Page 116 - HA Convention 2015

Service Priorities and Programmes Free Papers

SPP2.6 Staff Empowerment 13:15 Room 221

Monday, 18 May Transforming Clinical Handover in Nursing with Identify, Situation, Background Assessment and
Recommendation (ISBAR)
Szeto SM, Cheung TY, Ng M, Ng ML, Chan MK, Leung YP, Leung CC, Lau MK, Tong YC
Surgery Department, Ruttonjee and Tang Shiu Kin Hospitals, Hong Kong

Introduction

Effective clinical handover may improve the continuity of patient care and safety. Using the “Identify, Situation, Background,
Assessment and Recommendation” (ISBAR) as handover tool can provide a structured and standardised patient information
in clinical handover, and can ensure transferred patient’s information is more focus, timely and accurate which contributes to
safe patient care.

Objectives

(1) To develop a systematic and standardised process of shift-to-shift clinical handover in nursing; (2) to ensure effectiveness
and efficiency of nurses’ communication in clinical handover; and (3) to ensure the completeness of patient information in
clinical handover.

Methodology

The programme was piloted in a female surgical ward. Questionnaires of clinical handover were collected from nurses
in pre- and post-study. A cue card and checklist with ISBAR model were developed as a framework and handover tool
to guide and educate all nurses in shift handover. Scenarios of handover report were designed to fit in the five elements
of ISBAR for education and demonstration. Four months was spent on simulated training and empowering for nurses.
Outcome measurements included the nurses’ compliance rate of using ISBAR handover tool, handover time counting and
staff’s satisfaction by using the new handover tool. The positive result of the programme was shared and extended to male
surgery ward. The male surgery ward adopted the same methodology except to develop a checklist and audit form of ISBAR
handover tool to suit the male ward’s needs.

Results

Three weeks’ direct observation were evaluated. The average handover time in both wards was efficient. Female ward had
16% improvement in the first week, 23% in the second week and 22% in the third week. In male ward, the total average
handover time had been decreased by 28.57%. The compliance rate of using the ISBAR handover tool was over 93% in both
surgery wards. Results of staff satisfaction were positive in female ward: The number of nurses agreeing that some irrelevant
patient information reduced by using new handover tool was increased by a significant rate of 37%; staff satisfaction was
increased by 31% with the new current handover model, satisfaction with the duration of clinical handover was increased
by 25%; satisfaction that the new handover model can obtain patient’s most updated information accurately was increased
by 19%. The number of nurses agreeing that the unified duty handover mode can improve duty handover effectively was
raised by 12%. In male ward, prominent increase in 42% of nurses satisfied with the new handover tool and 31% increase in
handover time and irrelevant patient information reduced by new handover tool was increased by 37%.

Conclusion

Using ISBAR as clinical handover model are effective and efficient that can contribute to patient safety, minimise
communication error. Finally, nurse can spend more time in patient care.

HOSPITAL AUTHORITY CONVENTION 2015

114