A change which was introduced in my facility was clinical bedside handover between nurses. The Australian Commission on Safety & Quality in Health Care defined clinical handover as “the transfer of responsibility and accountability for some or all aspects of care for a patient, or group on temporary or permanent basis” (quoted in Anderson, Malone, Shanahan, & Manning, 2015, p. 2). The change to bedside clinical handover occurred slowly over time, and may be described as evolutionary.
There was a change agent that headed a team responsible for the change. The change agent and the team helped members of the staff understand the change and the important it would have on patient care. Members of staff were allowed to contribute by making their views known in relation to the change. Clinical handover is no longer done at the station. The change was motivated by the understanding that accurate communication during handover is crucial to the quality of care and safety of patients. Clinical handover at the station was suspected to be associated with serious communication problems, which might have adverse effects on patient care. It was expected that bedside handover would enhance patient-centered care and patient safety, especially because they enhance the continuity of care (Anderson et al., 2015; Chaboyer et al., 2009).
During the change process, nurses might improve communication and quality of care by encouraging reflection during handover, as well as mentoring. Bedside handover was used to mentor junior staff members as well as to socialize newcomers into our nursing culture (Chaboyer et al., 2009). New staff members and newcomers have a meaningful way of learning professional goals and values and developing group cohesion (Anderson et al., 2015).
In conclusion, the change that has occurred in my facility involves the transfer of patient responsibility and accountability between nurses. Clinical handover is now done at the bedside. There is no nursing done at the station. Bedside handover was considered as an opportunity to improve patient safety and patient outcomes. It also introduced an opportunity for mentoring and teaching. The change might be seen as evolutionary.
References
Anderson, J., Malone, L., Shanahan, K., & Manning, J. (2015). Nursing bedside clinical handover: An integrated review of issues and tools. Journal of Clinical Nursing, 24(5-6), 662-671.
Chaboyer, W., McMurray, A., Johnson, J., Hardy, L., Wallis, M., & Chu, F. Y. S. (2009). Bedside handover: Quality improvement strategy to “transform care at the bedside”. Journal of Nursing Care Quality, 24(2), 136-142.
