Nursing Case Study On Evidence-Based Practice

Question

Task:
Part 1: Nursing case study
You are working as a registered nurse in a large metropolitan hospital. In the ward in which you work, nurses often express frustration with the handover process, which takes up a lot of time and does not always provide full or appropriate information. To address this, the Nurse Unit Manager has recently introduced a new handover tool to standardise the process of handover. To evaluate the success of the tool, baseline data on nurse satisfaction with the handover process was collected via survey prior to the introduction of the tool, and again three months afterwards.

1. Based on the data presented, do you think the standardised handover tool has been effective in improving the quality of handover in your ward? Why/ why not?
2. How might the data obtained pre and post the introduction of this tool be used by the hospital when reporting against National Safety and Quality Health Service (NSQHS) Standard 6: Communicating for Safety?

Part 2 The hospital is considering introducing bedside handover, to involve patients and their families in the planning of care. Based on current evidence, do you think this practice is beneficial? Why, or why not? Please refer to the highest possible levels of research evidence available to justify your answer.

Answer

Background of nursing case study:
A very basic part of patient care in nursing practice is nursing handover. Nursing handover brings numerous benefits in patient care, if it is effectively done. When at the end of a nursing shift a nurse delivers the duty of patient care to fellow nurse is known as nursing handover (Tobiano et al. 2018). Nursing handover of any individual patient mainly has three sections: first one is patients past, which includes diagnosis of patient and treatment plan. Then comes the second section which includes the present situation of the patient and finally comes the third section that includes the works that are yet to be done. During these handover processes nurses often experience frustration due to communication gap and getting inappropriate information (Johnson, Sanchez and Zheng, 2016). Here in this nursing case study analysis the effectiveness of the handover tools is going to be discussed to standardize the process of patient care in any health care centre.

Aims and objective of the research:
The primary aim of the study is to evaluate the effectiveness of standardization of handover process in order to reduce the frustration or stress rate among nurses.

Objective:

1. To evaluate the advantages and disadvantages of the standardization of handover process.
2. To evaluate the relation between handover process and nurse stress.

Research question:

PICO Question

Is the standardization of handover process as compared to that of normal handover process is effective in reducing rate of frustration and stress among nurses?
Methodology:
In order to evaluate the effectiveness of the standardization of handover process, survey has been conducted. The response of the survey is evaluated by the help of different literature. The literature are extracted by the help of search strategy.

The articles are extracted by incorporating relevant keywords in different database such as, EMBASE, Medline and PUBMED. Boolean operators is also used to increase the efficiency of the search and to get more relevant articles.

Result and discussion,
From the provided case scenario, it has been found that in different wards of a large metropolitan hospital, registered nurses often express frustration with the handover process. This often takes a lot of time and provides inappropriate information most of the time, which generally creates frustration among the nurses. After marking this issue, to standardise the process of handover, the Nurse Unit Manager has decided to introduce new handover tool. After the implementation of the newly introduced nursing handover tool, a survey was conducted in order to evaluate its effectiveness. Through the survey the basic data on nurse satisfaction with the nursing handover process, preceding to introduction of the tool and after three months, has been collected. After conducting the whole survey some changes in nurse satisfaction has been observed.

The satisfaction level of handing over patients report from nurse to nurse between shift has been increased. This factor has a great value in the wellness and improvement of the patient as well as decreasing and omitting the frustration problem of the nurses during their shift change. It has been seen in many cases that interruption during duty hours and while giving patient report to on-going shift nurse increases frustration and stress. These situations can easily lead to clinical negligence. So, after implementing the tool in the hospital the level of interruption while giving patient report also had been decreased. Now, when a nurse transfers a patient’s information to her fellow nurse, it should never be misinterpreted or accumulated with unnecessary information. Excess unnecessary information can cause discontinuity and effect safety of a patient.

In this case of study, it has been observed by the conducted survey that when the nurse who is about to depart from her shift reports to the arriving nurse, sometimes they tend to provide unnecessary information which is not actually required in patient care. While only critical and necessary information needs to be added in nursing handover report to ensure the betterment of the patient without causing any kind of stress or work frustration to the on-shift nurse (Buus, Hoeck and Hamilton 2017) So, after receiving the data information from the conducted survey associating with the incorporation of the new tool for nursing handover system, it has been observed that now the nurses are more satisfied between shift nurse and nurse report exchanging Spooner, Aitken and Chaboyer2018).

Analysing the National safety and quality health service standard- six, some important nursing handover strategies have been found. These nursing handover strategies are used to efficiently communicate about patient’s health care. Communicating for Safety Standard is a national health care and quality standard which ensures effective communication to support health care and safety for patients. In this nursing case study, the data obtained before and after incorporating the nursing hand over tool in the hospital can be comfortably defined by the sixth standard of the National safety and quality health service standard (WH&S2016). As per the received data from the conducted survey on the newly introduced nursing handover tool, it has been shown that how the stress situation and frustration level has been improved. Which is also beneficial for better outcome of patient’s health? The conducted survey shows improvement in stress and frustrating behaviour among the nurses during their shift change. This reduces the chances of clinical negligence. Interruption during duty hours and while giving patient report to on-going shift nurse has been decreased by the new introduced tool. This reduces the risk on patient’s health and only better communication between both on-going and off going nurse can make this possible. A well communication between the shift nurses are very much important for the safety of the patient in their observation. Even according to National safety and quality health service standard 6, communicating is the key for preparing schedule for proper clinical handover. In order to organise relevant clinicians in clinical hand over healthy communications are so necessary. In that way both the clinician can easily identify the preferences and goals of a patient (Australian Commission on Safety and Quality in Health Care 2012) When a health centre introduces better communication system among their clinicians it improves the nursing handover process. This system involves Supporting patients, carers and even patient’s family members also involved in nursing handover. The wishes of the patient need to be carefully observed (Anstey et al. 2019)

