Effective communication is essential for patient safety because many medical errors are related with failure in communication between medical providers. The reason why communication failure occurs can be found in communication block by teamwork malfunction, communication skills that are not trained and standardized, and problems occurring during handoffs. Teamwork malfunction is usually caused by vertical hierarchy and interpersonal conflicts, which interrupts speaking up, expressing concerns, and sharing opinions. Communication skills that are not trained and standardized often result in miscommunication and omission of critical information. Structured and standardized communication techniques such as SBAR (situation-background-assessment-recommendation) should be implemented and developed. Handoff, which moves patient information to other staff, is a highly risky process, which also needs standardization along with implementation of checklists to reduce medical errors.
Checklist ; Humans ; Medical Errors ; Patient Handoff ; Patient Safety*

Effective communication is essential for patient safety because many medical errors are related with failure in communication between medical providers. The reason why communication failure occurs can be found in communication block by teamwork malfunction, communication skills that are not trained and standardized, and problems occurring during handoffs. Teamwork malfunction is usually caused by vertical hierarchy and interpersonal conflicts, which interrupts speaking up, expressing concerns, and sharing opinions. Communication skills that are not trained and standardized often result in miscommunication and omission of critical information. Structured and standardized communication techniques such as SBAR (situation-background-assessment-recommendation) should be implemented and developed. Handoff, which moves patient information to other staff, is a highly risky process, which also needs standardization along with implementation of checklists to reduce medical errors.
Checklist ; Humans ; Medical Errors ; Patient Handoff ; Patient Safety*

PURPOSE: This descriptive research was conducted to identify educational needs in pediatric nursing handoff training to improve students' handoff skills. METHODS: Data were collected using a survey with 188 senior nursing students and 48 pediatric nursing professors and clinical nurses. The survey included items on general information as well as experiences in handoff training, necessity, training content, and items for a handoff training program in pediatric nursing. RESULTS: Of the nursing students, 30.5% reported receiving handoff training during their clinical hours. After their handoff training, the students' confidence index was only 3.78 out of 10. Significantly, 98.3% of the respondents said that pediatric handoff training is necessary. In addition, participants reported that simulation practice (26.5%) is an appropriate educational method, and the time required for handoff training should be 8.16 hrs. Admission process was placed first as the most critical circumstance for handoff (56.8%). High demands were observed for the necessity of training content for patients with respiratory problems. CONCLUSION: The results of this study show the various educational needs for developing a patient safety pediatric handoff training program to promote nursing students' skills in handoff.
Surveys and Questionnaires ; Education ; Humans ; Needs Assessment* ; Nursing* ; Patient Handoff ; Patient Safety ; Pediatric Nursing* ; Students, Nursing*

PURPOSE: To date no studies have specifically evaluated the use of handovers amongst core surgical trainees (CSTs) in the United Kingdom. We examined handover practice at the Oxford School of Surgery to assess and improve CSTs' perception of handover use as well as its quality, and ultimately patient care. METHODS: Based on guidelines published by the British Medical Association and Royal College of Surgeons, a 5-point Likert style questionnaire that collected data on handover practice, its educational value, and the CSTs'satisfaction with handover was given to 50 CSTs in 2010. RESULTS: Forty CSTs (80.0%) responded to the questionnaire. The most striking findings revolved around the perceived educational value, formal training, and auditing practice of handovers throughout various units, which were all remarkably lower than expected. As a result, handover practice amongst CSTs was targeted and revised at the University Hospital's Department of Plastic Surgery, with the implementation of targeted changes to improve handover practice. CONCLUSION: The execution of daily handovers was an underused educational tool amongst surveyed CSTs and may be an important modality to target, particularly in the competency-based, time-limited training CSTs receive. We recommend modifications to current practice based on our results and the literature and encourage the assessment of handover practice at other institutions.
Great Britain ; Humans ; Patient Care ; Patient Handoff ; Strikes, Employee ; Surgery, Plastic ; Surveys and Questionnaires

INTRODUCTIONThe aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio.

METHODSA multifaceted approach was adopted, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months. Handover information transfer (i.e. senders' and recipients' verbal communication, and recipients' handwritten notes) and handover environmental factors were analysed. The relationship between 'to-do' tasks, and information transfer, handover quality and handover duration, were examined using analysis of variance.

RESULTSVerbal handovers for 152 patients were observed; handwritten notes on 102 (67.1%) patients and handover quality ratings for the handovers of 98 (64.5%) patients were collected. Although there was good task prioritisation (information transfer: p < 0.005, handover duration: p < 0.01), incomplete information transfer and poor implementation of nonmodifiable identifiers were observed. The high sender/recipient ratio of the hospital made face-to-face and/or bedside handover difficult to implement. Although the current handover method (i.e. use of telephone communication), allowed interactive communication, it resulted in systemic information loss due to the lack of written information. The handover environment was chaotic in the high sender/recipient ratio setting, and the physicians had no designated handover time or location.

CONCLUSIONHandovers in high sender/recipient ratio settings are challenging. Efforts should be made to improve the handover processes in such situations, so that patient care is not compromised.

