Effective Nursing Handoffs in Nursing Practice Research Paper

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Nursing Handoff Communication Research

Nursing handoffs are important components in the modern health care setting given their role in transfer of the responsibility and authority of care from one practitioner to another during shifts. Generally, nurses work in different shifts when providing patient care in order to reduce their work burdens and potential stressful moments. Therefore, nursing handoffs help ensure continuity of care during a patient's stay in the health care facility. Despite the significance of nursing handoff in continuity of care, this process has been characterized by numerous communication problems. In most cases, nursing handoffs are substandard and contribute to several challenges in enhancing patient outcomes and satisfaction. This study seeks to examine communication problems in nursing handoffs with a view of identifying effective strategies towards enhancing this process. This issue is important in current nursing practice with regards to enhancing patient outcomes and satisfaction. Effective nursing handoffs are achieved through proper communication strategies and processes that promote continuity of care.

Background and Significance of the Problem

Handoffs are essentially crucial elements that serve various functions including social bonding, team building, and coaching and teaching. In the health care setting, nursing handoffs play an important role with regards to information processing i.e. ensuring that essential information is transferred for patient safety. This implies that nursing handoffs are important in maintaining continuity of care during a patient's stay in a health care facility. Handoffs act as communication links between the various medical personnel or professionals providing patient care. Despite their significance in continuity of care and ensuring patient safety, nursing handoffs have recently been characterized by errors, care omissions, inefficiencies, increased costs, increased hospital stay, preventable re-hospitalizations, and unsuitable treatment (Halm, 2013, p.158). This is primarily because they are carried out in a substandard manner or are variable handoffs. This is major issue that requires examination in order to identify suitable measures for improving nursing handoffs with the aim of improving patient safety and promoting continuity of care.

Statement of the Problem and Purpose of Study

Variable or substandard nursing handoffs have contributed to several issues that affect patient safety and the quality of treatment. These kinds of nursing handoffs are brought by several inefficiencies and communication problems during the process. Therefore, the critical issue or problem is why inadequate nursing handoffs continue to take place regardless of its devastating impacts on patient care. The purpose of this study is to develop effective measures for improving nursing handoffs in order to enhance patient care and outcomes. This study will entail examining the major issues that contribute to substandard or variable handoffs, impact of inadequate nursing handoffs, and suitable measures for improving these handoffs.

Literature Review

The main reason for nursing handoff is to communicate patient information to ensure safe, continuous care. Given its significance in patient care, nursing handoff has received considerable attention in the nursing field and practice. This significant attention to this practice in the recent past has been fueled by the fact that it's renowned as a trouble spot in ensuring continuity of care and patient safety. Researchers in this field have examined numerous issues, particularly communication associated with nursing handoffs.

Nursing Handoff and Patient Safety

The significance of nursing handoff in ensuring continuity of care and patient safety has been long established. According to Popovich (2011), the main function of handoffs in nursing practice is to communicate patient information, which is used as the premise of ensuring safe, continuous care (p.55). This researcher argues that patient safety is the most important component of nursing handoff in relation to promoting continuity of care when essential information and responsibility of care of a patient is transferred from one healthcare provider to another. This view is supported by Abraham et al. (2011) who argue that nursing handoff plays a vital role in ensuring the continuity of activities relating to patient care (p.28). These researchers attribute the significance of nursing handoff in patient safety on the premise that it's a crucial clinical and organizational process that takes place in every level of the hospital. They further contend that the significance of nursing handoff in patient safety is evident in its three major aspects i.e. transfer of information, responsibility, and authority.

In support of these claims Farhan et al. (2011) postulates that ensuring safe transition of shift responsibility from the outgoing to incoming healthcare provider is one of the basic functions of nursing handoffs (p.1). However, these researchers state that this can be achieved through precise communication of information during the end of the shift.

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Unlike Popovich (2011) and Abraham et al. (2011), Farhan et al. (2011) examine the significance of nursing handoff in patient safety on the basis of transfer of information and responsibility. To this extent, they consider nursing handoff as the transfer of information and responsibility but not authority. Based on these researchers, nursing handoff involves transfer of patient information and/or responsibility of a department to help promote continuity of care and patient safety (Farhan et al., 2011, p.1).

Communication Challenges in Nursing Handoff

Abraham et al. (2011), state that nursing handoffs remain a major threat to patient safety and continuity of care despite their vital role in promoting the continuity of activities relating to patient care (p.28). As a result, nursing handoffs have been considered as remarkable haphazard since they sometimes contribute to patient harm instead of safety and continuity of care. Farhan et al. (2011) concurs with Abraham et al. (2011) by arguing that studies have shown that poor nursing handoffs were the most widespread causes of medical errors because of teamwork problems. While standardization of handoff structure and formal training have been adopted to enhance this nursing practice, nursing handoffs are still characterized by poor quality as evidenced in medical errors, which negatively affect patient safety and continuity of care. Blouin (2011) concurs with these researchers by stating that each nursing handoff presents a unique opportunity for medical errors even though its primary function and objective is to help promote safe, continuous care through providing accurate patient information (p.97).

In a study that examined the root cause of poor nursing handoffs, Popovich (2011) state that communication problems are the major factors that hinder the effectiveness of nursing handoffs (p.56). This is the same view provided by Abraham et al. (2011) who argue that communication failures have been identified as the leading causes of a series of clinical errors and unfavorable events during patient care (p.28). They stated that approximately 50% of communication failures or problems during nursing handoffs occur between care providers. Blouin (2011) also states that communication challenges are the root causes of unprecedented outcomes in nursing handoffs (p.97). This researcher supports his claim through the findings of a study that concluded that approximately 80% of serious clinical errors usually involve miscommunication between caregivers during transitions in the care delivery process. Actually, sentinel events reported to the Joint Commission between 1995 and 2006 were attributable to communication failures during transitions of care or nursing handoffs.

Even though they recognize the importance of accurate communication in nursing handoffs, Farhan et al. (2011) attribute poor transitions of care to other factors than communication. They argue that poor nursing handoffs are brought by lack of standardized structure and practice. This is primarily because research has shown that a gap exists between evidence and practice during nursing handoffs, which seemingly hinders the ability to standardize this important component of clinical practice. Moreover, the current healthcare system lacks a robust system through which safe nursing handoff of responsibility can take place and contributes to medical errors.

Improving Nursing Handoff Communication

While these researchers concurs that communication failures and breakdowns are the major causes of poor transitions of care, they provide different recommendations of potential solutions to help improve nursing handoff communication. Farhan et al. (2011) propose the establishment of a simple tool to provide the framework for nursing handoff (p.1). The simple tool incorporates medical and operational information that is vital for efficiency and organization of the subsequent shift. The authors further propose the use of ABC tool as part of a robust system and standardized structure and practice towards enhancing nursing handoff. Abraham et al. (2011) agree with Farhan et al. (2011) that standardization through the use of a handoff communication tool would help deal with problems associated with such transitions in care. However, Abraham et al. (2011) suggest that such a tool should be based on a body system format, which enables classification of patient care information based on varying body systems in order to eliminate variability in content and form of current process of nursing handoff (p.34). The handoff communication tool should be accompanied with strategies for streamlining pre-turnover activities through an information-push model in which information is sent to users without having them explicitly ask for the required information.

Popovich (2011) provides several recommendations to help improve nursing handoff communication including assuming responsibility for a patient, verifying his/her surrounding, and determining his/her condition and existing or pending treatments. The.....

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