In this part of the assignment bedside clinical handover system is going to be discussed. This process not only influences the quality of the care provided to the patient but also help in reducing the stress rate among nurses. This process helps ensuring the patients’ health care continuity (Bains et al. 2018). When one off shift nurse leaves and another off shift nurse starts their shift ,bedside report permits the patient to communicate with both family and nurse comfortably, which is a very useful way of maintaining communicating for patient safety. Thus, communication helps in reducing safety errors in patients’ health care and also removes miscommunication between nurses eventually reducing the stress rate (Slade et al.2018). Bedside clinical handover helps the nurse communicate constantly with the patient and patient’s family and other health care professionals, during their duty hours. That is the most important key of the wellbeing of the patient. According to Evan, Grunawalt, McClish, Wood and Friese (2012), review it is found that bedside report handover system intercepted unfavourable events of the patient’s health., when a patient health condition changes from the very recent observation throughout the report, it includes the beginning of a swift response. Bedside hand over is a great way to building a trust worthy and therapeutic relationship between nurse and the patient, which increases patient satisfaction in healthcare. This kind of bedside handover eliminates the scopes of irrelevant information and also reduces the blaming game of the responsible shift nurses. Bedside handover also helps in the improvement of ownership quality of the nurses and their team work spirit. Here, in this case study the hospital authority is considering to introduce bedside handover in patients’ health care, as involving patients and their families in the care plan along with the shift nurses. So, as per the above observation, if it introduced in the health care plan of the patients in the hospital, it will be a great initiative for the betterment of the patients (McCloskey et al.2019). from the above discussion, it can be easily stated that implementation of bedside handover will be effective in increasing the nurse satisfaction rate and thereby answers the main research question.

CONCLUSION:
From the above discussion, it can be concluded that standardising handover tools by helps in improving the nursing handover system. During improvisation of the handover processes nurses started experiencing enough work comfort and less frustration due to better communication and getting appropriate information. For the betterment of the patient and to improve the patient- nurse therapeutic relationship the handover tools implemented by the hospital nursing unit matches the standard of National Safety and Quality Health Service standard-six: communicating for safety, which plays a vital role in the wellbeing of the patient and patients’ safety. From the second part it can be concluded that introducing bedside clinical handover will also improvise the patient health care service, patient- nurse and shift to shift nurse communication for the betterment of the patient’s safety.

REFERENCE:
Anstey, M.H., Bhasale, A., Dunbar, N.J. and Buchan, H., 2019. Recognising and responding to deteriorating patients: what difference do national standards make?. BMC health services research, 19(1), p.639.

Australian Commission on Safety and Quality in Health Care, 2020. National Safety And Quality Health Service Standards. [online] Australian Commission on Safety and Quality in Health Care. Available at: [Accessed 15 October 2020].

Bains, V.K., Mackay, M., Kaan, A., Lloyd, E., LeSage, M., Third, K., McNamee, K., Nordby, D. and Bello, S., 2018. Bedside shift report: Benefits, barriers, and strategies for adopting a patientcentred approach to nurse handover. Canadian Journal of Critical Care Nursing, 29(2).

Evans, D., Grunawait, J., McClish, D., Wood, W. and Friese, C.R., 2012. Bedside Shift-to-Shift Nursing Report: Implementation and Outcomes. Medsurg Nursing, 21(5).

Johnson, M., Sanchez, P. and Zheng, C., 2016. The impact of an integrated nursing handover system on nurses' satisfaction and work practices. Journal of clinical nursing, 25(1-2), pp.257-268.

Johnson, M., Sanchez, P. and Zheng, C., 2016. The impact of an integrated nursing handover system on nurses' satisfaction and work practices. Journal of clinical nursing, 25(1-2), pp.257-268.

Mitchell, A., Gudeczauskas, K., Therrien, A. and Zauher, A., 2018. Bedside reporting is a key to communication. ARCHIVOS DE MEDICINA, 3(1), p.13.

Slade, D., Pun, J., Murray, K.A. and Eggins, S., 2018. Benefits of health care communication training for nurses conducting bedside handovers: An Australian hospital case study. The Journal of Continuing Education in Nursing, 49(7), pp.329-336.

Spooner, A.J., Aitken, L.M. and Chaboyer, W., 2018. Implementation of an Evidence?Based Practice Nursing Handover Tool in Intensive Care Using the Knowledge?to?Action Framework. Worldviews on Evidence?Based Nursing, 15(2), pp.88-96.

Tobiano, G., Bucknall, T., Sladdin, I., Whitty, J.A. and Chaboyer, W., 2018. Patient participation in nursing bedside handover: a systematic mixed-methods review. International journal of nursing studies, 77, pp.243-258.

WH&S, G.C.P.C.I., 2016. Communication for safety: Recommendations for ACHS accreditation assessment. ACORN, 29(1), pp.26-29.