Quality Improvement of Nursing Handover, Surgical Intensive Care Unit, Uttaradit Hospital

Abstract

Nursing handover is a method to communicate important patient information from one nurse shift to another shift in order to ensure quality continuing care and patient safety. The purpose of this developmental study was to improve the quality of nursing handover in the Surgical Intensive Care Unit at Uttaradit Hospital using the FOCUS-PDCA continuous quality improvement process. This method consists of nine steps: find a process to improve; organize a team that knows the process; clarify current knowledge of the process; understand causes of process variation; select the process improvement; plan the improvement; do the improvement; check the results; act to hold the gain and continue improvement Deming 1993, as cited in McLaughlin & Kaluzny, 1999). Participants included thirteen registered nurses. The research instruments were interview guidelines, an observation checklist, satisfaction, barriers and suggestions for quality improvement of nursing handover in the future and the record of incidents caused by nursing handover. Data were analyzed using descriptive statistics and content analysis.

            Results revealed that after using the FOCUS-PDCA continuous quality improvement process and SBAR technique for communication, registered nurses could correctly and completely perform more than 96 percent of nursing handover protocol and no incidents were found from nursing handover. All registered nurses were satisfied with the nursing handover protocol because of the clarity of the critical issues of patients which saved time. There was evidence of referrals for patient care information. Problem and suggestions for quality improvement of nursing handover in the future included incomplete critical or risk issues, some nurses did not completely review the patient^’s data and did not visiting assess patients before performing nursing handover.

            The results of this study showed that improving the way nurses report patient information during the change of shift contributes to good nursing handover culture. There is a common practice standard, beneficial for nurse to perform the nursing handover process and a good outcome to patient. As a result, nursing administrators can apply this protocol to improve the quality of nursing handovers in other units.