Download or read book Improving Post Anesthesia Care Unit Handoff Implementation of a Standardized SBAR Tool written by Martin E. Ibeawuchi and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Patient safety may be at risk when details are omitted during anesthesia handoff. According to the Joint Commission (2015), up to 80% of serious medical errors occur due to miscommunication from one provider to another. Therefore, the purpose of this project was to introduce a structured, standardized, and consistent handoff tool for use between Certified Registered Nurse Anesthetists (CRNA) and Post Anesthesia Care Unit (PACU) nurses that will result in increased knowledge and increased rates of tool use. Prior research supported the use of an effective communication tool in the clinical setting to improve the handoff process. The Situation, Recommendation, Background, and Assessment (SBAR) handoff communication tool was implemented. There were two phases of the project implementation. Phase one was a didactic SBAR educational intervention taught by the project manager (PM). There was a pre and post SBAR knowledge test given and data was collected. The second phase focused on the observation of patient handoffs in the PACU. The measured outcomes of the EBP project demonstrated a 17% aggregate mean posttest score increase indicating a significant improvement in knowledge. Implementation of the SBAR led to evidence-based change in practice, standardization, and improved anesthesia handoff communication. Keywords: Handoff, communication, standardized handoff communication, post-anesthesia checklist, patient safety, and post-anesthesia care unit. " -- Abstract

Download or read book Improving Anesthesia Communication in the Post Anesthesia Care Unit a Handoff Tool written by Rene Daniel Garcia and published by . This book was released on 2019 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The Post Anesthesia Care Unit (PACU) is a dynamic place where multiple critical tasks occur at a rapid pace which elevates the risks for a medical error. A breakdown in communication during the patient handoff that occurs among the anesthesia providers and the PACU nurses can have detrimental patient outcomes. Patient safety may also be at risk when vital patient information is omitted during the anesthesia handoff. Research demonstrated that the use of a standardized handoff tool in the PACU setting increased patient safety by improving communication and the providers' satisfaction with the handoff process (Lambert, 2018). This evidence-based practice (EBP) change project sought to improve communication during this critical phase by utilizing the Written Handoff Anesthesia Tool (WHAT) as a standardized communication tool. The project manager used the Anesthesia Handoff Communication Survey to evaluate the anesthesia providers and the PACU nurses' satisfaction with the handoff. The PACU handoff communication tool survey (HCTS) was used to identify the adequacy, contributing factors, and specific patient data omitted by the senders (anesthesia providers) before and after the implementation of the WHAT. The adequacy of the handoff process significantly improved among the mentioned providers (p

Download or read book Utilizing Checklists to Improve Handoff in the Post Anesthesia Care Unit PACU written by Luis Tollinche and published by . This book was released on 2017 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: ImportanceMiscommunication from multiple care transfer has been shown to increase morbidity and mortality. To mitigate adverse events, use of checklists to standardize handoff communications in post anesthesia care unit (PACU) has been studied and shown to effectively reduce medical errors. ObjectiveThe goal is to establish measures to avoid miscommunication and improve patient safety through standardized PACU handoff protocol using a checklist.DesignA total of 120 handoffs were observed by two research assistants in real time for pre-implementation and post-implementation of a handoff checklist. 60 handoffs were observed for each pre- and post-implementation period. Using a 12-item checklist, each observer quantified items reported during every observed handoff. Additional data points, such as: duration of the report, training of the anesthesia staff giving report, and total number of questions asked by PACU staff were collected for further analysis.SettingM6 surgical floor post anesthesia care unit (PACU) at Memorial Sloan Kettering Cancer Center (MSKCC).Participants120 handoffs were observed between June 13, 2016 and July 15, 2016 from 10AM to 5PM., which included observation of interactions between RN, PACU midlevel providers (nurse practitioners, physician assistant), attending anesthesiologists, certified nursing anesthetists (CRNAs), anesthesiology residents, CRNA students, attending surgeons, surgical fellows, surgical residents, and surgical PA-C. Intervention(s) for clinical trials or exposure(s) for observational studiesDuring pre-implementation period, all staff were not informed of the research agenda. Post-implementation period, electronic and physical copy of the checklist were distributed to anesthesia staff only. At every observed handoff, anesthesia staff were reminded to follow the order of items on the checklist.Main outcome(s) and measure(s)u2022tOverall data transfer increased from 9 to 11 items during handoff with a checklist. u2022tMedian duration of handoff increased from 3 minutes to 4 minutes per handoff. u2022tNumber of follow up questions asked by PACU staff stayed consistent pre- and post-implementation period. u2022tImprovements in data transfer were independent of anesthesia training. Resultsu2022tImprovements in handoff were independent of duration of the report. The median number of 11 items stayed consistent through all lengths of reports.u2022tSurgical staff reported consistently a median of 6 items during pre- and post-implementation periods, whereas anesthesia staff improved from 5 reported items to 9. Overall handoff improvement is likely due to anesthesia staff report. u2022tData showed most improvement in anesthesia related items (ie. Allergies, Anesthesia Technique, and Airway) and least improvement in surgery related items (ie. Underlying diagnosis for the procedure, Procedure done, PACU plan, and Disposition).u2022t40 out of 60 staff were not compliant in following the order of the list. However, the 20 handoffs that adhered to the order reported a median of 12 items.Conclusions and RelevanceImplementation of a checklist for PACU handoff increased overall data transfer independent of duration of the report, improving patient safety. This result was noted across all trainings of anesthesia providers. For future directions, we recommend incorporating staff feedback into Plan-Do-Study-Act cycles for an improved checklist to ensure compliance and familiarize the staff with the use of a checklist through multimodal training modules.

