48
3. Johnson, L., McCarty, E., and Mikos, K. (2017). Standardizing Handoff Communication Using Voice Technology. Clinical Nurse Specialist, 21(2), 114. doi:10.1097/00002800-200703000-00053
4. Nasarwanji, M. F., Badir, A., and Gurses, A. P. (2016). Standardizing Handoff Communication. Journal of Nursing Care Quality, 31(3), 238-244. doi:10.1097/ncq.0000000000000174
5. Danis, D., Klinkner, G., Malec, A., and Rees, S. (2017). Improving Patient Safety by Standardizing Handoff Communications. Clinical Nurse Specialist, 21(2), 106. doi:10.1097/00002800-200703000-00025