The quality of intensive care unit nurse handover related to end of life: a descriptive comparative international study

2.50
Hdl Handle:
http://hdl.handle.net/11287/593935
Title:
The quality of intensive care unit nurse handover related to end of life: a descriptive comparative international study
Authors:
Ganz, F. D.; Endacott, R.; Chaboyer, W.; Benbinishty, J.; Ben Nun, M.; Ryan, H.; Schoter, Amanda; Boulanger, Carole; Chamberlain, W.; Spooner, A.
Abstract:
BACKGROUND: Quality ICU end-of-life-care has been found to be related to good communication. Handover is one form of communication that can be problematic due to lost or omitted information. A first step in improving care is to measure and describe it. OBJECTIVE: The objective of this study was to describe the quality of ICU nurse handover related to end-of-life care and to compare the practices of different ICUs in three different countries. DESIGN: This was a descriptive comparative study. SETTINGS: The study was conducted in seven ICUs in three countries: Australia (1 unit), Israel (3 units) and the UK (3 units). PARTICIPANTS: A convenience sample of 157 handovers was studied. METHODS: Handover quality was rated based on the ICU End-of-Life Handover tool, developed by the authors. RESULTS: The highest levels of handover quality were in the areas of goals of care and pain management while lowest levels were for legal issues (proxy and advanced directives) related to end of life. Significant differences were found between countries and units in the total handover score (country: F(2,154)=25.97, p=<.001; unit: F(6,150)=58.24, p=<.001), for the end of life subscale (country: F(2, 154)=28.23, p<.001; unit: F(6,150)=25.25, p=<.001), the family communication subscale (country: F(2,154)=15.04, p=<.001; unit: F(6,150)=27.38, p=<.001), the family needs subscale (F(2,154)=22.33, p=<.001; unit: F(6,150)=42.45, p=<.001) but only for units on the process subscale (F(6,150)=8.98, p=<.001. The total handover score was higher if the oncoming RN did not know the patient (F(1,155)=6.51, p=<.05), if the patient was expected to die during the shift (F(1,155)=89.67, p=<.01) and if the family were present (F(1,155)=25.81, p=<.01). CONCLUSIONS: Practices of end-of-life-handover communication vary greatly between units. However, room for improvement exists in all areas in all of the units studied. The total score was higher when quality of care might be deemed at greater risk (if the nurses did not know the patient or the patient was expected to die), indicating that nurses were exercising some form of discretionary decision making around handover communication; thus validating the measurement tool.
Citation:
Int J Nurs Stud. 2015 Jan;52(1):49-56.
Publisher:
Elsevier
Journal:
International journal of nursing studies
Issue Date:
1-Jan-2015
URI:
http://hdl.handle.net/11287/593935
DOI:
10.1016/j.ijnurstu.2014.07.009
PubMed ID:
25443309
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S0020-7489(14)00192-8
Type:
Journal Article; Comparative Study
Language:
eng
ISSN:
1873-491X
Appears in Collections:
2015 RD&E publications; Intensive Care Unit (ICU); Clinical School publications

Full metadata record

DC FieldValue Language
dc.contributor.authorGanz, F. D.en
dc.contributor.authorEndacott, R.en
dc.contributor.authorChaboyer, W.en
dc.contributor.authorBenbinishty, J.en
dc.contributor.authorBen Nun, M.en
dc.contributor.authorRyan, H.en
dc.contributor.authorSchoter, Amandaen
dc.contributor.authorBoulanger, Caroleen
dc.contributor.authorChamberlain, W.en
dc.contributor.authorSpooner, A.en
dc.date.accessioned2016-01-19T12:37:36Zen
dc.date.available2016-01-19T12:37:36Zen
dc.date.issued2015-01-01en
dc.identifier.citationInt J Nurs Stud. 2015 Jan;52(1):49-56.en
dc.identifier.issn1873-491Xen
dc.identifier.pmid25443309en
dc.identifier.doi10.1016/j.ijnurstu.2014.07.009en
dc.identifier.urihttp://hdl.handle.net/11287/593935en
dc.description.abstractBACKGROUND: Quality ICU end-of-life-care has been found to be related to good communication. Handover is one form of communication that can be problematic due to lost or omitted information. A first step in improving care is to measure and describe it. OBJECTIVE: The objective of this study was to describe the quality of ICU nurse handover related to end-of-life care and to compare the practices of different ICUs in three different countries. DESIGN: This was a descriptive comparative study. SETTINGS: The study was conducted in seven ICUs in three countries: Australia (1 unit), Israel (3 units) and the UK (3 units). PARTICIPANTS: A convenience sample of 157 handovers was studied. METHODS: Handover quality was rated based on the ICU End-of-Life Handover tool, developed by the authors. RESULTS: The highest levels of handover quality were in the areas of goals of care and pain management while lowest levels were for legal issues (proxy and advanced directives) related to end of life. Significant differences were found between countries and units in the total handover score (country: F(2,154)=25.97, p=<.001; unit: F(6,150)=58.24, p=<.001), for the end of life subscale (country: F(2, 154)=28.23, p<.001; unit: F(6,150)=25.25, p=<.001), the family communication subscale (country: F(2,154)=15.04, p=<.001; unit: F(6,150)=27.38, p=<.001), the family needs subscale (F(2,154)=22.33, p=<.001; unit: F(6,150)=42.45, p=<.001) but only for units on the process subscale (F(6,150)=8.98, p=<.001. The total handover score was higher if the oncoming RN did not know the patient (F(1,155)=6.51, p=<.05), if the patient was expected to die during the shift (F(1,155)=89.67, p=<.01) and if the family were present (F(1,155)=25.81, p=<.01). CONCLUSIONS: Practices of end-of-life-handover communication vary greatly between units. However, room for improvement exists in all areas in all of the units studied. The total score was higher when quality of care might be deemed at greater risk (if the nurses did not know the patient or the patient was expected to die), indicating that nurses were exercising some form of discretionary decision making around handover communication; thus validating the measurement tool.en
dc.language.isoengen
dc.publisherElsevieren
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S0020-7489(14)00192-8en
dc.titleThe quality of intensive care unit nurse handover related to end of life: a descriptive comparative international studyen
dc.typeJournal Articleen
dc.typeComparative Studyen
dc.identifier.journalInternational journal of nursing studiesen

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