Download or read book The Nurse Anesthetist O R to SICU Patient Handoff Implementing a Standardized SBAR Tool written by Nkiruka Udodi and published by . This book was released on 2018 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "The perioperative period involves complex tasks that create opportunities for medical errors. Complications suffered by critically ill surgical patients during transition of care in the perioperative period can have devastating results. Crucial to this time is the communication breakdown that often impedes an effective handoff process, thereby increasing risks for poor patient outcomes, as well as a decrease in the satisfaction of the care provided by certified registered nurse anesthetists (CRNAs). For these reasons, this evidence-based practice (EBP) change project sought to improve communication during the transition of care, by utilizing Situation, Background, Assessment, and Recommendation (SBAR) as a standardized reporting tool. During the seven-week implementation period, the direct observation of 45 handoff reports revealed a 100% (45/45) increased use of the SBAR tool from a 0% (0/30) use pre-implementation. Data collected before and after the implementation of the SBAR tool to determine the CRNAs' satisfaction with its use pre-and post-survey group mean score showed an increase from 2 to 4.4 (p

Download or read book Use of a Handoff Communication Tool Between Certified Registered Nurse Anesthetists Anesthesiologists and Post Anesthesia Care Unit Nurses written by Rachel Louise Johnson and published by . This book was released on 2016 with total page 104 pages. Available in PDF, EPUB and Kindle. Book excerpt: Ineffective communication in the post-anesthesia care unit (PACU) is considered to cause incidences of increased error, mortality, morbidity, which leads to decreased patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the patient transfer process. Using a structured handoff tool as the centerpiece for communication will require the development of routine actions by the anesthesia providers and the PACU nurse, which will introduce consistency in communication. An organized handoff process should be adopted as standard operating procedure as it will lessen much of the weak links in patient handoffs, which currently pose increased risks to morbidity, mortality, and generally undesirable outcomes to the patient care (Hudson, McDonald, Hudson, Tran, & Boodhwani, 2015; Nagpal et al., 2010a). This doctoral project assessed whether the introduction of a structured, standardized, and consistent communication handoff tool would result in favorable perception of usage. Evidenced-based studies were reviewed and supported the need to institute an effective handoff communication tool in the clinical setting. A well-known mnemonic communication tool "I PUT PATIENTS FIRST" designed by Moon, Gonzales, and Woods (2015) were introduced to the CRNAs, Anesthesiologists, and PACU RNs. The sample (N=28) consisted of CRNAs (n=14), Anesthesiologists (n=5), and PACU RNs (n=9) that used the tool for 2 weeks. To measure favorable perception of usage, this project included a post handoff survey that revealed favorable perception of usage of a communication tool as a means that could increase patient safety, decrease errors, and improve verbal communication, efficiency, and quality of care. --Page ii.

