Amy J Spooner1, Leanne M Aitken2, Amanda Corley3, Wendy Chaboyer4. 1. The Prince Charles Hospital, Critical Care Research Group, Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia. Electronic address: amyjspooner@gmail.com. 2. NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia; School of Nursing and Midwifery, Griffith University, Nathan, Australia; Intensive Care Unit, Princess Alexandra Hospital, Woolloongabba, Australia; School of Health Sciences, City University London, London, United Kingdom. 3. The Prince Charles Hospital, Critical Care Research Group, Intensive Care Unit, The Prince Charles Hospital, Brisbane, Australia. 4. NHMRC Centre of Research Excellence in Nursing, Menzies Health Institute Queensland, Griffith University, Gold Coast, Australia.
Abstract
BACKGROUND: Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. OBJECTIVES: The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. METHODS: This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited. Focus groups were conducted using a nominal group technique to generate and prioritise minimum dataset items. Nurses were presented with content from previous team leader handovers and asked to select which content items to include in a minimum dataset. Participant responses were summarised as frequencies and percentages. RESULTS: Seventeen senior nurses participated in three focus groups. Participants agreed that ISBAR (Identify-Situation-Background-Assessment-Recommendations) was a useful tool to guide clinical handover. Items recommended to be included in the minimum dataset (≥65% agreement) included Identify (name, age, days in intensive care), Situation (diagnosis, surgical procedure), Background (significant event(s), management of significant event(s)) and Recommendations (patient plan for next shift, tasks to follow up for next shift). Overall, 30 of the 67 (45%) items in the Assessment category were considered important to include in the minimum dataset and focused on relevant observations and treatment within each body system. Other non-ISBAR items considered important to include related to the ICU (admissions to ICU, staffing/skill mix, theatre cases) and patients (infectious status, site of infection, end of life plan). Items were further categorised into those to include in all handovers and those to discuss only when relevant to the patient. CONCLUSIONS: The findings suggest a minimum dataset for intensive care nursing team leader shift-to-shift handover should contain items within ISBAR along with unit and patient specific information to maintain continuity of care and patient safety across shift changes.
BACKGROUND: Despite increasing demand for structured processes to guide clinical handover, nursing handover tools are limited in the intensive care unit. OBJECTIVES: The study aim was to identify key items to include in a minimum dataset for intensive care nursing team leader shift-to-shift handover. METHODS: This focus group study was conducted in a 21-bed medical/surgical intensive care unit in Australia. Senior registered nurses involved in team leader handovers were recruited. Focus groups were conducted using a nominal group technique to generate and prioritise minimum dataset items. Nurses were presented with content from previous team leader handovers and asked to select which content items to include in a minimum dataset. Participant responses were summarised as frequencies and percentages. RESULTS: Seventeen senior nurses participated in three focus groups. Participants agreed that ISBAR (Identify-Situation-Background-Assessment-Recommendations) was a useful tool to guide clinical handover. Items recommended to be included in the minimum dataset (≥65% agreement) included Identify (name, age, days in intensive care), Situation (diagnosis, surgical procedure), Background (significant event(s), management of significant event(s)) and Recommendations (patient plan for next shift, tasks to follow up for next shift). Overall, 30 of the 67 (45%) items in the Assessment category were considered important to include in the minimum dataset and focused on relevant observations and treatment within each body system. Other non-ISBAR items considered important to include related to the ICU (admissions to ICU, staffing/skill mix, theatre cases) and patients (infectious status, site of infection, end of life plan). Items were further categorised into those to include in all handovers and those to discuss only when relevant to the patient. CONCLUSIONS: The findings suggest a minimum dataset for intensive care nursing team leader shift-to-shift handover should contain items within ISBAR along with unit and patient specific information to maintain continuity of care and patient safety across shift changes.