Shifting change A design perspective on nurse

handover education

Nicola Fuller, Joakim Nesset Sundal, Amanda Wangen

How can we develop a practical solution to the problem riddled handover procedures?

errors in abbreviation

left out information

poor hand writing misspelled medication

errors in numerical value

inability to identify the nurse responsible for care

funneling of information

Unnecessary information

distractions

interruptions

noise

fatigue

forgetfulness

lack of knowledge

lack of confidence

little experience

poorly written communication

variation in process

time constraints

Communication

People are different

How to accommodate for a problem when the people involved are all different?

Education

“Between 60-90% provided no formal training of the handover.”

Gill, Giuliani, Masterson, Shrichand

A Systematic Review of Educational Resources for Teaching Patient Handover Skills to Residents

Workshops at hospital

Nursing school Fellow nurses

Opportunity

Solution long lasting affordable

Initiate change accommodate for different systems

SBAR  I-­‐PASS  DRAW  

•  Ability  to  transfer  informa8on  adequately,          8mely  and  responsibly  •  Independent  problem  solving  •  Work  in  team  •  Confidence  in  communica8on  skills  

 

Preferred  skills  Assump8ons  

Learning  outcomes  

 

Learning By Doing

“There is reported variability in quality, lack of structure in how handoffs usually occur

and variances in shift handoffs.”  

Byers,  Frieson,  White  

   

Handoffs: Implications for Nurses, 2008

Problem Solving

Structure of package

1.  Existing teaching methods / research 2.  Psychological research of methods 3.  Resources and activities for use

“Learning is generally enhanced when

learners encounter the same principles in a variety of formats.”

Davis

Tools for Teaching, 2012

Methods

– Use of existing materials

–  Initial understanding

– Simulated activities •  Methods of effective comprehension •  Problem based learning and case studies

“Reform is not enough, that would simply mean improving a broken model.

We need a revolution.”

Sir Ken Robinson

Bring  on  the  Learning  Revolu1on,  2010