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

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    URI
    http://hdl.handle.net/11287/593935
    Author
    Ganz, F. D.
    Endacott, Ruth
    Chaboyer, W.
    Benbinishty, J.
    Ben Nun, M.
    Ryan, H.
    Schoter, Amanda
    Boulanger, Carole
    Chamberlain, W.
    Spooner, A.
    Date
    2015-01-01
    Journal
    International journal of nursing studies
    Type
    Journal Article
    Comparative Study
    Publisher
    Elsevier
    DOI
    10.1016/j.ijnurstu.2014.07.009
    Metadata
    Show full item record
    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 URL
    http://linkinghub.elsevier.com/retrieve/pii/S0020-7489(14)00192-8
    Collections
    • 2015 RD&E publications
    • Clinical School publications
    • Intensive Care Unit (ICU)
    • Nursing & Allied Health professionals

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