Proposed Topic (Most preferred): :
Clinical Safety and Quality Service II (Projects aiming to enhance clinical safety and outcomes, clinical governance / risk management)
Proposed Topic (Second preferred): :
HA Young Investigators Session (Projects to be presented by HA staff who had joined HA for 10 years or less)
Authors (including presenting author) :
Raymond LEUNG (1), Karin CHOW (1), TMH Stroke Nursing Team
Affiliation :
(1) Stroke Nursing Team, Acute Stroke Unit, Department of Medicine and Geriatrics, Tuen Mun Hospital
Introduction :
Clinical handover is an important element in nursing to ensure accurate communication of clinical condition and risk among nurses. Traditionally, nursing handover is done verbally, which structure of handover is highly individualized. The absence of organized and unified handover may lead to redundance of work and possible miscommunication. To make situation worse, specialty nurses often need to work with patients in multiple wards and require a systematic patient list for handover. Therefore, Tuen Mun Hospital Stroke Nursing Team trialed the use of standardized electronic handover to improve the situation.
Objectives :
To evaluate the use and impact of electronic nursing handover in specialty nursing setting.
Methodology :
Pilot quality improvement project with quantitative and qualitative evaluation.
Result & Outcome :
A shared spreadsheet was created and hosted on Hospital Authority owned “HA Teams” platform. The spreadsheet consisted of patients’ personal information and clinical progress for handover. Stroke nurses manually updated the spreadsheet during handover. The platform was set up since June 2023 and piloted for 3 months. 15 stroke nurses participated in the trial and completed a post evaluation. Over 450 entries were created and updated during the trial.
The overall satisfaction score of the novel platform was 7.4 out of 10. Participant reported that the platform allowed simple overview of all patients’ status without need of accessing each patient’s record during handover. The platform also enabled straightforward update of information. However, some challenges were reported, such as increased time spent in preparation due to need of manual creation and transcription of information. Rapid patient turnover rate in stroke unit also resulted in demands of frequent patient list updates.
The pilot project demonstrated the feasibility and potential of using standardized electronic nursing handover in stroke nursing. The electronic handover improved the communication and efficiency among stroke nurses. However, some improvements are needed to put the platform into actual clinical use, such as better interfacing with clinical system to enable automated patient information transfer and update. Integration with digital healthcare documentation workflow to empower functions like automatic capture of vital signs and clinical progress could also be considered. The electronic handover could also benefit other healthcare workers and promote more effective clinical handover and ultimately promote better patient safety.