Download or read book Keeping Patients Safe written by Institute of Medicine and published by National Academies Press. This book was released on 2004-03-27 with total page 485 pages. Available in PDF, EPUB and Kindle. Book excerpt: Building on the revolutionary Institute of Medicine reports To Err is Human and Crossing the Quality Chasm, Keeping Patients Safe lays out guidelines for improving patient safety by changing nurses' working conditions and demands. Licensed nurses and unlicensed nursing assistants are critical participants in our national effort to protect patients from health care errors. The nature of the activities nurses typically perform â€" monitoring patients, educating home caretakers, performing treatments, and rescuing patients who are in crisis â€" provides an indispensable resource in detecting and remedying error-producing defects in the U.S. health care system. During the past two decades, substantial changes have been made in the organization and delivery of health care â€" and consequently in the job description and work environment of nurses. As patients are increasingly cared for as outpatients, nurses in hospitals and nursing homes deal with greater severity of illness. Problems in management practices, employee deployment, work and workspace design, and the basic safety culture of health care organizations place patients at further risk. This newest edition in the groundbreaking Institute of Medicine Quality Chasm series discusses the key aspects of the work environment for nurses and reviews the potential improvements in working conditions that are likely to have an impact on patient safety.

Download or read book Improving Nurse to nurse Hand off Communication at the Bedside Using SBAR written by Marie-Elena Barry and published by . This book was released on 2014 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Accurate communication during a patient transfer is essential to ensure safe and quality patient care; however studies have shown that over two-thirds of all adverse patient events including patient death are related to communication errors. Miscommunication between health care providers during hand-off communication, nurse shift change, or during an interdepartmental transfer presents a risk for sentinel events such as preventable patient falls. Performing nursing hand-off while using a standardized tool at the bedside has been identified as an important strategy to improve patient care, involve the patient in care, and to decrease miscommunication during nursing shift changes. An acute stroke rehabilitation unit implemented an evidence-based practice (EBP) project to; 1). Improve provider knowledge of bedside reporting using a standardized clinical hand-off tool: Situation-Background-Assessment-Recommendation (SBAR) and, 2). Determine if patient falls in an acute rehabilitation stroke unit will decrease after implementation of standardized bedside reporting. SBAR is a standardized communication tool that provides a framework for consistent communication and has been shown in multiple studies to effectively communicate patient information and reduce adverse patient events such as preventable falls. Through top down leadership changes, the SBAR communication tool was chosen and became the standard of care on the stroke unit." -- Abstract.

Download or read book Implementation Toolkit for Clinical Handover Improvement written by Australian Commission on Safety and Quality in Health Care and published by . This book was released on 2011 with total page 55 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Caring Matters Most written by Mark Lazenby and published by Oxford University Press. This book was released on 2017 with total page 177 pages. Available in PDF, EPUB and Kindle. Book excerpt: Caring Matters Most is a compact, highly readable book that explores the ethical nature of daily nursing practice and gives readers a path for being better nurses through the cultivation of five habits: trustworthiness, imagination, beauty, space, and presence. This book is an ideal resource for academic or practicing nurses interested in healthcare ethics or philosophy.

Download or read book Quality Management in Intensive Care written by Bertrand Guidet and published by Cambridge University Press. This book was released on 2016-02-15 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is one of the first to comprehensively summarise the latest thinking and research in the rapidly evolving field of quality management in intensive care. Quality indicators and outcome measures are discussed with a practical focus on patient-centred, evidence-based implementation for safer and more effective clinical practice. Chapters on topics such as teambuilding, patient satisfaction, mortality and morbidity, and electronic management systems are organised into three sections, covering quality management at the scale of the individual patient, the intensive care unit, and the national and international level. Written by a team of over forty international experts in the specialty, with editors who have been heavily involved for many years with the European Society of Intensive Care Medicine, the book reflects commonly accepted goals and guidelines for best practice, and will be valuable for practitioners worldwide. The ideal one-stop resource for intensive care physicians as well as ICU and hospital managers.

