Structural equation modeling was employed on cross-sectional survey data collected from a large sample of nurses in Canada (N = 2,174). The aim of this article was to examine a moderated mediation model whereby high-involvement work practices are purported to reduce nurses' burnout via psychological empowerment, and colleague support is expected to moderate the mediating role of psychological empowerment in the high-involvement work practices-burnout link. The impact of human resource practices on nurses' well-being, the underlying mechanisms involved, and the contextual factors that enhance or impede their success are not fully clear.
These strategies had a significant effect on reducing medication errors related to handovers. The multi-modal approach improved the comprehensiveness and completeness of clinical nursing handovers. Medication error incidents related to handovers was reduced by 72% over a six-month period. However, handovers of detailed observations of patients improved from 72.7% to 87.9% (p = 0.215) and handovers of relevant history of patients improved slightly from 93.9% to 97.0% (p = 1.000) but was not statistically significant. The results of the post-implementation audit of nurses performing handovers (n = 33) showed that handovers using standardized documentation improved from 0% to 21.0% (p = 0.005), which was statistically significant. An evidence-based four-pronged approach was employed, including adequate human resource coverage during handovers, a structured and standardized handover, visual cues and a teaching video. The pre- and post-implementation audits were conducted using JBI PACES audit criteria.
This project was implemented in three phases from January 2017 to November 2017 at three adult surgical wards of a tertiary hospital, utilizing the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) module. Thus, evidence-based interventions were needed so that patient handovers and continuity in safe patient care could improve. These resulted in ineffective handovers and compromised the patient's safety. In three adult surgical wards of a Singapore tertiary hospital, a lack of consistency was found in the local handover process when shifts changed. Nurses use structured handover tools to handover patient information. The objective of this evidence-based quality improvement project was to improve clinical nursing handovers between registered nurses.Ĭlinical nursing handovers transfer critical information about the patient's care to oncoming shift nurses. Nursing leaders play a significant role in supporting the project and building a positive evidence-based practice environment. Further audits are required to sustain the evidence-based practice change. The project has successfully improved nurses' clinical handovers and contributed to safe patient care. Eighty-two per cent of the nurses felt that the handover guide had reduced the number of monitoring errors and delays in treatment. Verbal face-to-face handovers occurred throughout the implementation. Registered nurses' handovers of patient information to enrolled nurses improved from 11% to 27% (P < 0.000). The post-intervention audit showed a significant increase (P < 0.001) in the compliance of handover of essential patient information. The baseline audit in March 2017 revealed a poor compliance in handover of essential patient information. The project utilized the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tools.
This project was conducted in two orthopedic wards of a tertiary hospital, and occurred in four phases over 12 months. Non-standardized, incomplete handovers can lead to delays or errors in treatment, increased lengths of stay, and poor health outcomes.
Handover techniques vary in different healthcare organizations. Nursing handover involves the transfer of the responsibility of care for a patient from one nurse to another. This evidence-based quality improvement project aimed to evaluate the effectiveness of a handover guide in improving handovers from registered nurses to enrolled nurses.
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