Nursing handover of vital signs at the transition of care from the emergency department to the inpatient ward: An integrative review

Cross, Rachel; Considine, Julie; Currey, Judy

doi:10.1111/jocn.14679

Cited by 10 publications

(6 citation statements)

References 44 publications

(110 reference statements)

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“…Moreover, several accountability factors’ interactions have also been covered by other authors. Cross et al 29 discussed the importance of an appropriate handover between emergency department and ward nurses, which is reflected in the staff social interactions factor and its relations, while Nibbelink and Brewer 30 found that factors such as nursing experience, cultural influences, education, situational awareness and autonomy affected nursing decision-making, which were also indicated in the results of this research. This overlap between this research and others shows how common most of the factors mentioned and their relations are in different clinical contexts, statement that is further supported by Cummings et al 31 in their scope review.…”

Section: Discussionmentioning

confidence: 54%

Decision-making in an emergency department: A nursing accountability model

Rubio-Navarro

Garcia-Capilla²,

Torralba-Madrid

et al. 2019

Nurs Ethics

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Introduction: Nurses who work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective: The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design: Data were analysed, codified and triangulated using qualitative ethnographic content analysis. Participants and research context: This research is set in a large emergency department in the Midlands area of England. Data were collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies. Ethical considerations: Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results: The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations among the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion: The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion: The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen.

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Section: Discussionmentioning

confidence: 54%

Decision-making in an emergency department: A nursing accountability model

Rubio-Navarro

Garcia-Capilla²,

Torralba-Madrid

et al. 2019

Nurs Ethics

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show abstract

“…Another cause of responsibility discontinuity, as mentioned by some respondents, was a lack of awareness of mutual responsibility between the sender and the receiver 33 . Time pressure was also pointed out as a plausible latent factor behind adverse events regarding patient handoffs by some ED nurses, and other work unit nurses when sending patients to the ICU, as has also been found in other studies 3,4 …”

Section: Discussionmentioning

confidence: 70%

“…One of the most complex, difficult, and typical intra‐hospital handoff types is those between work units, that is, inter‐unit handoffs . For example, patients are transferred from the emergency department (ED) to general wards, 3 from the operating room (OR) to the intensive care unit (ICU) 4 or from the ICU to general wards 5 . A patient's handoff from one speciality to another is a complex and high‐risk event in the care process and errors and adverse events can easily occur.…”

Section: Introductionmentioning

confidence: 99%

Organizational climate for safe and effective inter‐unit handoffs in Japanese hospitals

Itoh

2021

Health Planning & Management

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Objectives To extract the organizational climate factors that contribute to safe and effective inter‐unit patient handoffs, as well as to capture their crucial characteristics in the context of current Japanese hospitals. Methods A questionnaire survey was conducted among nursing staff in 31 general hospitals, collecting a total of 5117 valid responses (69% response rate). Results A five‐factor model was established to determine the inter‐unit handoff climate within hospitals. This comprised information and responsibility‐related risk, role understanding, communication, handoff environment, and guidelines and process. Based on nursing staff perceptions, the inter‐unit handoff climate in Japanese hospitals were generally found to be moderate or moderate‐to‐high levels across all five of the factors. Nursing staff's perceptions of all five climate factors differed significantly across hospitals and work units, rather than working conditions (full‐time vs. part‐time) or professions (nurse vs. nurse assistant). All five handoff factors were verified their significant impacts on patient safety awareness and handoff quality. Furthermore, in hospitals where staff perceptions of handoff climate were more positive, information was transferred more effectively. Conclusions An inter‐unit handoff climate structure was extracted and verified its impact on handoff quality and safety. Due to moderate climate levels in Japanese hospitals, as well as background factors such as low risk awareness among staff and busy situations, promoting a more positive organizational culture is suggested for creating safer and more effective inter‐unit handoffs. Improving the current handoff guidelines and processes in hospitals and using non‐licensed assistive staff more effectively are also recommended.

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“…Outro extrato do DSC 3 revelou uma rotina de verificação e registro dos sinais vitais previamente ao deslocamento como um cuidado direcionado à segurança. De acordo com a literatura, os sinais vitais são informações importantes para efetividade da transferência do cuidado e embasamento das condutas clínicas, dado que insuficiências neste conteúdo são apontadas como fatores de risco para eventos adversos durante a internação (17) .…”

Section: Discussionunclassified

Comunicação entre equipes e a transferência do cuidado de pacientes críticos

Petry

Diniz

2020

Rev Rene

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Objetivo: compreender o processo de comunicação entre os profissionais de saúde durante a transferência do cuidado intra-hospitalar do paciente crítico. Métodos: estudo qualitativo, com coleta de dados por meio de entrevista com técnicos de enfermagem, enfermeiros e médicos atuantes na Unidade de Emergências Médicas e Unidade de Terapia Intensiva Adulto, perfazendo 18 profissionais. Os dados foram apreciados segundo o Discurso do Sujeito Coletivo. Resultados: evidenciou-se fragilidades no conhecimento dos profissionais quanto aos seus papeis e uma comunicação verbal estabelecida de modo superficial, como repercussão da impropriedade na utilização do instrumento de transferência existente, dificultando a obtenção de uma linha de cuidado contínua. Conclusão: a transferência do cuidado é executada entre os cenários, entretanto, o processo de comunicação se estabelece de maneira frágil e apresenta lacunas decorrentes da inexistência de um protocolo e do pouco reconhecimento acerca de sua importância por parte dos profissionais.

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Nursing handover of vital signs at the transition of care from the emergency department to the inpatient ward: An integrative review

Abstract: Vital signs are an important component of clinical handover and are perceived to be indicators for patient safety and risk of future adverse events.

Cited by 10 publications

References 44 publications

Decision-making in an emergency department: A nursing accountability model

Decision-making in an emergency department: A nursing accountability model

Organizational climate for safe and effective inter‐unit handoffs in Japanese hospitals

Comunicação entre equipes e a transferência do cuidado de pacientes críticos

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