Interactive questioning in critical care during handovers: a transcript analysis of communication behaviours by physicians, nurses and nurse practitioners

Rayo, Michael F.; Mount-Campbell, Austin F.; O’Brien, James M.; White, Susan; Butz, Alexandra; Evans, Kris; Patterson, Emily S.

doi:10.1136/bmjqs-2013-002341

Cited by 47 publications

(61 citation statements)

References 30 publications

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“…In the same issue [30] concluded that nursing students performed significantly better when providing and receiving handoff after they gain handoff knowledge in training program. Additionally, [33] has described the positive effect of handoff training in handoff receiver skills. Without handoff education, the nursing students lacked awareness of the importance of an active handoff recipient in creating a shared mental model.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of Handoff Educational Program on Nurses Interns’ Knowledge, and Communication Competence

Seada¹

2017

AJNS

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Abstract:With the growing complexity of health care, the ability to communicate becomes essential within the health team members. Health care organization has great expectations for new graduate nurses to communicate skillfully while promoting safe patient care. Student nurses interns may lacked experiences with important communication skills and are fearful of making mistakes which may affect patient safety. One way to improve handoff communication skill among nurses interns is through education. This study was intended to examine the effectiveness of handoff educational program on nurse's interns' handoff knowledge, and communication competence. Quasi -experimental study design was utilized: The study was conducted in intensive care units which affiliated with Kaser El Ainy hospital where nurses interns were trained. Study sample composed of 30 nurses interns who were undertaking their internship year between 2016-2017. Data were collected through utilizing Handoff knowledge questionnaire that was developed by the researcher and Handoff communication competence observational checklist developed by [1] and modified by the researchers to measure hand-off communication competence of nurses interns during the process of bedside handover. Results revealed that there were statistical significant and marked improvement in nurses interns' levels of handoff knowledge dimensions as well as statistical significant differences in their mean scores of hand-off communication competence during different periods of assessment. The current study provide evidence that handoff educational program enhance nurses interns handoff communication competence. Handoff communication skills should taught formally during nursing academic education concerning the way that information is given, verified as well as all handoff communication competencies during process of patient bedside handoff. Future researches with larger sample sizes and multiple settings are recommended to substantially evaluate the effectiveness of educational program on handoff communication competencies.

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Section: Discussionmentioning

confidence: 99%

Effectiveness of Handoff Educational Program on Nurses Interns’ Knowledge, and Communication Competence

Seada¹

2017

AJNS

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“…Resident physicians participating in patient handofs may not interact regularly with each other, may be located in diferent parts of the healthcare systems, may have diferent skill and experience levels, or may come from diferent clinical backgrounds [3]. Adherence to hierarchical norms between junior and senior residents or atendings can further exacerbate relational communication barriers relecting diferences across levels of training or between clinician types in the willingness to engage in interactive questioning strategies to assertively challenge erroneous assumptions and actions during a handover with peers [7,17]. Entrenchment of handof routines in departmental or hospital mores may require transformational change of an institution's culture in order to improve them [19].…”

Section: Barriers To Efective Handofsmentioning

confidence: 99%

“…More than merely the passive transfer of information, optimum handofs necessitate the eicient communication of information among participants [3]. Expansion of duty hour restrictions for resident physician trainees in North America have increased handof frequency, augmented the potential for inefectual handof-induced complications, and stimulated the need for new interventions to improve handover quality [7]. The shift from the traditional model of continuous inpatient medicine to a team-based model has further focused atention on patient handofs [3].…”

Section: Transitions Of Care: Handof Deinitionmentioning

confidence: 99%

“…The Accreditation Council for Graduate Medical Education (ACGME) recently mandated that residency programs provide formal educational programs about patient care transitions and that faculty monitor ensure adequate handof skills through direct observation [3,19,21]. TJC, the ACGME, and the Society of Hospital Medicine jointly encourage compliance with a structured format for verbally communicating information utilizing an ordered acronym mnemonic, SBAR: (1) Situation, (2) Background, (3) Assessment, and (4) Recommendation [7].…”

Section: Regulatory Agencies' Input To Enhance Handofmentioning

confidence: 99%

“…Active communication strategies by the oncoming clinician improve patient safety by detecting erroneous assessments and actions, thereby confronting diagnostic momentum and ixation bias [7]. Face-to-face group handof, an active communication strategy, enriches the quality of handofs more than a reliance on writen or electronic notes [16].…”

Section: Active Communication Enhances Handofsmentioning

confidence: 99%

See 2 more Smart Citations

Transitions of Care: Complications and Solutions

Salen¹

2017

Vignettes in Patient Safety - Volume 1

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The delivery of medical care relies on efective, succinct, and ongoing communication between healthcare providers, called handofs. Handofs involve the transfer of professional responsibility and accountability for aspects of care for patients to another clinician or clinical team on a temporary or permanent basis. Handofs have the potential for deleterious clinical impact if inadequately done. Only recently has data become available that demonstrate improvements in handofs reduce the rate of subsequent clinical care error. This clinical vignete and subsequent discussion focuses on physician, particularly the resident physician in training, transfer of care: handof complications, barriers to efective handofs, regulatory agencies' input on handof improvement, standardization of the handof process, assessment of the quality of handof, handof error avoidance, and improving the quality of handof.

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Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection

et al. 2020

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IMPORTANCE Clostridioides difficile infection is the most common hospital-acquired infection in the United States, yet few studies have evaluated the cost-effectiveness of infection control initiatives targeting C difficile. OBJECTIVE To compare the cost-effectiveness of 9 C difficile single intervention strategies and 8 multiintervention bundles. DESIGN, SETTING, AND PARTICIPANTS This economic evaluation was conducted in a simulated 200-bed tertiary, acute care, adult hospital. The study relied on clinical outcomes from a published agent-based simulation model of C difficile transmission. The model included 4 agent types (ie, patients, nurses, physicians, and visitors). Cost and utility estimates were derived from the literature. INTERVENTIONS Daily sporicidal cleaning, terminal sporicidal cleaning, health care worker hand hygiene, patient hand hygiene, visitor hand hygiene, health care worker contact precautions, visitor contact precautions, C difficile screening at admission, and reduced intrahospital patient transfers. MAIN OUTCOMES AND MEASURES Cost-effectiveness was evaluated from the hospital perspective and defined by 2 measures: cost per hospital-onset C difficile infection averted and cost per quality-adjusted life-year (QALY). RESULTS In this agent-based model of a simulated 200-bed tertiary, acute care, adult hospital, 5 of 9 single intervention strategies were dominant, reducing cost, increasing QALYs, and averting hospital-onset C difficile infection compared with baseline standard hospital practices. They were daily cleaning (most cost-effective, saving $358 268 and 36.8 QALYs annually), health care worker hand hygiene, patient hand hygiene, terminal cleaning, and reducing intrahospital patient transfers.

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Interactive questioning in critical care during handovers: a transcript analysis of communication behaviours by physicians, nurses and nurse practitioners

Cited by 47 publications

References 30 publications

Effectiveness of Handoff Educational Program on Nurses Interns’ Knowledge, and Communication Competence

Effectiveness of Handoff Educational Program on Nurses Interns’ Knowledge, and Communication Competence

Transitions of Care: Complications and Solutions

Evaluation of the Cost-effectiveness of Infection Control Strategies to Reduce Hospital-Onset Clostridioides difficile Infection

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