Greater accountability in nursing handover

Nursing handover exemplifies both the nurse’s professional ethics and the profession’s integrity. The article by Yetti et al. acknowledges the critical role of structure and process in handover implementation. At the same time, they emphasised the fundamental necessity to establish and update handover guidelines. I assert that effective patient handover practices do not simply happen; instead, nurses require pertinent educational support. It is also pivotal to develop greater professional accountability throughout the handover process. The responsibility for ensuring consistent handover quality should be shared between nurse managers and those who do the actual handover practices.

A dramaturgical analysis of a paediatric team handover

Introduction: The paediatric team handover process is a crucial workplace practice and comprises the transfer of patient information from one shift to another involving medical professionals and students. A qualitative study was performed to analyse the feasibility, functionality, benefits and limitations of the dramaturgical approach when applied to examining a handover session. Methods: Data relating to one handover were collected and analysed from video and audio recordings, notes created by two independent observers and a de-identified copy of the handover sheet. Results: The dramaturgical constructs and subsequent findings allowed us to make informed inferences about the dynamics of the handover procedure. The directors/lead actors consisted of a consultant and a registrar. One consultant was transitory and the remaining 12 attendees were either major support, support or bit actors. The students (bit actors/audience) were included when a learning point was emphasised. The script was informal and improvised as the discussion emphasised certain facets of patient care or accentuated learning points. The staging involved the seating arrangement, a whiteboard, computer screen and ongoing data presentation. The performance suggested a handover of two halves: one emphasising learning and the other allocation of patient care responsibility. Conclusion: We concluded that the real-life drama occurring within a handover was feasibly analysed, with its functionality demonstrated, using the dramaturgical investigative system. The multifaceted recordings enabled researchers to review the ‘authentic’ handover system without censorship. These findings have implications for educational and organisational research.

Mitigating Broadcasting Storm Using Multihead Nomination Clustering in Vehicular Content Centric Networks

Vehicles are highly mobile nodes; therefore, they frequently change their topology. To maintain a stable connection with the server in high-speed vehicular networks, the handover process is restarted again to satisfy the content requests. To satisfy the requested content, a vehicular-content-centric network (VCCN) is proposed. The proposed scheme adopts in-network caching instead of destination-based routing to satisfy the requests. In this regard, various routing protocols have been proposed to increase the communication efficiency of VCCN. Despite disruptive communication links due to head vehicle mobility, the vehicles create a broadcasting storm that increases communication delay and packet drop fraction. To address the issues mentioned above in the VCCN, we proposed a multihead nomination clustering scheme. It extends the hello packet header to get the vehicle information from the cluster vehicles. The novel cluster information table (CIT) has been proposed to maintain several nominated head vehicles of a cluster on roadside units (RSUs). In disruptive communication links due to the head vehicle’s mobility, the RSU nominates the new head vehicle using CIT entries, resulting in the elimination of the broadcasting storm effect on disruptive communication links. Finally, the proposed scheme increases the successful communication rate, decreases the communication delay, and ensures a high cache success ratio on an increasing number of vehicles.

Using lean management approach in improving clinical team leader handover process: nursing services

This report describes the result of the study using lean management approach in improving clinical team leader handover process in nursing services at Sultan Bin Abdulaziz Humanitarian City, the largest rehabilitation facility in the Middle East with 511-bed capacity and more than 20 nursing inpatient units. Clinical handover refers to the transfer of professional responsibility and accountability for some or all aspects of care for a patient, or group of patients, to another pehealthcare system is a crson or professional group on a temporary or permanent basis. It is in fact a valuable and essential part of the care processes in the hospitals. However, clinical team leaders face a challenging role during handover due to prolonged process, causing extra nursing working hour beyond their 12-hour scheduled shift, resulting in additional burden and exhaustion. The aim of this project was to test the effectivity of the lean management approach in improving the duration of clinical handover by reducing the handover time frame to 50% through eliminating unnecessary steps towards a more efficient, sustainable and effective communication between clinical nursing team leaders. The project results demonstrated the effectiveness and efficiency of the team leader clinical handover process by decreasing the duration by 50%. One hundred per cent of nursing units that were involved in the project were able to start and end their team leader handover process by the average of the selection target of 20–30 min of handover duration.

988 A Quality Improvement Project; Improving the Quality and Safety of Handover During COVID-19

Aim The World Health Organisation (WHO) positions effective handover, in its top five patient safety solutions. During our District Hospital Trust’s COVID-19 response, an unprecedented reorganisation of all teams occurred. All surgical and medical speciality junior doctors were re-deployed and split into 4 zones to cover the hospital. In this quality improvement project (QIP), we sought to understand our trainees’ thoughts on this new multi-zonal handover process and aimed to identify risk-reduction measures to aid better patient care. Method The opinions of trainees on the new handover system were obtained using an online Likert scale survey. Following the responses, a new morning and night handover proforma was developed. This was used trust-wide and a post-intervention repeat survey was conducted to assess the new changes. Results The primary survey received 31 responses with feedback illustrating mixed effectiveness of the existing handover process. Free text comments highlighted issues surrounding “safety”, “poor organisation”, “poor continuity of care” with one serious incident reported. Post-intervention of a new handover proforma, a repeat online survey received 25 responses. Results were significantly more positive with >84% of responses being in the “strongly agree to agree” category, including for “continuity of care”, “organisation”, and “safety”. Conclusions This QIP illustrates a good example of a low-cost intervention to create a better handover system and aid hospitals during time of crises. For us, it managed to reform the handover process and ultimately improved our patient care. Forthcoming, we would like to create a national best practice guide for effective handover.