Clinical Handover Practice in the Emergency and Trauma Department of SASMEC@IIUM: An Observational Qualitative Study.
DOI:
https://doi.org/10.31436/ijcs.v6i2.324Keywords:
Clinical handover, Practice, Emergency and Trauma Department, QualitativeAbstract
Introduction: Clinical handover is a critical nature of communication between the staff, given it physicians, nurses or even the assistant medical officer. Specifically, in Emergency and Trauma Department(ETD) where turnover of patients is high in a fast-paced environment with unpredictable events, the tendency of communication failure and errors increased. In ensuring safety and efficient clinical handover practice, demands critical information that needed to be informed when communicate between the shifts or the staff. Therefore, this study mainly to identify the best way of clinical handover that would assist in better communication amongst emergency healthcare providers as well as within different departments. Objective: To examine the current shift handover practices amongst emergency staff at SASMEC@IIUM, identify the resources and supports to enhance clinical handover effectiveness and to determine the barriers and facilitators on the effectiveness of clinical handover. Methodology and Methods: A descriptive, qualitative study was conducted by selecting samples through purposive sampling technique. Nurses, physicians and assistant medical officers were selected in this study. The sample size was determined using the ‘saturation criterion’. Topic guide interview has been selected for the participants to share their opinions, suggestions, and experiences. Open-ended questions have been used to identify the participants’ perspectives towards the current practices of clinical handover in Emergency and Trauma Department of SASMEC. Data were then analysed using thematic analysis and later developed into sub-themes and themes. Findings: Six themes were identified for this study which consist of 1) learning methods of clinical handover, 2) information passed to next shift, 3) information expected to receive, 4) opinions on current handover, 5) handover effectiveness 6) suggestions for improvement. The themes described mostly on the experiences, opinions and suggestions from the healthcare professionals working in the Emergency and Trauma Department of SASMEC. Conclusion: This study found that the healthcare providers in ETD have various backgrounds of learning clinical handover, with some of them have different working experiences since they worked in other hospitals, departments, or settings previously. In addition, they also described their own experiences in handling clinical handover in ETD SASMEC, together with the factors that affect the effectiveness of the clinical handover process. Besides, the findings were also concentrated on the elements that the participants assumed may be beneficial for the improvement of clinical handover overall that could be done in future.
Keywords: Clinical handover, Practice, Emergency Department, Qualitative, Malaysia
References
Australian Medical Association. Safe handover: safe patients. AMA Clinical Handover Guide. AMA, Sydney, 2006. Available from: http://ama.com.au/node
British Medical Association (2004). Safe handover: safe patients – guidance on clinical handover for clinicians and managers. London: British Medical Association
Campbell, D., & Dontje, K. (2019). Implementing Bedside Handoff in the Emergency Department: A Practice Improvement Project. Journal of Emergency Nursing, 45(2), 149–154. https://doi.org/10.1016/j.jen.2018.09.007
Chaboyer, W., McMurray, A. & Wallis, M. (2010). Bedside nursing handover: A case study. International Journal of Nursing Practice, Vol 16; 27-34.
Chien, L. J., Slade, D., Dahm, M. R., Brady, B., Roberts, E., Goncharov, L., Taylor, J., Eggins, S., & Thornton, A. (2022). Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context. Journal of Advanced Nursing, 78(5), 1413–1430. https://doi.org/10.1111/jan.15110
Chung, J. Y. S., Li, W. H. C., Ho, L. L. K., Cheung, A. T., & Chung, J. O. K. (2021). Newly graduate nurse perception and experience of clinical handover. Nurse Education Today, 97. https://doi.org/10.1016/j.nedt.2020.104693
Cross, R., Considine, J., & Currey, J. (2019). Nursing handover of vital signs at the transition of care from the emergency department to the inpatient ward: An integrative review. Journal of Clinical Nursing, 28(5–6), 1010–1021. https://doi.org/10.1111/jocn.14679
Fealy, G., Donnelly, S., Doyle, G., Brenner, M., Hughes, M., Mylotte, E., Nicholson, E., & Zaki, M. (2019). Clinical handover practices among healthcare practitioners in acute care services: A qualitative study. Journal of Clinical Nursing, 28(1–2), 80–88. https://doi.org/10.1111/jocn.14643
Golling, M., Behringer, W., & Schwarzkopf, D. (2022). Assessing the quality of patient handovers between ambulance services and emergency department – development and validation of the emergency department human factors in handover tool. BMC Emergency Medicine, 22(1). https://doi.org/10.1186/s12873-022-00567-y
Gu, X., Andersen, H.B., Madsen, M.D., Itoh, K. & Siemsen, I.M. (2012) Nurses’ Views of Patient Handoffs in Japanese Hospitals. Journal of Nursing Care Quality, 27(4): 372-380.
Javidan, A. P., Nathens, A. B., Tien, H., & da Luz, L. T. (2020). Clinical handover from emergency medical services to the trauma team: A gap analysis. Canadian Journal of Emergency Medicine, S21–S29. https://doi.org/10.1017/cem.2019.438
Kerr, M. (2002). A qualitative study of shift handover practice and function from a socio-technical perspective. Journal of Advanced Nursing, Vol 37(2); 125-134. https://doi.org/10.1046/j.1365-2648.2002.02066.x
Kilic, S.P., Ovayolu, N., Ovayolu, O. & Ozturk, M.H. (2017). The approaches and attitudes of nurses on clinical handover. International Journal of Caring Sciences, Vol 10 (1); 136-145.
Makkink, A. W., Owen, C., Stein, A., & Bruijns, S. R. (2022). The Prehospital to Emergency Department Hand Over Model (PEDHOM): a conceptual model addressing content, process, and communication in prehospital to Emergency Department handover. https://doi.org/10.21203/rs.3.rs-1418631/v2
Manias, E., Geddes, F., Watson, B., Jones, D. & Della, P. (2015). Communication failures during clinical handovers lead to a poor patient outcome: Lessons from a case report. SAGE Open Medical Case Reports. DOI: 10.1177/2050313X15584859
Norton, C. (2020). From handover to takeover: should we consider a new conceptual model of communication? In British Journal of Midwifery (Vol. 28, Issue 3).
Thomas, A.N. & MacDonald, J. (2016). Patient safety incidents associated with failures in communication reported from critical care units in the North West of England between 2009 and 2014. Journal of Intensive Care Society, Vol 17(2); 129-135. DOI: 10.1177/1751143715626938
Thompson, J. E., Collett, L. W., Langbart, M. J., Purcell, N. J., Boyd, S. M., Yuminaga, Y., Ossolinski, G., Susanto, C., & McCormack, A. (2011). Using the ISBAR handover tool in junior medical officer handover: A study in an Australian tertiary hospital. Postgraduate Medical Journal, 87(1027), 340–344. https://doi.org/10.1136/pgmj.2010.105569
Tobiano, G., Chaboyer, W. & McMurray, A. (2013) Family members’ perceptions of the nursing bedside handover. Journal of Clinical Nursing 22(1-2): 192-200.
Weston, E. J., Jefferies, D., Stulz, V., & Glew, P. (2022). Exploring nurses’ perceptions of clinical handover in regional health care facilities: A exploratory qualitative study. Journal of Nursing Management. https://doi.org/10.1111/jonm.13719