Adult ; Communication ; Continuity of Patient Care ; Data Collection ; Female ; Hospitals, University ; Humans ; Male ; Patient Handoff ; Patient Safety ; Physicians ; Singapore ; Young Adult

PURPOSE: Shift work is inherent to emergency medicine practice. However, the intershift handoff between emergency physicians has been identified as a high-risk area for medical errors. We evaluated the current handoff processes in an emergency department in Korea and the attitudes of emergency medicine residents toward the need for standardized guidelines. METHODS: A questionnaire survey was conducted on emergency medicine residents working in training hospitals (one resident per hospital) in Korea. The questionnaire asked about the current handoff method, whether there was a standardized handoff format, and asked residents on their experiences and opinions about the handoff practice. RESULTS: A total of 29 emergency medicine residents responded to the survey. A majority of hospitals were found to have no uniform handoff format in their emergency department (26 hospitals, 90%). In addition, only a small number of hospitals had an educational program for intershift handoff (7 hospitals, 24%). A large majority of responders (97%) reported experiencing medical errors related to handoff. CONCLUSION: There is currently a significant lack of handoff format or educational programs on intershift handoff in Korean emergency medicine training hospitals. Further research and effort for the establishment of effective standardized handoff and training programs are strongly needed.
Education ; Emergencies* ; Emergency Medicine* ; Korea* ; Medical Errors ; Methods ; Patient Handoff ; Surveys and Questionnaires

PURPOSE: This study was conducted to develop a handoff education program for nursing students and examine the effects of it on nursing students'self-efficacy, communication ability, and clinical performance ability. METHODS: A quasi-experimental design was used with a nonequivalent control group pretest-posttest method. The experimental group (n=31) received handoff education using SBAR; the control group (n=31) received non-SBAR handoff education. Self-efficacy, communication ability, clinical performance ability were measured to evaluate the effects of the program. RESULTS: The experimental group showed significant improvements in self-efficacy (p<.001), and communication ability (p=.025) compared to the control group. However, there was no significant difference in the clinical performance ability between the groups (p=.618). CONCLUSION: The results indicate that the handoff education program using SBAR is effective in improving nursing students'self-efficacy and communication ability.
Communication ; Education ; Humans ; Methods ; Nursing ; Patient Handoff ; Self Efficacy ; Students, Nursing

OBJECTIVE: This study investigated and compared the perspectives on emergency medicine (EM) professionalism competencies of medical students and EM residents. In addition, how they learned their EM professionalism was also investigated to develop the base of an educational program of professionalism in the field of EM. METHODS: Medical students in four medical colleges/schools and EM residents were recruited for the questionnaire. Regarding the importance and educational need for EM professionalism, 23 items for medical students and 59 items for EM residents were asked. The items were rated on a five point Likert scale. The perspectives of the two groups were compared. The learning methods for professionalism were investigated. RESULTS: A total of 198 medical students and 109 EM residents responded to the questionnaire. The residents responded with mean of 3.0 or more on all items, agreeing on the importance and educational need. On the other hand, the mean scale was less than 4.0 in communication and cooperation with society and social accountability. The students responded with a mean scale of 4.0 or more on all items and agreed on the importance and educational need. Of the 23 common items, there were differences between the two groups in 17 items, showing a higher mean value in the students. The most common methods of learning EM professionalism was bedside teaching during the clinical clerkship for students, and patient handover or board round for residents. CONCLUSION: EM residents tended to place more importance on medical care than social communication, cooperation, and ethical items. The most common learning method of EM professionalism was clinical practice-associated activities. The results of this study could help to develop a systematic and realistic educational program of EM professionalism in EM clerkship and resident training.
Clinical Clerkship ; Emergencies ; Emergency Medicine ; Hand ; Humans ; Learning ; Methods ; Patient Handoff ; Professionalism ; Social Responsibility ; Students, Medical

PURPOSE: This study was done to analyze the effectiveness of simulation-based integrated practice program (maternal-child) on nursing knowledge, self-confidence, and clinical competence of nursing students. METHODS: A nonequivalent control group pre-post experimental design was used to compare experimental and control group. The experimental group received the integrated simulation practice and the control group received a separate simulation for maternal care and for newborn care. RESULTS: The experimental group who had the integrated simulation had significantly higher scores for self-efficacy on nursing handover (F=0.480 p=.012) and oxygen therapy in newborn care (F=3.262 p=.037), and for clinical competence (F=2.639, p<.001) and personal satisfaction with debriefing compared to the control group (F=2.179, p=.044). But the experimental group did not have significantly higher scores in nursing knowledge. Conclusions The results indicate that an integrated simulation practice is an effective practice method to improve self-confidence, clinical competence and satisfaction. Also this study had significance in providing a setting similar to the clinical situation.
Clinical Competence ; Humans ; Infant, Newborn ; Nursing* ; Oxygen ; Patient Handoff ; Patient Simulation ; Personal Satisfaction ; Research Design ; Students, Nursing*

PURPOSE: The purpose of this study was to develop a model for handoff education for nursing students based on simulation using video and to identify educational effects of a simulated situation in pediatric care units. METHODS: Data were collected from May 1 to 30, 2016. Participants were 84 senior nursing students in Seoul(video group: 43, simulation group: 41). Both groups were given a lecture and pre-briefing on handoff education. The simulation group had nursing practice on resolving health issues for respiratory distress using a high-fidelity baby simulator. The video group watched a video recording of a scenario based simulation, and used a summarized handoff situation to practice patient handoff to another student. RESULTS: There was no significant difference between the two groups for handoff self-confidence, problem solving ability, handoff competence(self-assessment of students), or learning satisfaction. Self-confidence increased significantly in both groups. Handoff competency evaluated by the instructor was higher in the video group compared to the simulation group(t=2.33, p=.022). CONCLUSION: Nursing student education for handoff practice utilizing a video in the pediatric unit was more cost effective. Therefore, it could be a useful educational method for students in learning patient handoff practices and helpful for related research.
Clinical Competence ; Education ; Humans ; Learning ; Methods ; Nursing ; Patient Handoff ; Patient Simulation ; Pediatric Nursing ; Problem Solving ; Students, Nursing ; Video Recording