LAUSR

Quality Improvement in Nursing Clinical Handover Nursing Clinical handover(CH) is a crucial point of vulnerability in patient care that can lead to errors and/or adverse events if incomplete or inaccurate (Department of health 2015, Manias et al 2016).The Department of Health clinical guidelines for CH (2015) key recommendations are use of a communication tool such as ISBAR3 (identify, situation, background, assessment, recommendation, readback, risk), involve patient/carer and verbal handover with written documentation. A literature search regarding research into nursing clinical handover yielded multiple articles supporting these recommendation but no gold standard process identified yet. Many research methods were used to evaluate CH both qualitative and quantitative. A change to existing process was necessary to improve timeliness of process, increase efficiency and effectiveness of handover, reduce risk of errors associated with clinical handover, promote interaction during handover as per the national guidelines and to involve parents/patients in handover as per national guidelines A new 3 step CH process, based on the national guidelines and up to date research literature, was introduced on a surgical ward specialising in neurosurgery and craniofacial surgery in Temple Street Children’s University Hospital, Dublin in Feb 2108 following an audit of previous practice. Subsequent audit and staff survey identified the benefits of the new process which has since been implemented by other wards in the hospital The new CH process has succeeded in implementing the national guidelines and is a quality improvement project that addresses patient safety, reduction in medication errors, improvements in metrics data, facilitates ‘hello my name is’, and use of the communication tool ISBAR 3. It improves communication with patients and families and also improves time management as nurses can finish on time and reduces by 50% the time a nurse is away from patients for handover. One to one handover in quiet area (incl any undergrad or supernumerary students as per allocated area) Bedside review of each patient with both commencing and finishing nurse Group handover in office with all staff