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Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants HCA (2014) Shift Handover: A Training Programme for Nurses & Heath Care Assistants Name: Date: Faciitated by: Cinica Strategy and Programmes Division Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 1

2 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Tabe of Contents Suggested Programme Outine...4 Part 1: Introduction...5 Part 2: Existing Practice...6 Part 3 (a): Best Practice...7 Part 3 (b): HCA Handover...9 Part 3 (c): Meet and Greet...10 Part 4 (a): Impementing Change: ISBAR...11 Part 4 (b): Impementing Change: Supporting Resources...14 Part 4 (c): Impementing Change: Best Practice Concepts...16 Part 5: Consoidating Change...18 References...19 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 3

Suggested Programme Outine Wecome/Introductions/My Name is? (10 minutes) Introduction & Background to Shift Handover Part 1: Introduction (10 minutes) Part 2: Existing Practice (15 minutes) Part 3 (a): Best Practice (20 minutes) Part 3 (b): Heathcare Assistant Handover (20 minutes) Part 3 (c): Meet & Greet (15 minutes) Part 4 (a): Impementing Change: ISBAR (20 minutes) Part 4 (b): Impementing Change: Supporting Resources (15 minutes) Part 4 (c): Impementing Change: Best Practice Concepts (15 minutes) Part 5: Consoidating Change: Group Work (Scenarios/Probem Soving) / Sustainabiity & Moving Forward (30 minutes) Part 6: Concusion & Programme Evauation (10 minutes) Note to A Participants: As the programme content is deivered through a variety of teaching methodoogies (DVD, Refective Practice & Group Exercises), the purpose of this workbook is to faciitate each participant to document key earning points from the DVD and/or observations from refective practice/group exercises. It can subsequenty be used as a reference document for Shift Handover as required. Additiona resources to be provided as required: ISBAR Tempate Patient Status Communication Sheet Handover Prompts Handover Operationa Procedure Safety Pause Information Sheet Evauation Form Pease note this programme has received NMBI (Nursing and Midwifery Board of Ireand) Category 1 Approva and has been awarded 4.5 CEU s (Continuing Education Units) 4 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Part 1: Introduction; Expected Learning Outcomes: Participants wi understand how to conduct a cear, comprehensive, person centred handover within a timey manner using a standardised, structured format to achieve the foowing key objectives: Improved Patient Outcomes Reduced Near Miss/Adverse Incidents Reduced Repetition Improved Patient Satisfaction Rates Enhanced Safety and Effectiveness in the Deivery of Care. Enhanced Education within Handover Improved Quaity of Information Disseminated within Handover Reduced Length of Handover Subsequent Increase in the Amount of Time Avaiabe to Provide Care Directy to Patients. Discussion: Refective Questions What are your thoughts on handover? What are the current chaenges you face in handover? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 5

Part 2: Existing Practice; Expected Learning Outcomes: Participants wi understand; The deficits of existing handover practices The interna and externa forces affecting shift handover processes How ineffective handover processes can infuence patient outcomes Discussion: Refective Questions What did you observe within that cip? / What were the positive/negative aspects of the handover process? Is this what happens in your setting? / Are you famiiar with this type of handover? What are the key issues arising from this handover? How woud you sove these issues? 6 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Part 3 (a): Best Practice; Expected Learning Outcomes: Participants wi understand: How the best practice handover process works Key eements affecting shift handover processes How effective handover processes can infuence patient outcomes Discussion: Refective Questions Are you famiiar with this type of handover? What are the main differences between this and the previous handover process? What were the positive/negative aspects of the handover process? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 7

How wi this impact on the deivery of care? Do you think this coud work in your setting? What coud be the chaenges to impementing this handover process? 8 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Part 3 (b): HCA Handover: Expected Learning Outcomes: Participants wi understand: The importance of incuding the HCA in handover to communicate key eements of patient care The type of information that is required by the HCA to deiver care within his/her scope of practice How effective handover processes between the nurse and HCA can infuence patient outcomes Discussion: Refective Questions What did you observe within that cip? Is this what happens in your setting? Do you think this approach wi work? How this wi affect the deivery of patient care? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 9

Part 3 (c): Meet and Greet: Expected Learning Outcomes: Participants wi understand: The concept of Meet and Greet The importance of Meet and Greet in affecting the therapeutic reationship between patients and staff The importance of Meet and Greet in supporting effective communication processes and patient safety as part of handover Discussion: Refective Questions What did you observe within that cip? Is this what happens in your setting? Do you think this approach wi work? How this wi affect the deivery of patient care? 10 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Part 4 (a): Impementing Change: ISBAR (Identify, Situation, Background, Assessment and Recommendation): Expected Learning Outcomes: Participants wi understand; What ISBAR is and how it is used in tandem with the nursing process and a chosen mode of nursing to support the exchange of reevant information in a structured, standardised format. Exampes of Information given under each heading of ISBAR are: Identify: Name Age Address or Pace of Residence Consutant Date of Admission Situation (Observations): Admitting Probem/Reason for Admission Reevant Past Medica/Surgica History Resuscitation Infection Prevention and Contro (IPC) Status Current Treatments Competed Investigations Reevant Test Resuts Aergies Estimated Date of Discharge Observations: Eary Warning Score (EWS) Vita Signs Frequency of Observations Teemetry Background: Living Conditions Socia History (incuding Toos such as This is Me, for exampe, which may be used for patients with dementia/cognitive impairment). Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 11

