Change-of-shift report
A change-of-shift report, also referred to as a sign-out report or handoff, is a critical component in the healthcare setting, particularly in hospitals. This document facilitates the transfer of vital patient information from outgoing healthcare providers, such as nurses, to their incoming counterparts at the end of a work shift. The primary purpose of this report is to ensure continuity of care, allowing the next shift to be informed about the patient’s condition, treatment updates, and any significant changes that occurred during the previous shift.
Effective change-of-shift reports aim to minimize the risk of harm to patients by clearly identifying major health concerns that may require prompt attention. They typically include details like medication schedules, vital signs, and specific notes on patient responses to treatments. To enhance patient safety, healthcare organizations have implemented standardized handoff communication processes, which are designed to be thorough and minimize miscommunication. Privacy concerns also arise during these discussions, as they may occur in public areas of hospitals, potentially compromising patient confidentiality. Some institutions have adopted bedside shift reporting to directly associate information with the patient, thereby reinforcing safety and privacy.
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Change-of-shift report
A change-of-shift report, also known as a sign-out report or handoff, is an essential hospital document that allows a healthcare provider such as a nurse whose work shift is ending to transfer inpatient information to hospital personnel on the next work shift who will be caring for the patient. This transfer of information allows continuity in providing care to a patient who has been hospitalized. This report also serves as a venue for healthcare personnel to discuss any changes that the patient might have developed during the most recent shift, thereby summarizing patient progress. One of the most important goals of change-of-shift reports is to reduce the risk of harm to patients by identifying major health issues that require immediate medical attention.
Overview
Previous studies have shown that the utilization of change-of-shift reports plays a major role in patient care, because it ensures continuity in healthcare services for the patient. The relaying of information allows healthcare personnel to provide a similar level of care to the patient regardless of time of day or shift. This information may include the time and dosage of medications given to the patient, vital signs such as temperature, blood pressure, and pulse rate, and any changes in the patient’s response to treatment. Change-of-shift reports are essential, because they identify any issues that require extra monitoring or treatment during the next shift.
In 2006 the Joint Commission made handoff communication a National Patient Safety Goal for US health care organizations accredited by the commission. To meet this goal, health care organizations are expected to have a standardized handoff communication process. The process should be completed the same way each time; include verbal, in-person communication; be a two-way conversation that allows staff to ask and respond to questions, and limit distractions and interruptions.
One issue that has been linked to change-of-shift reports is the venue for discussion of patient conditions during turnover. It is possible that such discussion between outgoing and incoming personnel are performed in the hallway or nurses’ stations of hospitals where patients, family members, and other visitors could hear the discussion, thus violating patient privacy.
The transfer of sufficient and correct information to the incoming shift of healthcare personnel also poses a challenge. Miscommunication of patient information may be detrimental to the patient, particularly when it involves the administration of the wrong drug, dose, or procedure. It is also possible that the information provided by outgoing personnel may be linked to the wrong patient. To address this problem, bedside shift reporting has been adapted by certain hospitals, which allows the association of specific medical information to the actual patient situated next to them, thereby increasing patient safety.
Bibliography
Capek, Justin, Jane Pascarella, and Danielle Wymard-Tomlinson. "Effective Communication at Change of Shift." Nursing 2013 Critical Care 8.5 (2013): 22–24. Digital file.
Friesen, Mary Ann, Susan V. White, and Jacqueline F. Byers. "Chapter 34; Handoffs: Implications for Nurses." Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Ed. R. G. Hughes. Rockville: Agency for Healthcare Research and Quality, 2008. NCBI. Web. 11 Aug. 2016.
Jeffs, L., et al. "Clinicians’ Views on Improving Inter-Organizational Care Transitions." BMC Health Services Research 13:289 (2013): n.pag. Print.
Patton, Kurt A. Handoff Communication: Safe Transitions in Patient Care. Global ed. N.p.: HCPro, 2007. Digital file.
Pincavage A. T. "What Do Patients Think about Year-End Resident Continuity Clinic Handoffs? A Qualitative Study." Journal of General Internal Medicine 28.8 (2013): 999–1007. Print.
Starmer, A. J., et al., I-PASS Study Education Executive Committee. "Development, Implementation, and Dissemination of the I-PASS Handoff Curriculum: A Multisite Educational Intervention to Improve Patient Handoffs. Academic Medicine 89.6 (2014): 876–84. Print.