Content and Methods of Clinical Information Exchange during Nursing Handoff

Benham-Hutchins, Marge

Monday, 31 October 2011

Marge Benham-Hutchins, RN, PhD
College of Nursing - Denton Campus, Texas Woman's University, Denton, TX

Learning Objective 1: Describe the use of exploratory social network analysis for examining nursing handoff communication.

Learning Objective 2: Discuss the methods used by nurses assuming patient care to access clinical information.

The transfer of patient responsibility between nurses during shift change is a complex process that is particularly vulnerable to communication error that may result in medical error, increased length of stay, redundant or unnecessary laboratory and diagnostic testing, and/or patient dissatisfaction. Research is needed to inform both workflow and health information technology design principles that support the exchange of clinical information between nurses during shift change. This poster will present preliminary findings from an ongoing study that examines how nurses prefer to exchange patient information and what specific patient information is desired by the nurses assuming care.

Purpose: The purpose of this descriptive, exploratory study is to clarify the content and methods of clinical information exchange used by nurses during shift change handoff.

Aims: 1. Identify how nurses exchange patient clinical information during shift change handoff. 2. Identify the clinical information required and/or desired by nurses assuming care of a patient including content (by diagnosis); source of information/method of exchange (paper, electronic, verbal); provider source; and which source is preferred by the nurse and why. 3. Examine the use of synchronous and asynchronous (paper, electronic) communication methods.

Setting and Sample: The setting is an urban teaching hospital; three medical-surgical units participated. Institutional review board approval was obtained. The sample for this ongoing study is consenting nurses participating in a shift change handoff in a participating unit.

Data Collection: Observation and a network analysis questionnaire.

Analysis: Exploratory social network analysis incorporates methodological pluralism. Information exchange (relational) data was analyzed using social network analysis metrics; demographic data was examined using descriptive statistics, and qualitative thematic content analysis was used to examine the results of open ended questions and observation data.

Findings: Preliminary findings indicate extensive use of the electronic health record (EHR) and minimal verbal exchange of patient information.

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