Intrahospital Handovers before and after the Implementation of ISBAR Communication: A Quality Improvement Study on ICU Nurses’ Handovers to General Medical Ward Nurses
Abstract
:1. Introduction
2. Aim
3. Materials and Methods
3.1. Design
3.2. Quality Improvement Method
3.3. Setting
3.4. Sample and Recruitment
3.5. Inclusion Criteria
3.6. The ISBAR Intervention
3.7. Instrument
3.8. Statistical Analysis
3.9. Ethical Considerations
4. Results
4.1. Adherence to the 26 Items in the ISBAR Scoring Tool
Domain | ISBAR Items | Baseline (n = 25) N (%) | Post-Int (n = 25) N (%) | Difference | p-Value |
---|---|---|---|---|---|
Identification | 1. State patients name | 20 (80) | 24 (96) | 4 (16%) | 0.189 b |
2. State year of birth | 20 (80) | 23 (92) | 3 (12%) | 1.00 b | |
Situation | 3. State reason for admission | 25 (100) | 24 (96) | −1 (−4%) | 1.00 b |
4. State date of admission | 23 (92) | 22 (88) | −1 (−4%) | 1.00 b | |
5. Give a brief summary of the treatment provided | 23 (92) | 25 (100) | 2 (8%) | 0.490 b | |
6. State current condition | 22 (88) | 25 (100) | 3 (12%) | 0.235 b | |
7. State any infection and type of isolation | 10 (40) | 4 (16) | −6 (−24%) | 0.114 b | |
Background | 8. State previous illnesses of significance | 23 (92) | 22 (88) | −1 (−4%) | 1.00 b |
9. List medications of importance | 22 (88) | 21 (84) | −1 (−4%) | 1.00 b | |
10. State allergy if relevant | 1 (4) | 1 (4) | 0 (0%) | 1.00 b | |
11. Indicate significant psychological and cognitive state | 17 (68) | 20 (80) | 3 (12%) | 0.333 a | |
12. State physical function level and mobilisation status | 21 (84) | 22 (88) | 1 (4%) | 1.00 b | |
13. State care needs and any dialogue with the municipality | 16 (64) | 16 (64) | 0 (0%) | 1.00 a | |
14. State special conditions for relatives (children < 18 years) | 6 (24) | 8 (32) | 2 (8%) | 0.529 a | |
Assessment Airway Breathing | 15. State observations (SaO2, RR, expectorate, blood gas) | 22 (88) | 20 (80) | −2 (−8%) | 0.702 b |
16. State treatment (O2 supplementation, inhalations, PEP/PEEP, pulmonary physiotherapy) | 19 (76) | 20 (80) | 1 (4%) | 0.733 a | |
Circulation | 17. State observations (BP, HR, temperature, diuresis) | 23 (92) | 23 (92) | 0 (0%) | 1.00 b |
18. State treatment (IV accesses, IV treatment/infusion) | 18 (72) | 21 (84) | 3 (12%) | 0.306 a | |
Disability | 19. State observations of level of awareness (GCS/AVPU, pupils, MR/CT, NHISS score) | 7 (28) | 11 (44) | 4 (16%) | 0.239 a |
Exposure | 20. State elimination status and any treatment | 20 (80) | 20 (80) | 0 (0%) | 1.00 a |
21. State nutritional status (diet, nutrition score and treatment) | 18 (72) | 19 (76) | 1 (4%) | 0.747 a | |
22. State any pain (VAS and pain treatment) | 11 (44) | 9 (36) | −2 (−8%) | 0.564 a | |
23. State any wounds or risk of wounds | 9 (36) | 8 (32) | −1 (−4%) | 0.765 a | |
24. If not mentioned earlier, brief summary of examinations (performed/planned) or blood tests | 21 (84) | 20 (80) | −1 (−4%) | 1.00 b | |
Recommendation | 25. Recommend follow-up treatment | 22 (88) | 22 (88) | 0 (0%) | 1.00 b |
26. State any treatment restriction (CPR/respirator minus) | 0 (0) | 3 (12) | 3 (12%) | 0.235 b |
4.2. Adherence to the Structure of the ISBAR Communication
4.3. Time Spent on the Handover
5. Discussion
6. Limitations
7. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Public Involvement Statement
Guidelines and Standards Statement
Use of Artificial Intelligence
Acknowledgments
Conflicts of Interest
References
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Mean (Seconds) | Median (Seconds) | Percentiles (25–75%) | p-Value | |
---|---|---|---|---|
Baseline | 293 | 277 | 93–591 | 0.184 a |
Post-intervention | 246 | 216 | 70–592 |
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Reime, M.H.; Tangvik, L.S.; Kinn-Mikalsen, M.A.; Johnsgaard, T. Intrahospital Handovers before and after the Implementation of ISBAR Communication: A Quality Improvement Study on ICU Nurses’ Handovers to General Medical Ward Nurses. Nurs. Rep. 2024, 14, 2072-2083. https://doi.org/10.3390/nursrep14030154
Reime MH, Tangvik LS, Kinn-Mikalsen MA, Johnsgaard T. Intrahospital Handovers before and after the Implementation of ISBAR Communication: A Quality Improvement Study on ICU Nurses’ Handovers to General Medical Ward Nurses. Nursing Reports. 2024; 14(3):2072-2083. https://doi.org/10.3390/nursrep14030154
Chicago/Turabian StyleReime, Marit Hegg, Linda Skaug Tangvik, Mats Aleksander Kinn-Mikalsen, and Tone Johnsgaard. 2024. "Intrahospital Handovers before and after the Implementation of ISBAR Communication: A Quality Improvement Study on ICU Nurses’ Handovers to General Medical Ward Nurses" Nursing Reports 14, no. 3: 2072-2083. https://doi.org/10.3390/nursrep14030154