Nurses’ experience of the transfer of <scp>ICU</scp> patients to general wards: A great responsibility and a huge challenge

Enger, Ronny; Andershed, Birgitta

doi:10.1111/jocn.13911

Cited by 44 publications

(51 citation statements)

References 52 publications

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“…It is noted that approximately half of the practices and strategies indicated by the studies can negatively influence the quality of the transitions. Among the main barriers are ineffective communication ( 21 , 23 - 25 , 27 , 36 - 38 ) , lack of planning, and choosing the inappropriate time for discharge, both from the point of view of time/day of discharge and the patient’s readiness to be discharged ( 11 , 14 , 19 - 22 , 24 - 25 , 27 - 28 , 30 , 32 - 35 , 37 - 38 , 42 ) . The ideal conditions for patient discharge should consider, in addition to the clinical aspects, their level of dependence, the availability of family support, and the capacity of the destination unit/team to meet their demands ( 28 , 37 ) .…”

Section: Discussionmentioning

confidence: 99%

Transition of care at discharge from the Intensive Care Unit: a scoping review

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

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Objective: to map the available evidence on the components of the transition of care, practices, strategies, and tools used in the discharge from the Intensive Care Unit (ICU) to the Inpatient Unit (IU) and its impact on the outcomes of adult patients. Method: a scoping review using search strategies in six relevant health databases. Results: 37 articles were included, in which 30 practices, strategies or tools were identified for organizing and executing the transfer process, with positive or negative impacts, related to factors intrinsic to the Intensive Care Unit and the Inpatient Unit and cross-sectional factors regarding the staff. The analysis of hospital readmission and mortality outcomes was prevalent in the included studies, in which trends and potential protective actions for a successful care transition are found; however, they still lack more robust evidence and consensus in the literature. Conclusion: transition of care components and practices were identified, in addition to factors intrinsic to the patient, associated with worse outcomes after discharge from the Intensive Care Unit. Discharges at night or on weekends were associated with increased rates of readmission and mortality; however, the association of other practices with the patient’s outcome is still inconclusive.

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Section: Discussionmentioning

confidence: 99%

Transition of care at discharge from the Intensive Care Unit: a scoping review

Hervé

Zucatti

Lima

2020

Rev. Latino-Am. Enfermagem

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“…Following a scoping review of the ICU transfer literature, Stelfox and colleagues 6 suggest that a multi-pronged approach is likely necessary to Breengineer^the transfer process and highlight a need for better patient and family engagement within the transfer process. 33,35 A recent qualitative study of perceived barriers and facilitators to high-quality transfer practices reported that ICU providers, ward providers, and patients and families all recommended the use of both communication tools (e.g., standardized written summary of patient course and treatment plan) and employing multimodal communication practices (i.e., verbal, written, electronic) to document the transfer to ensure continuity of care. 36 This was further echoed in our study, with both administrator groups identifying an opportunity to improve transfer practices by providing patients and families with more information and engaging them in the transfer process (e.g., shared decision-making).…”

Section: Discussionmentioning

confidence: 99%

Administrator Perspectives on ICU-to-Ward Transfers and Content Contained in Existing Transfer Tools: a Cross-sectional Survey

et al. 2018

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“…Lost or inaccurate information is a well-known problem in clinical handovers both within ICU and during transfers between ICU and other hospital ward units (Blum & Tremper, 2009;Dutra et al, 2018;Enger & Andershed, 2018;Ganz et al, 2015;Zakrison et al, 2016). Incomplete handover is associated with medical errors and inadequate care (McCloskey et al, 2019;Smeulers et al, 2014).…”

Section: Discussionmentioning

confidence: 99%

Information concerning ICU patients’ families in the handover—The clinicians’ «game of whispers»: A qualitative study

Nygaard

Haugdahl

Brinchmann

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore how information concerning ICU patients´ families is included in the ICU clinicians’ daily handover. Background Handover refers to the transfer of information and care responsibility between clinicians. An effective and precise handover are of great importance to ensure quality of care. Although improvements in handovers have received increasing attention in recent decades, little is known about how information about ICU patients’ family members is included in handovers. Design A qualitative study using Charmaz’ constructivist grounded theory approach. Methods Data were gathered through participant observation, focus groups, dyadic and individual interviews of physicians and nurses from four ICUs in different Norwegian hospitals. The data consist of 270 observation hours, seven focus groups, three dyadic interviews and two individual interviews. Field notes and transcribed interview data were analysed using constructivist grounded theory approach. COREQ checklist was applied as reporting guideline for this study. Findings “A game of whispers” emerged as the core category, representing missing information about the patient's family during the handover. Together with three subcategories: “documentation dilemmas,” “being updated” and “talking together,” the core category explains how transfer of family‐related information between clinicians is continually processed and resolved. Conclusions This study indicates challenges related to appropriate and high‐quality handover concerning ICU patients´ families. Oral handovers are essential in terms of clinicians’ need to elaborate on written information and update each other. However, oral transmission involves a high risk of information loss during the handover. Written documentation about the family seems to be inadequate and poorly structured. Relevance to clinical practice The study findings suggest a need for increased awareness in practice and research of the importance of transferring appropriate and reliable information about patients’ families between ICU clinicians. User‐friendly handover tools and patient records that include information on patients’ family members should be developed.

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Nurses’ experience of the transfer of ICU patients to general wards: A great responsibility and a huge challenge

Cited by 44 publications

References 52 publications

Transition of care at discharge from the Intensive Care Unit: a scoping review

Transition of care at discharge from the Intensive Care Unit: a scoping review

Administrator Perspectives on ICU-to-Ward Transfers and Content Contained in Existing Transfer Tools: a Cross-sectional Survey

Information concerning ICU patients’ families in the handover—The clinicians’ «game of whispers»: A qualitative study

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