Assessment: The information exchanged here shoud correspond with the patient probems/nursing diagnoses documented within the care pan. he foowing exampes are based on the Activities of Daiy Living used as part of the Roper, Logan and Tierney Mode of Nursing and are incuded here for iustration ony. Maintaining Safe Environment: Pressure Areas Waterow Score Intravenous (IV) Cannuae and Visua Infusion Phebitis (VIP) Score Eating and Drinking: Dietary Requirements Assistance with Dietary Requirements Fuid Baance Intake and Output Weights Mobiising: Mobiity Fas Risk Assessment Recommendations (Recap, Review & Responsibiities) What needs to happen today? Nursing Needs Concerns Outstanding Referras Pending Tests/Investigations/Procedures Discharge Pan or Overa Pan of Care Any Other Comments or Actions needed Safety Pause 12 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Discussion: Refective Questions Are you famiiar with ISBAR as a communication too? / Have you used ISBAR prior to this (either in handover or as a genera communication too)? Do you think ISBAR can support handover? How wi ISBAR enhance the exchange of information at handover? How wi using ISBAR affect the deivery of patient care? Referring to the mode of nursing and assessment process used in your cinica area, is there additiona information that shoud be incuded under each heading of ISBAR? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 13

Part 4 (b): Impementing Change: Supporting Resources: Expected Learning Outcomes: Participants wi understand; What the supporting resources are and how they are used as part of handover to support a structured, standardised approach to the exchange of reevant information. ISBAR Tempate: Handover Prompts: Patient Status Communication Sheet: Handover Operating Procedure: 14 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Discussion: Refective Questions Do you think these resources can support handover? Can you think of other resources that may support handover? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 15

Part 4 (c): Impementing Change: Best Practice Concepts: Expected Learning Outcomes: Participants wi understand; What best practice in Shift Handover entais How best practice concepts are incorporated into handover to support a structured, standardised approach to the exchange of reevant information On the Move: Patient Communication Boards: Cear Roes and Responsibiities: Safety Pause: Identification of Priorities: 16 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Confidentiaity: Discussion: Refective Questions Are you famiiar with these best practice concepts? Do you think these best practice concepts can support handover? How wi the best practice concepts affect the deivery of patient care? Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 17

Part 5: Consoidating Change: Expected Learning Outcomes: Participants wi understand: How the best practice handover process works Key eements affecting shift handover processes How effective handover processes can infuence patient outcomes Discuss how to sustain the improvements made through impementation of the best practice process Participants are required to deveop fictiona patient scenarios to engage in the opportunity to simuate a handover using ISBAR and the supporting resources Discussion: Refective Questions How wi you impement the best practice handover process in your area? How wi you engage your coeagues to participate in the best practice handover process? How wi you sustain the improvements you have made? Thank you for your participation in this programme and pease compete the evauation form. Your feedback is required to inform future programmes. 18 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

References Cahi, J. (1998) Patient s Perceptions of Bedside Handovers. Journa of Cinica Nursing. 7 (4). 351-359. Cited in Scove, S. (2010) Roe of the Nurse to Nurse Handover in Patient Care. Nursing Times 24 (20), 35-39. Coins, G. (2014) Using Simuation to Deveop Handover Skis. Nursing Times. 110 (8) 12-14. Francis R (2013) Report of the Mid Staffordshire NHS Foundation Trust Pubic Inquiry, The Mid Staffordshire NHS Foundation Trust, Stationary Office, London, United Kingdom Hoban, V (2003) How to Hande a Handover. Nursing Times. 99 (9) 54-55. HIQA (2013) Patient Safety Investigation Report into Services at University Hospita Gaway (UHG) HIQA, Dubin, Ireand HIQA (2013) Nationa Standards for Safer Better Heathcare HIQA, Dubin, Ireand Department of Heath (2013) Nationa Cinica Effectiveness Committee: Nationa Eary Warning Score: Nationa Cinica Guideine No. 1. Department of Heath, Dubin, Ireand. Department of Heath & HSE Quaity & Patient Safety Directorate (2013) The Safety Pause Information Sheet. Department of Heath & HSE, Dubin, Ireand. Keogh, B. (2013) Review into the Quaity of Care and Treatment Provided by 14 Hospita Trusts in Engand, NHS, United Kingdom. HSE (2011) HSE Standards and Recommended Practices for Heathcare Records Management. HSE, Dubin,Ireand. Lamond, D. (2000). The Information Content of the Nurse Change of Shift Report: A Comparative Study. Journa of Advanced Nursing. 31(4), 794-804. NHS Institute for Innovation & Improvement (2008) Reeasing Time to Care, The Productive Ward. Shift Handovers, Version 2. NHS, United Kingdom. NHS Institute for Innovation & Improvement (2008) Reeasing Time to Care, The Productive Ward. Patient Status at a Gance, Version 3. NHS, United Kingdom. Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 19

Roper N., Logan W.W. & Tierney A.J. (2000). The Roper-Logan-Tierney Mode of Nursing: Based on Activities of Living. Edinburgh: Esevier Heath Sciences. Scove, S. (2010) Roe of the Nurse to Nurse Handover in Patient Care. Nursing Times 24 (20), 35-39. Wong, MC., Yee, KC., Turner P. (2008) Cinica Handover Literature Review. Tasmania, eheath Services Research Group, University of Tasmania. Cited in Coins, G. (2014) Using Simuation to Deveop Handover Skis. Nursing Times. 110 (8) 12-14. Word Heath Organisation (2007) Coaborating Centre for Patient Safety Soutions. Communication during Patient Hand-Overs. Patient Safety Soutions. Geneva, WHO. 20 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

Notes: Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014) 21

Notes: 22 Participant Workbook For Shift Handover: A Training Programme for Nurses and Heath Care Assistants (2014)

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