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Clinical Hand Off

The document discusses clinical handoff, which involves communicating important patient details between healthcare providers. It describes types of handoffs like shift changes and patient transfers. Guidelines are provided for shift handovers using ISBAR format at the patient's bedside to ensure continuity of care. Benefits of bedside reporting are also outlined.

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123 views22 pages

Clinical Hand Off

The document discusses clinical handoff, which involves communicating important patient details between healthcare providers. It describes types of handoffs like shift changes and patient transfers. Guidelines are provided for shift handovers using ISBAR format at the patient's bedside to ensure continuity of care. Benefits of bedside reporting are also outlined.

Uploaded by

Sabari
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PPTX, PDF, TXT or read online on Scribd
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CLINICAL HANDOFF

WHAT IS CLINICAL HANDOFF

A communication skill that involves giving important details


about the patient to another member of the multidisciplinary
team.
PURPOSE

The purpose of this campaign is to provide nurses with a


structured approach for the safe communication of clinical
handover.
TYPES OF HANDOVER

Nurse to doctor
Shift Handover briefing

Patient transfer
Handover
Shift handover
It is the handover of a Nurse from a night shift or a day shift
that holds responsibility for care, to the nurse who will be
assuming responsibility for the care of the patient.
• ISBAR format is applied.
• Handover occurs by each patients’ bedside that gives
additional information about the patient so that continuity of
care is present.
THE BENEFITS OF BEDSIDE REPORTING
INCLUDE ,
•Increased patient involvement and understanding of care.

•Decreased patient and family anxiety, decreased feelings of


“abandonment” at shift changes.

•Increased accountability of nurses, increased teamwork and


relationships among nurses and patients

• Decreased potential for mistakes.

NOTE: Please ensure shift handovers to occur


at bed side
TRANSFER HANDOVER

• Handover given when patients are transferred from one unit to


another unit within the hospital(For procedure, treatment,
surgery or to another ward).
• All patients transferred from one clinical area to another
clinical area require handover to be documented.
• This includes details of the transfer time indicating a transfer
of professional responsibility and accountability.
What to see when we receive a patient from another
unit
(I2LMSP, A-E)

• Identification of patient using IPSG Goal 1


• Infection control precautions(like MRSA positive, HBSAG positive)
• Check for any lines and drains
• Medical and surgical history ( Past/present)
• Plan of care( Critical information, Food / drug allergy investigations
planned / pending ,Pending reports for collection ,Medications,
Referrals, procedures, monitoring
• Talk about numbers ( A to E assessment )
A to E assessment

AIRWAY BREATHING CIRCULATION DISABILITY EXPOSURE

• Brief about •SPO2 + O2 •Blood pressure •GCS •Pressure


Patients Therapy •Mean arterial •AVPU Areas
airway •Respiratory Pressure •Pain score •Cuts/bruises
rate •Heart rate •Blood •Invasive
•Work of •Fluid balance Glucose level Devices( IV
breathing •AEWS Lines, urinary
•? cough catheter)
•Temperature
ISBAR FORMAT

A communication tool used to give PROMPT and


APPROPRIATE information to another member of the
multidisciplinary team in a concise yet assertive
manner.
I • IDENTIFICATION

S • SITUATION

B • BACKGROUND

A • ASSESSMENT

R • RECOMMENDATIONS
HOW TO GIVE EFFECTIVE ISBAR
HANDOVER

SCENARIO 1

NURSE TO DOCTOR HANDOVER


OVER TELEPHONE
Mrs. JONES PLAN OF CARE

65YRS OLD PAIN MANAGEMENT

DAY 6
OBSERVATION
ROAD TRAFFIC MONITORING
ACCIDENT

MULTIPLE RIB NOT FOR SURGERY


FRACTURE
MORNING
8.30 AM

-RELAXED
-SPO2 > 96%
-BP 125/60mmHg

MORNING 10.30AM

-ANXIOUS
-SPO2 92% ON RA
-BP 95/54 mmHg

YOU ARE GOING TO GIVE A ISBAR HANDOVER


IDENTIFICATION
• Introduce Yourself:
- name, position, location

Verify receiver’s identity

• Identify Patient – name, Namaste sir/ madam


age, sex, location This is nurse X calling from
M ward 4th floor main
building .
Am I speaking to Dr. Y
Cardiologist.
I am concerned about
Mrs. Jones 65yr female in M ward
SITUATION

•State purpose
-symptom/ problem
•Patient stability / level
Of concern

If URGENT –
Say so, make it clear I am concerned about my
from the start. Patient who has become short
of breath and blood pressure
has significantly dropped.
BACKGROUND

DATE OF ADMISSION
Mrs. Jones is a 65yr old female who
PAST MEDICAL
was admitted into hospital 6 days ago
HISTORY
following a RTA. She sustained multiple
Rib fractures and is currently being treated
RELEVENT
For her pain management and needs and
MEDICATIONS
Her past medical history is Hypertension.
On her drug chart she has her usual
hypertensive's, BD Oxycodone M/R
(Modified Release)And PRN Oxycordone
I/R (immediate release)
ASSESSMENT

•Vital signs
•Current status
of the patient/
•What have you
already done
for the patient

Mrs. Jones oxygen level dropped to


92% on RA- we placed her on 4L oxygen
therapy. Her BP dropped to 95/54mmHg.
She is tachycardia and her respiratory rate
is 22br/min. She is under 15 minutes
observation recordings.
No IV fluids prescribed.
RECOMMENDATIONS

-What you want done


-Treatment/
investigations
underway or that
need monitoring
-Review : by whom,
when and of what? I am concerned about my
-Plan depending on Patient, please come to see her.
results/clinical Is there anything you need me to
course do or organise before you come to
see the patient?
ISBAR
It is used only for the emergency reporting
 Nurse to doctor
 Nurse to any level of escalation ( Met
Manager/Senior nurse)
 ER to OT, Cath lab, ICU’s
 Ward to ICU
THANK
YOU

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