Download or read book Vignettes in Patient Safety written by Michael S. Firstenberg and published by BoD – Books on Demand. This book was released on 2018-01-10 with total page 204 pages. Available in PDF, EPUB and Kindle. Book excerpt: Over the past two decades, the healthcare community increasingly recognized the importance and the impact of medical errors on patient safety and clinical outcomes. Medical and surgical errors continue to contribute to unnecessary and potentially preventable morbidity and/or mortality, affecting both ambulatory and hospital settings. The spectrum of contributing variables-ranging from minor errors that subsequently escalate to poor communication to lapses in appropriate protocols and processes (just to name a few)-is extensive, and solutions are only recently being described. As such, there is a growing body of research and experiences that can help provide an organized framework-based upon the best practices and evidence-based medical principles-for hospitals and clinics to foster patient safety culture and to develop institutional patient safety champions. Based upon the tremendous interest in the first volume of our Vignettes in Patient Safety series, this second volume follows a similar vignette-based model. Each chapter outlines a realistic case scenario designed to closely approximate experiences and clinical patterns that medical and surgical practitioners can easily relate to. Vignette presentations are then followed by an evidence-based overview of pertinent patient safety literature, relevant clinical evidence, and the formulation of preventive strategies and potential solutions that may be applicable to each corresponding scenario. Throughout the Vignettes in Patient Safety cycle, emphasis is placed on the identification and remediation of team-based and organizational factors associated with patient safety events. The second volume of the Vignettes in Patient Safety begins with an overview of recent high-impact studies in the area of patient safety. Subsequent chapters discuss a broad range of topics, including retained surgical items, wrong site procedures, disruptive healthcare workers, interhospital transfers, risks of emergency department overcrowding, dangers of inadequate handoff communication, and the association between provider fatigue and medical errors. By outlining some of the current best practices, structured experiences, and evidence-based recommendations, the authors and editors hope to provide our readers with new and significant insights into making healthcare safer for patients around the world.

Download or read book Implementation of Bedside Shift Report in the Medical Surgical Unit written by Perla Alday and published by . This book was released on 2015 with total page 32 pages. Available in PDF, EPUB and Kindle. Book excerpt: Change of shift report is a critical time when nurses transfer information about the patient. Failure to communicate efficiently can cause medical errors. A typical nurse-to-nurse report does not allow the visualization of the patient or patient/family concerns to be addressed. This can cause vital information to be missed, therefore placing the patient at risk. In order to provide safe patient care, the adequate transfer of information needs to be provided. To decrease the frequency of medical errors, the implementation of a standardized communication tool is required. The use of bedside shift report is essential to nursing practice. Bedside repot is a method of nurse to nurse handoff communication performed at the patient's bedside. Nurses are able to assess the patient in person while obtaining vital information. A nurse's accountability can be higher while including the patient in their plan of care and patient satisfaction improved. Any issues and concerns can be addressed at the moment, increasing patient safety. As concerns arise with the traditional method of nursing handoff tool, the need for bedside shift report is needed to increase patient safety, therefore decreasing the number of medical errors and sentinel events. Bedside shift report is implemented to a medical surgical unit with the main goal of increasing patient safety using an improved method of nurse-to-nurse handoff communication. This paper will describe the problem, solution to the process of the issue, implementation plan, evaluation, and dissemination plan. It will also describe studies before and after the implementation with nurse and patient's perception of the process. Results from the review of studies shown reveal how other clinical settings have benefited from bedside shift report, improving patient's safety.

Download or read book Improving Patient Outcomes Through Use of the Teach back Method in the Post Anesthesia Care Unit written by Kathleen O'Sullivan and published by . This book was released on 2014 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: The setting for this Clinical Nurse Leader (CNL) project was the Post Anesthesia Care Unit (PACU) at a level I trauma center in the Bay Area. The goal was to improve the discharge education performed by the PACU nurses to improve patient safety and decrease the chance of complications or readmissions to this hospital. With no clear instructions for how discharge teaching should be done, the nurses have many differing styles which leaves room for gaps in discharge planning. This influenced the implementation of the teach-back method during discharge planning in order to ensure proper education and increased patient understanding. A literature review revealed that the teach-back method has helped to decrease hospital readmissions and prevents complications patients may experience during home self-care. The Joint Commission, Agency for Healthcare Research and Quality, and the Institute for Healthcare Improvement all state that the teach-back method for discharge planning is best practice. Project data was collected through observation, microsystem assessments and through nurse and patient surveys. Interventions included nurse education at staff meetings, one on one in-service educations and teach-back handouts. The pre-intervention nurse survey (n=26) showed that 80% of the nurses were familiar with the teach-back method while only 36% of nurses used teach-back during discharge planning regularly. The patient survey (n=25) revealed that patients were able to retain 68% of the information presented during discharge education. One on one in-service education on the teach-back method is still being conducted at this time, with high nurse satisfaction. Follow-up surveys will commence when 100% of the staff have completed the in-service. The expected final outcome of this project is the implementation of the teach-back method during discharge planning by all nurses and increased patient understanding of discharge education.

