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In a health care setting, handoff communication between medical personnel plays a critical role in ensuring patient safety and improving the effectiveness of patient care, and problems with this type of communication may lead to highly adverse results. This paper investigates problems that may occur during communication between members of the perioperative staff and provides some recommendations that might help address these problems so as to improve the quality of medical service in a perioperative setting.
Literature Review
On the whole, the research literature indicates that handoff communication among nurses, as well as between nurses and other medical staff members, is pivotal for the safety of the patient in a perioperative setting (Braaf, Riley, & Manias, 2015; OBrien, Graham, & Kelly, 2016; Robinson, 2016). For instance, according to Braaf et al. (2015), nurses often utilize documentation for handoff communication about patients, but there are numerous problems with this approach to communication.
The authors found that excessive reliance on documentation to provide other staff members with information during patient transition (and a lack of verbal communication), low quality of documentation (e.g., inaccuracies in documents, outdated information), and obstructed access to documents (e.g., resulting from an excessive amount of documentation) has an adverse impact on patient safety (Braaf et al., 2015).
At the same time, according to OBrien et al. (2016), the use of certain tools that are intended to improve the quality of handoff communication may also be associated with certain difficulties. For instance, the utilization of the 2009 World Health Organization surgical safety checklist was found to potentially entail several problems; for example, nurses complained about the additional workload, about not being provided with sufficient instruction when the checklist was initially introduced, and about the unresponsiveness of other surgery team members (OBrien et al., 2016).
Finally, Robinson (2016) emphasizes that effectual handoff communication between nurses is paramount for patient safety, in particular during times when a patient experiences a transition. According to the author, deficiencies and mistakes which occur during this phase of communication may critically and adversely impact the safety of the patient (Robinson, 2016). The author proposes to utilize a perioperative handoff communication instrument named PEARLS, which was created according to the Six Sigma methodology and allows for ensuring that the nurses know and understand the information about the patient that is significant in a given situation (Robinson, 2016).
Addressing the Problem of Lack of Communication
It is clear from the literature review that insufficient or ineffective handoff communication between nurses in a perioperative setting may have an adverse impact on the quality of health care and on patient safety. Therefore, it is paramount to take steps aimed at enhancing communication in this context. In particular, it is advisable to improve the quality of patient documentation or to utilize electronic health records for better and more standardized access to information (Braaf et al., 2015; Middleton et al., 2013). New communication instruments, such as PEARLS, may also be implemented to improve handoff communication among nurses (Robinson, 2016). Finally, when introducing such tools, it is necessary to ensure that all the staff are sufficiently prepared (e.g., via training or briefing) to use them (OBrien et al., 2016).
Conclusion
All in all, effective and timely handoff communication between nursing personnel in the perioperative setting is essential for patient safety. To improve the quality of communication at this critical juncture, more effective documentation (for instance, electronic health records) can be implemented, tools for effective communication (such as PEARLS) can be introduced, and medical staff can be provided with adequate instruction about how to use them.
References
Braaf, S., Riley, R., & Manias, E. (2015). Failures in communication through documents and documentation across the perioperative pathway. Journal of Clinical Nursing, 24(13-14), 1874-1884. Web.
Middleton, B., Bloomrosen, M., Dente, M. A., Hashmat, B., Koppel, R., Overhage, J. M.,&Zhang, J. (2013). Enhancing patient safety and quality of care by improving the usability of electronic health record systems: Recommendations from AMIA. Journal of the American Medical Informatics Association, 20(e1), e2-e8. Web.
OBrien, B., Graham, M. M., & Kelly, S. M. (2016). Exploring nurses use of the WHO safety checklist in the perioperative setting. Journal of Nursing Management, 25(6), 468-476. Web.
Robinson, N. L. (2016). Promoting patient safety with perioperative hand-off communication. Journal of PeriAnesthesia Nursing, 31(3), 245-253. Web.
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