{"id":613,"date":"2016-08-16T14:31:43","date_gmt":"2016-08-16T14:31:43","guid":{"rendered":"http:\/\/emedsa.org.au\/CoreMed\/?p=613"},"modified":"2018-03-06T10:30:21","modified_gmt":"2018-03-06T10:30:21","slug":"clinical-handover","status":"publish","type":"post","link":"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/16\/clinical-handover\/","title":{"rendered":"Clinical Handover"},"content":{"rendered":"<p><a href=\"http:\/\/twitter.com\/share?url=http%3A%2F%2Femedsa.org.au%2FCoreMed%2F2016%2F08%2F16%2Fclinical-handover%2F&amp;count=none&amp;text=Clinical Handover - CoreMed\" class=\"twitter-share-button\">Tweet<\/a><\/p><p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-625 aligncenter\" src=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/HandoverBaton.jpg\" alt=\"HandoverBaton\" width=\"960\" height=\"702\" srcset=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/HandoverBaton.jpg 960w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/HandoverBaton-300x219.jpg 300w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/HandoverBaton-768x562.jpg 768w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/HandoverBaton-624x456.jpg 624w\" sizes=\"auto, (max-width: 960px) 100vw, 960px\" \/><\/p>\n<p><b>INTRODUCTION<\/b><\/p>\n<ul>\n<li>Can be verbal or in written form<\/li>\n<li>Identified as\u00a0an event that regularly presents high risk-exposure to patient care<\/li>\n<li>Incomplete or misinterpreted information leads to delays in patient review, an under-appreciation of illness, or delays in adequate response to deterioration<\/li>\n<li>It occurs whenever there is a transfer of responsibility (temporarily or permanently) of components of patient care to another clinician <em>e.g. doctor-nurse, doctor-doctor, specialist-GP, doctor-allied health etc<\/em><\/li>\n<li>The principles of handover can be applied similarly to <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/17\/case-presentations\/\">patient referrals, clinic letters and discharge letters<\/a><\/li>\n<\/ul>\n<p><strong>PLANNING<\/strong><\/p>\n<ul>\n<li>Performing good handover should never be routine, it requires careful thought and preparation<\/li>\n<li>Despite the various tools and mnemonics that are available to improve consistency and completeness in the process <em><a href=\"http:\/\/www.patientsafetysolutions.com\/docs\/February_14_2012_Handoffs_More_Than_Battle_of_the_Mnemonics.htm\">e.g. SBAR, ISBAR, ISOBAR, I-PASS, I-PASS, ABCD<\/a>, <\/em>it is always worthwhile first\u00a0reflecting on all the patient information at hand and synthesising the essential facts that need to be conveyed<\/li>\n<li><span style=\"text-decoration: underline;\">Over-inclusivity<\/span> can be as dangerous as scant information by drowning out the important messages with irrelevant information. \u00a0Tools can be used poorly.<\/li>\n<li>Beyond the components of the patients history, examination findings and provisional diagnoses, <em>it is essential that\u00a0clinicians must convey an impression of how stable or severe their condition is, the timeliness for next review and contingency plans if the situation deteriorates..<\/em><\/li>\n<li>The latter aspects are actually more important to risk evaluation than diagnoses and is reflected by the <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/07\/24\/chronology-of-disease-illustrated\/\">chronological progression of disease<\/a>.<\/li>\n<\/ul>\n<p>A way of summarising this is in the following graphic<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-671\" src=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Slide1.jpg\" alt=\"Slide1\" width=\"720\" height=\"540\" srcset=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Slide1.jpg 720w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Slide1-300x225.jpg 300w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Slide1-624x468.jpg 624w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Slide1-240x180.jpg 240w\" sizes=\"auto, (max-width: 720px) 100vw, 720px\" \/><\/p>\n<p><strong>PRESENTATION<\/strong><\/p>\n<ul>\n<li>Structured format are useful in organising your thoughts and can be applied verbally or in written form<\/li>\n<li>Be <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/17\/case-presentations\/\">succinct<\/a><\/li>\n<li>If the situation is dire or critical learn to use <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/17\/case-presentations-scripted-approaches\/\">scripted approaches<\/a>, Use phrases like <em>&#8216;I am worried about&#8230;&#8221;, \u00a0&#8220;I have a puzzling situation I am concerned about&#8221;<\/em><\/li>\n<li>Use <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/17\/case-presentations-logical-flow-and-speaking-naturally\/\">natural prose to convey a progressive and logical flow<\/a><\/li>\n<\/ul>\n<p><strong>THE RECEIVER<\/strong><\/p>\n<ul>\n<li>Following the handover, it is important that the receiver performs a read-back that confirms they have correctly interpreted the important points (see the above graphic again)<\/li>\n<\/ul>\n<p>The following format is a good summary and is particularly suitable for the acute care environment (it can be modified accordingly for community and primary healthcare)<\/p>\n<p>&nbsp;<\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-614 aligncenter\" src=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover.jpg\" alt=\"Handover\" width=\"909\" height=\"1280\" srcset=\"http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover.jpg 909w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover-213x300.jpg 213w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover-768x1081.jpg 768w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover-727x1024.jpg 727w, http:\/\/emedsa.org.au\/CoreMed\/wp-content\/uploads\/2016\/08\/Handover-624x879.jpg 624w\" sizes=\"auto, (max-width: 909px) 100vw, 909px\" \/><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tweet INTRODUCTION Can be verbal or in written form Identified as\u00a0an event that regularly presents high risk-exposure to patient care Incomplete or misinterpreted information leads to delays in patient review,&#8230; <a href=\"http:\/\/emedsa.org.au\/CoreMed\/2016\/08\/16\/clinical-handover\/\">Read more &raquo;<\/a><\/p>\n","protected":false},"author":1,"featured_media":625,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"episode_type":"","audio_file":"","cover_image":"","cover_image_id":"","duration":"","filesize":"","date_recorded":"","explicit":"","block":"","filesize_raw":"","footnotes":""},"categories":[1],"tags":[],"class_list":["post-613","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"_links":{"self":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/613","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/comments?post=613"}],"version-history":[{"count":15,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/613\/revisions"}],"predecessor-version":[{"id":672,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/posts\/613\/revisions\/672"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/media\/625"}],"wp:attachment":[{"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/media?parent=613"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/categories?post=613"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/emedsa.org.au\/CoreMed\/wp-json\/wp\/v2\/tags?post=613"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}