Nursing Handoff Challenges

Posted by nurse on December 1, 2010 under Critical Care, Featured | Be the First to Comment

Occupational challenges in nursing never end. End of shift reports, patient handoffs, and access to records can be frustrating barriers to nursing efficiency. Patients can be waiting for a handoff that never happened, or one administrator forgot because another case took immediate precedence. Nurses can come on the opening shift before closing shift nurses have finished their end of day reports and crucial details can be missed.

Handoffs are critical that they maintain smooth flow between admitting patients for examination, waiting for tests, gaining new information about treatment, and completing patient care. Handoffs occur when one supervisor directs a nurse to a new task when his or her duties concerning another patient have not been completed. Suggestions to managers or nursing administrators should be reviewed by all staff for handoff improvement where possible.

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Complicated questions can arise when nursing handoffs are not handled efficiently. The business of nursing is nursing. This means interchange of important information in a timely manner must be routinely forwarded. What type of test is needed, and when was it taken? How much blood is needed, and what type? Who is responsible for moving the patient back to the waiting room, and do they know what they are waiting for?

When large volumes of patients are involved, handoffs can save huge amounts of time communicating between staff regarding patients. Is this patient waiting for lab results? Why is that room still occupied? Is a nurse trying to get an answer regarding previous test cultures, and can the doctor explain them better? Patients can get forgotten and records misplaced when nurses and staff are not clearly tasked.

Follow up reports and notes after patients have left also matter. End of day reporting includes exam room condition checklists and incoming patient preparation surveys. Census data or supply reorder  information may need furthering to another contact for time sensitive action. Does the doctor need to work up the chart more for review and filing? Does the sharps container need removal? Is the shredding volume overdo for processing?

Smooth running physician offices, organized admitting wards, hospital emergency or trauma departments and crowded surgical schedules mean that names and test procedures can overlap.  Written or taped note to the file may not always work. Access to computerized file information may be slow. Completeness of the information matters. Succinctness does too.

Information during the doctor’s exam, follow up, and staff operations is critical in nursing care. Patient treatment and recovery are at stake with every detail. Quality of care can be lost with one missed handoff. Patients rely on nurses and physicians to manage their internal procedures most efficiently for patient wellness. Don’t let the mistake be yours.