001 Can we make the emergency department handover safer?

Abstract

Background Handover of care is one of the most perilous procedures in medicine.1 The unique shift-based work in the ED, where there is a high degree of patient turnover, unpredictability and patient volume can create challenges to good quality clinician and nursing handover. The above highlights a need for an improved and standardised patient bedside handover tool for both clinicians and nurses involving and empowering patients and families. Both handover tools will cement safe continuity of information between shift changes and improved communication with patients and families. Method and results A standard operating procedure, flowchart and clinician’s handover tool was designed to maximise safe handover as illustrated in [figure 1][1]. The tool has been introduced into the department since June 2017. After the introduction of the tool, an evaluation survey of 30 participants across various grades of clinicians was performed. ![Abstract 001 Figure 1][2] Abstract 001 Figure 1 Clinicians handover tool Building on the success of the clinician’s handover tool; a standard operating procedure, flowchart and the first standardised nurse’s handover tool was designed as illustrated in [figure 2][3]. ![Abstract 001 Figure 2][2] Abstract 001 Figure 2 Nurses handover tool Conclusions For the month of September 2017, 30 completed surveys evaluating the clinician’s handover tool was collected. 100% positive responses were received stating they found it useful. The handing over clinicians commented feeling more satisfied that ‘their patient was appropriately and safely handed over at the bed side in front of the family’. The nurse’s handover over tool was praised as nurses felt ‘happier’ with handover and more satisfied to leave shift ‘without forgetting significant patient information’. Both tools have become routine practice within the ED and are very useful adjuncts to improve patient safety within the department. Multidisciplinary handover post-shift work at the bedside has become standardised practice and improved patient safety with continuity of care with these tools. Regular ongoing audit have demonstrated that the tools are routinely used by both clinicians and nurses. Reference 1. British Medical Association. Safe handover: safe patients. Guidance on clinical handover for clinicans and managers. London: BMA, 2004. [1]: #F1 [2]: pending:yes [3]: #F2