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An exploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit
Authors:McFetridge Brian  Gillespie Mark  Goode Deborah  Melby Vidar
Institution:B McFetridge, RN, BSc (Hons) Nursing, PG Cert Specialist Nursing Practice –Critical Care, PG Dip Education for Nurses, Midwives and Health Visitors, Lecturer in Nursing, School of Nursing, University of Ulster, Magee Campus, Londonderry, UK;;M Gillespie, BSc (Hons), RN, MSc, PG Dip Nurse Education, PG Cert Specialist Nursing Practice, Lecturer in Nursing, School of Nursing, University of Ulster, Magee Campus, Londonderry, UK;;D Goode, MSc, PG Dip Nurse Ed, PG Cert Specialist Practice Nursing, BSc (Hons), RN, School of Nursing, University of Ulster, Magee Campus, Londonderry, UK;;V Melby, MPhil, BSc (Hons), PGCTHE, RN, RNT, Senior Lecturer in Nursing, School of Nursing, University of Ulster, Magee Campus, Londonderry, UK
Abstract:The transfer of information between nurses from emergency departments (EDs) and critical care units is essential to achieve a continuity of effective, individualized and safe patient care. There has been much written in the nursing literature pertaining to the function and process of patient handover in general nursing practice; however, no studies were found pertaining to this handover process between nurses in the ED environment and those in the critical care environment. The aim was to explore the process of patient handover between ED and intensive care unit (ICU) nurses when transferring a patient from ED to the ICU. This study used a multi-method design that combined documentation review, semistructured individual interviews and focus group interviews. A multi-method approach combining individual interviews, focus group interviews and documentation review was used in this study. The respondents were selected from the ED and ICU of two acute hospitals within Northern Ireland. A total of 12 respondents were selected for individual interviews, three nurses from ED and ICU, respectively, from each acute hospital. Two focus groups interviews were carried out, each consisting of four ED and four ICU nurses, respectively. Qualitative analysis of the data revealed that there was no structured and consistent approach to how handovers actually occurred. Nurses from both ED and ICU lacked clarity as to when the actual handover process began. Nurses from both settings recognized the importance of the information given and received during handover and deemed it to have an important role in influencing quality and continuity of care. Nurses from both departments would benefit from a structured framework or aide memoir to guide the handover process. Collaborative work between the nursing teams in both departments would further enhance understanding of each others' roles and expectations.
Keywords:Communication  Critical care  Documentation  Emergency care  Information transfer  Patient handover
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