Nurses As Knowledge Workers

Abstract

Patient care handoffs are critical to ensuring continuity of care and patient safety. Current definitions of handoffs focus on information, but preventing errors and improving quality require knowledge. The objective of this study was to determine whether knowledge and wisdom were exchanged during medical and surgical patient care handoffs and to discover how these were expressed. The study was a directed content analysis of 93 handoffs using the data/information/knowledge/wisdom framework. Results indicated knowledge was present in all handoffs, comprising 41% of the phrases across the two types of units. No wisdom was coded. The percentage and types of knowledge phrases differed between medical and surgical units. Handoffs could be more knowledge based by linking handoff content to patient problems and goals. Future handoffs could be computationally derived, context-specific, and linked to problem-focused care plans and patient summaries. Improved data visualization and cognitive support are needed.

Communicating Data, Information, and Knowledge in the Nursing Handoff

“…The nurse-to-nurse change-of-shift handoff communication primarily comprised data (34.7%) and information (51.7%), with minimal knowledge (13.6%) being shared. These results are similar to the study by Matney et al 25 examining the presence of data, information, knowledge, and wisdom in the handoff communication. A possible rationale for the low percentage of knowledge in the nursing handoff is the experience level related to the number of years on this medical-surgical unit and total years of experience as a nurse.…”

“…23,24 When nurses are engaged in the interactive collaborative nursing handoff process, they are sharing patient data, information, and knowledge. 15,25…”

“…Knowledge is the process of synthesizing and connecting an information segment to another information segment, creating deeper meaning, context, and conceptual understanding 23,24 . When nurses are engaged in the interactive collaborative nursing handoff process, they are sharing patient data, information, and knowledge 15,25 Table 1. provides definitions and examples of data, information, and knowledge.…”

Nurses’ Wisdom in Action in the Emergency Department

“…The three sub processes are types of information gathering: obtaining patient history, assessing the patient, and obtaining pertinent information from the care record. Information is data structured within the context of care and was always obtained prior to the action of using knowledge or applying a judgment (Matney, Maddox, & Staggers, 2014). …”

Handoffs and Patient Safety

“…Findings from our study suggest that the handoff exchange may be improved by decreasing distractions and noise, providing dedicated handoff time, minimizing concomitant meetings, and providing a structured but flexible written tool. Other researchers have found and argued for similar improvements (Abraham et al, 2014;Collins et al, 2011;Flemming & Hubner, 2013;Holly & Poletick, 2014;Johnson et al, 2012;Kerr et al, 2011;Matney, Maddox, & Staggers, 2014;Meissner et al, 2007;O'Connell et al, 2008;Randell et al, 2011;Riesenberg et al, 2009;Staggers et al, 2011;Staggers, Clark, Blaz, & Kapsandoy, 2012;Staggers & Jennings, 2009;Strople & Ottani, 2006;Welsh et al, 2010). Nurses began to develop a standardized tool during the study.…”