The development and implementation of a framework for best practice with regard to nursing/midwifery shift handover
Wynne-Jones, Jacqueline Anne
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Any point, at which transfer of information about the care or condition of a patient occurs, has the potential for communication to be ineffective or inadequate, leading to compromised care. This includes shift handover, ward /hospital transfers, discharge, and individual transfer of care. Handover of information among nurses/midwives occurs frequently. Continuity of care is fragmented due to the various shifts worked by nursing/ midwifery staff. Therefore a consistent approach to clinical handover is important to ensure effective, accurate information transfer. With this project, I have acknowledged the problems that poor, or, no communication produces. I have explored different ways of handing over, by looking at studies nationally and internationally. Current practice from three wards at Waikato hospital was identified from staff questionnaires and patient interviews. Best practice was then piloted on three wards (one of which was rural). Feedback from patients was overwhelmingly supportive of the new standardised process. Most nurses also supported the new handover practice. Following feedback from staff and patients post trial, recommendations have been made for best practice. These recommendations have been supported with a package to acknowledge and facilitate a smooth implementation. This package includes guidelines, and a tool, as well as statements to address issues identified around privacy. The challenge now is for strong leaders to support the organisation, and facilitate this change in practice.