Download or read book Application of the Patient Checklist Tool in Anesthesia Handoffs written by and published by . This book was released on 2017 with total page 48 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Accurate and essential communication is required during the transfer of patient care from one health care provider to another. Communication errors during the handoff process have been identified as contributing factors in sentinel events. There is a plethora of literature supporting a standardized transfer of care process as well as several accepted handoff communication tools for the various units within a healthcare institution. However, in the anesthesia domain, there is currently only one protocol specifically created for the transfer of patient care between certified registered nurse anesthetists (CRNAs). The PATIENT protocol, created by Dr. Suzanne M. Wright, CRNA, PhD (2013) provides a systematic approach in reporting accurate patient information during the transfer of care process. The purpose of this exploratory replication scholarly project was to determine if CRNAs believed the established PATIENT transfer of care protocol enhances communication between CRNAs during the anesthesia handoff process. Descriptive statistics and correlation methods were utilized and analysis of the data suggest the majority of CRNA participants liked the idea of a standardized TOC tool and agreed the PATIENT protocol provided an effective way to organize patient information. The PATIENT protocol is a tool that could be implemented during all anesthesia transfer of care periods promoting safe anesthesia practice leading to positive patient outcomes."--Abstract.

Download or read book Patient Safety and Quality written by Ronda Hughes and published by Department of Health and Human Services. This book was released on 2008 with total page 592 pages. Available in PDF, EPUB and Kindle. Book excerpt: "Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

Download or read book Guide to Health Informatics written by Enrico Coiera and published by CRC Press. This book was released on 2015-03-06 with total page 690 pages. Available in PDF, EPUB and Kindle. Book excerpt: This essential text provides a readable yet sophisticated overview of the basic concepts of information technologies as they apply in healthcare. Spanning areas as diverse as the electronic medical record, searching, protocols, and communications as well as the Internet, Enrico Coiera has succeeded in making this vast and complex area accessible and understandable to the non-specialist, while providing everything that students of medical informatics need to know to accompany their course.

Download or read book Moderate Procedural Sedation and Analgesia E Book written by Michael Kost and published by Elsevier Health Sciences. This book was released on 2019-03-09 with total page 314 pages. Available in PDF, EPUB and Kindle. Book excerpt: Introducing the definitive resource designed for practitioners working in the rapidly expanding area of moderate procedural sedation and analgesia clinical practice. Moderate Procedural Sedation and Analgesia: A Question and Answer Approach focuses on the preprocedural, procedural, and postprocedural care of the moderately sedated patient in a variety of settings. This comprehensive text is designed to provide all the content and tools nurses and other clinicians need to demonstrate competency in moderate sedation and analgesia. Additionally, this user-friendly text is written by well-known sedation/analgesia expert, Michael Kost and recommended by standards of practice from the ANA, AORN, and the American Academy of Pediatrics. New clinically focused text ensures clinicians involved in the administration and management of patients receiving moderate sedation have access to the most up-to-date information. Strong safety focus throughout the book explains how technology and clinician practice can improve sedation administration. Chapters organized in clinical problem/question plus answer format help you easily comprehend material. Follows the latest TJC Sedation/Anesthesia Guidelines ensuring you are ready for medication administration in clinical practice. Pediatrics and Geriatrics chapters cover specific sedation practice recommendations that address the substantive clinical practice challenges associated with these patient populations. Pharmacologic profiles of medications detail their use in the moderate sedation practice setting.