Pediatric Critical Care Medicine:
May 2014 - Volume 15 - Issue 4_suppl - p 200
Changing The Practice Of 'Chinese Whispers': An Action Research Approach To Optimise ThePICUNursing Shift Handover
Davis, C.; Coetzee, M.
Background and aims: Described as being similar to a chain of 'Chinese Whispers', handover of information between health professionals is internationally recognised as a necessary but potentially risky aspect of patient care. Consequently, the WHO called for a standardised handover approach. Effecting a change in healthcare has been identified as a challenge and an increased use of participative change management methodologies is emerging in response.
Aims: The aim was, by use of a participative approach, to optimise the quality and efficiency of nursing shift handover in the PICU at Red Cross Children's Hospital.
Methods: Ethics approval was gained and an action research approach was applied. Nurses from the study setting, together with the researcher, worked in action research cycles to diagnose existing handover practice and plan, implement and evaluate appropriate optimisation strategies.
Results: The study concentrated on the bedside and unit handover. Analysis of the bedside handover identified challenges related to content and process which led to a handover information form being developed and conversations to optimise the time window for handover. Analysis of the unit handover also emphasised difficulties with process and so was converted to an electronic handover presentation. A standard operating procedure was proposed to make the optimal bedside and unit handover practice explicit.
Conclusions: Evaluation of optimisation strategies demonstrated potential to optimise the pre-existing handover practice. Implementing change was however challenging since people need to be ready for change. Handover also impacts on other aspects of care provision and a constant need for re-engagement with management is constrained by clinical service taking priority.