Quality Improvement of Nursing Handover in a Trauma Unit, Uttaradit Hospital

Abstract

The objective of this study was to develop a quality improvement for nursing handover in a trauma unit, Uttaradit Hospital. This study used the FOCUS-PDCA continuous quality improvement process, which included nine steps: 1) identify a process to improve; 2) organize to improve the process; 3) clarify current knowledge of the process; 4) understand the source of process variation; 5) select the process improvement; 6) plan the improvement; 7) do the improvement; 8) check the results and act to hold the gain; and 9) make improvements continuously. The study also concurrently used the concept of the SBAR communication process, consisting of four steps: 1) situation; 2) background; 3) assessment; and 4) recommendation. The purposive sampling technique was used to select participants. Participants were 18 registered nurses from the trauma unit at Uttaradit Hospital, organized into two teams: three from the quality development team and 15 from the operations team. The research instruments were interview guidelines, an observation checklist guideline for nursing handover, and an incident report. Data were analyzed using descriptive statistics (frequency and percentages).

Results revealed that after applying the FOCUS-PDCA continuous quality improvement process and the SBAR communication process, registered nurses could correctly and completely perform more than 80% of the nursing handover protocol, and no incidents were found from nursing handover. Therefore, nursing administrators in other departments can apply this nursing handover development as a guideline to improve their nursing handover in order to continuously improve the quality of patient care