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Poster Numbers 185 – 241 – People & places: Poster No: 201
Improving nursing handover in a specialist palliative care unit
  1. Louise Smith,
  2. Sue Gale,
  3. Jayne Glynn,
  4. Shila Tank,
  5. Leanne Newberry and
  6. Mel Graham
  1. Michael Sobell House

Abstract

Background Nursing handover plays a pivotal role in the continuity of patient care. Having recognised limitations in their own handovers, nurses in a 16-bed inpatient unit embarked on a multi-phased project aimed at redressing problems.

Aims To identify Healthcare Professionals' (HCPs) opinions about their handovers, gain a better understanding of the impeding factors and identify opportunities for improvement.

Methods Quantitative and qualitative data were collected via observation, survey and audit. A survey was undertaken in Phase 1 to identify HCPs' beliefs, preferences and ideas on how their handover could be improved. Phase 2 comprised an audit and assessment of handover structure and content. Based on emergent themes contemporaneous changes to practice were made.

Findings Phase 1 shows that 91% of respondents said handover should not exceed 30 min, 70% wanted clarity on what information should be included/excluded, 74% wanted a dedicated ‘question time’ to avoid verbal interruptions. Respondents also wanted to introduce deterrents to reduce staff lateness, physical interruptions and utilise a preprinted pro-forma. Guidelines were developed and audited. By the end of Phase 2 the duration of handover had halved to 20 min. Staff lateness and interruptions had significantly reduced. Use of the pro-forma became standard practice as it facilitated the delivery and recording of pertinent patient information and reduced note-taking. The naming of drugs (+/- dose) ceased as inaccuracies were common. However, key patient information was frequently omitted and factual errors occurred for varying reasons including; inaccurate source documents, illegible writing, and poor communication.

Conclusion A high level of adherence to the guidelines was achieved, duration halved and handover was more succinct, structured and patient focused. The main emergent theme related to the quality of the information given and this is subject to further enquiry.

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