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Clinical handover is an essential part of medical practice that includes the transfer of professional responsibility and accountability for a patient from one professional to other professional. The delivery of continuous and safe health care is essentially dependent on the communication and transfer of the patient’s health information between individual nurses or the health care teams. ISBAR is clinical tool that helps nurses to follow right steps during clinical handover (Elcock, 2012, pp. 56-75). In this essay, the focus is to compare and contrast the right and wrong ways of clinical handover with the help of two different videos on clinical handover.
The “National safety and quality heath service standards” included the importance and the role of clinical handover in standard 6. Within this standard, the commission has described the system and strategies for effective clinical communication during clinical handover. The initial key step in this practice is following the ISBAR format. In two videos of discussion, one has followed the proper steps necessary in clinical handover, but the other did not follow the necessary steps (Chaboyer, 2011).
In the first video, it has been seen that the nurses has properly followed the ISBAR format and done their job in ethically correct way. Initially, in the first video, it has been seen that the nurses within whom the clinical handover will be done, have greeted each other and with the patient’s consent they entered into the patient’s room. They nurses greet the patient and introduced themselves. After introduction, they positioned themselves for the handover. In contrast, in the second video, these initial steps were missing. It has been seen that, the nurses are completing their clinical handover in the patient’s room, where other patients are also calling them with their concerns. Therefore, it can be said that, the nurses were not able to arrange a calm and quite environment for the patient, where recovery is encouraged and the errors in handover be reduced. The nurses neither greeted the patient, nor took the patient’s consent about their clinical handover. Due to lack of concentration, it has been seen that one nurse forgot to tell some patient’s details to the other nurse. It could lead to a major health issue of the patient (Chaboyer, McMurray & Wallis, 2008).
According to the standard 6 in National standards, nurses have to use ISBAR assessment tool for assessing the patient’s health needs at the period of clinical handover. The first step of ISBAR format is identifying the patient. In the first video, it has been seen that the nurse identified the patient from the patient’s documentation and took her consent about the name, in which the patient would be called. In contrast, in the second video, the patient greeted the nurses and the nurses, without taking patient’s consent and identifying the patient, directly started talking about patient’s details. This behavior is not ethically correct. Identifying the patient in such a way, that gives the patient comfort, strengthens the nurse-patient relationship, which was not possible in the case of second video, as the patient was not recognized properly (Ahmed et al., 2012).
The next step in ISBAR format is analyzing the situation. In the first video, it has been seen that the nurses discussed about the current situation of the patient, while allowing the patient to participate in the conversation. It helps the patient to feel valued. In the first video, it has also seen that the patient’s family was also involved during the information sharing. It is one of the essential steps in person-centered care, which is very popular therapeutic approach nowadays (Foronda et al., 2015). In contrast to this, in the second video, being in a wrong environment, the nurses could not discuss about the patient’s current situation properly. The patient was not involved in their communication; they limited their discussion within themselves. However, another patient prevented the efficient hand over of patient’s clinical data. It was also observed that the patient was not satisfied (Elcock, 2012, pp. 56-75).
The third step in the framework is to know about the background information of the patient. In the first video, it has been seen that the background information of the patient is being discussed with both the patient and the nurse in next shift. It provided the opportunity to clarify the health history with the patient, thereby understanding the patient’s background more critically. Nurses strengthen the nurse-patient relationship through calling her by name and by listening her with respect and dignity about her background. According to the ethical codes of nursing in Australia, it important to show respect to the patient in any circumstances. In addition, partnership with the patient is also very important. In contrast, in the second video, the nurses did not involve the patient into their conversation and thus the patient was very much dissatisfied. No background information of the patient was discussed (Australian Commission on Safety and Quality in Health Care, 2010).
In the next step, assessment of the patient is done. In this step, the patient has been involved solely; the nurses allowed the patient to tell about her feelings, issues and asked questions about her health and safety (Foronda et al., 2014). In the “The National Safety and Quality Health Service Standards”, standard 6 depicts that nurses should provide opportunity to the patient to ask questions. In the first video, it has been seen that, the patient as well as her family members has been provided enough space to clarify things about her health. In contrast, the second video shown that, lack of calm and comfortable environment, the patient denied participating in the conversation and the nurses failed to establish a trustworthy relationship with the patient, which can have negative impact upon her health (Nicol et al., 2012).
The final step is about response. In the first video, the nurses covered all the needful regarding the patient and asked the patient to clarify her doubts. Finally, the nurse remind the patient how to inform the nurse, when she would be rounding and completed the clinical handover procedure in a correct and ethical way. In contrast, in the second video, the nurses discussed the patient’s documents within themselves and the patient’s dissatisfaction led to her denial of communication with the nurses. They did not completed the clinical handover in an ethical way, did not gave the opportunity to the patient to ask anything. The result of this poor clinical handover event was poor health outcome of the patient due to dissatisfaction (Group et al., 2012).
From this essay, it has been revealed that effective clinical handover helps to reduce the rate of medication errors and misinterpretation by nurses. It helps to structure the nursing practices assigned to a specific nurse. It also helps to reduce conflicts within the nurses and decreases nurse’s burnout regarding shifts. This essay compared two different situations of clinical handovers, by analyzing the right and wrong process done by the nurses.
Ahmed, J., Mehmood, S., Rehman, S., Ilyas, C., & Khan, L. U. R. (2012). Impact of a structured template and staff training on compliance and quality of clinical handover. International Journal of Surgery, 10(9), 571-574.
Australian Commission on Safety and Quality in Health Care,. (2010). OSSIE Guide to Clinical Handover Improvement, Sydney, ACSQHC. www.safetyandquality.gov.au. Retrieved 24 August 2016, from http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/ossie.pdf
Chaboyer, W. (2011). Clinical Handover. www.health.qld.gov.au. Retrieved 24 August 2016, from https://www.health.qld.gov.au/psq/handover/docs/ch_presentation2.pdf
Chaboyer, W., McMurray, A., & Wallis, M. (2008). Standard Operating Protocol for Implementing Bedside Handover in Nursing. www.safetyandquality.gov.au. Retrieved 24 August 2016, from http://www.safetyandquality.gov.au/wp-content/uploads/2012/02/SOP-Bedside-Handover.pdf
Elcock, K. (2012). Getting into nursing. Los Angeles: SAGE/Learning Matters.
Foronda, C. L., Alhusen, J., Budhathoki, C., Lamb, M., Tinsley, K., MacWilliams, B., ... & Bauman, E. (2015). A Mixed?Methods, International, Multisite Study to Develop and Validate a Measure of Nurse?to?Physician Communication in Simulation. Nursing education perspectives, 36(6), 383-388.
Foronda, C., Gattamorta, K., Snowden, K., & Bauman, E. B. (2014). Use of virtual clinical simulation to improve communication skills of baccalaureate nursing students: a pilot study. Nurse education today, 34(6), e53-e57.
Group, A., Fortune, P., Davis, M., Hanson, J., & Phillips, B. (2012). Human Factors in the Health Care Setting. Hoboken: Wiley.
Nicol, M., Bavin, C., Cronin, P., Rawlings-Anderson, K., Cole, E., & Hunter, J. (2012). Essential nursing skills. Elsevier Health Sciences.
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