Running Memory for Clinical Handoffs: A Look at Active and Passive Processing

Anderson-Montoya, Brittany L.; Scerbo, Mark W.; Ramirez, Dana E.; Hubbard, Thomas W.

doi:10.1177/0018720816672514

Cited by 8 publications

(11 citation statements)

References 56 publications

(69 reference statements)

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“…SAGAT was sensitive with both experienced and inexperienced participants. Overall these findings are consistent with recent work showing that with increasing levels of domain expertise people rely more on running memory, actively updating and processing new information as the task proceeds, as opposed to passive working memory that simply tries to memorize information without further processing (Anderson-Montoya, Scerbo, Ramirez, & Hubbard, 2017).…”

Section: Resultssupporting

confidence: 91%

A Systematic Review and Meta-Analysis of Direct Objective Measures of Situation Awareness: A Comparison of SAGAT and SPAM

2019

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Objective: To examine evidence of sensitivity, predictiveness, and methodological concerns regarding direct, objective measures of situation awareness (SA). Background: The ability to objectively measure SA is important to the evaluation of user interfaces and displays, training programs, and automation initiatives, as well as for studies that seek to better understand SA in both individuals and teams. A number of methodological criticisms have been raised creating significant confusion in the research field. Method: A meta-analysis of 243 studies was conducted to examine evidence of sensitivity and predictiveness, and to address methodological questions regarding Situation Awareness Global Assessment Technique (SAGAT), Situation Present Assessment Technique (SPAM), and their variants. Results: SAGAT and SPAM were found to be equally predictive of performance. SPAM (64%) and real-time probes (73%) were found to have significantly lower sensitivity in comparison to SAGAT (94%). While SAGAT was found not to be overly memory reliant nor intrusive into operator performance, SPAM resulted in problems with intrusiveness in 40% of the studies examined, as well as problems with speed-accuracy tradeoffs, sampling bias, and confounds with workload. Concerns about memory reliance, the utility of these measures for assessing Team SA, and other issues are also addressed. Conclusion: SAGAT was found to be a highly sensitive, reliable, and predictive measure of SA that is useful across a wide variety of domains and experimental settings. Application: Direct, objective SA measurement provides useful and diagnostic insights for research and design in a wide variety of domains and study objectives.

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Section: Resultssupporting

confidence: 91%

A Systematic Review and Meta-Analysis of Direct Objective Measures of Situation Awareness: A Comparison of SAGAT and SPAM

2019

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“…If nurses communicate more information and knowledge in the handoff, the RNs receiving the handoff will be able to more efficiently process the information and avoid experiencing cognitive overload. Prior research on cognitive processing indicates that the capacity to process incoming information increases when more information and knowledge are received because the individual is able to activate long-term memory, and this results in the person's ability to recall more relevant information 4,5,36 . Nurses are highly capable of communicating the patient's story in the form of information and knowledge and increase the ability of the receiving RN to recall more relevant patient information.…”

Section: Discussionmentioning

confidence: 99%

“…Two of the primary root causes of medical errors in the healthcare setting are miscommunication and cognitive lapses, which account for 100 000 deaths per year 2,3 . The cognitive lapses are attributed to the healthcare provider experiencing cognitive overload, which impedes his/her ability to recall essential patient information from the transfer of care 4,5 . In addition, 80% of all healthcare sentinel events are related to miscommunication occurring during the transfer of patient care between healthcare providers 6,7 .…”

mentioning

confidence: 99%

Communicating Data, Information, and Knowledge in the Nursing Handoff

Galatzan

Carrington

2021

CIN: Computers, Informatics, Nursing

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Miscommunication occurring during the nursing handoff continues to be a primary cause of sentinel events and adverse patient outcomes. The primary purpose of the nursing handoff is to communicate essential patient data, information, and knowledge to ensure the safe continued continuity of care. The aim of this study was to examine the content of the nurse-to-nurse change-of-shift handoff communication in terms of data, information, and knowledge for both bedside and nonbedside handoffs of a patient who has experienced a clinical event. The setting was an urban medical center on a medical-surgical floor.The sample consisted of one nurse giving and one nurse receiving the handoff (n = 19 registered nurses). Five bedside and five nonbedside handoffs were audio recorded and analyzed using content analysis. The handoff overall contained 34.7% data, 51.7% information, and 13.6% knowledge. The nonbedside handoff compared with the bedside handoff contained a substantially higher percentage of data and less information. The percentage of knowledge being communicated in both the nonbedside and bedside handoff was low at 13.6% and 13.7%, respectively. The percentage of data compared with the percentage of knowledge in the handoff places the nurses at greater risk of experiencing cognitive lapses due to cognitive overload.

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“…The sharing of nonpatient‐related information during the nursing hand‐off could cause “clouding” of the hand‐off message, requiring the nurses to mentally sort between relevant and irrelevant information. The process of filtering and prioritizing information could potentially lead to cognitive overload (Anderson‐Montoya et al, 2017).…”

Section: Discussionmentioning

confidence: 99%

“…The cognitive lapses occurring during the transition of care communication leading to miscommunication and inconsistent recall of essential information account for 80% of sentinel events in the acute care setting (Joint Commission, 2017b). Cognitive lapses are a consequence of the healthcare provider experiencing cognitive overload, which impedes the individual's ability to recall relevant information during and after the transfer of care (Anderson‐Montoya et al, 2017). Despite emphasis placed on the transition of care communication by organizations such as Joint Commission as a priority patient safety goal (Joint Commission, 2017a) and continued nursing research focusing on the hand‐off, miscommunication and poor patient outcomes continue to occur (Galatzan & Carrington, 2018).…”

Section: Introductionmentioning

confidence: 99%

Examining the meaning of the language used to communicate the nursing hand‐off

Galatzan

Carrington

2021

Research in Nursing & Health

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The miscommunication and inconsistent recall of patient information due to cognitive lapses that occur during the hand‐off between healthcare providers account for 80% of sentinel events in acute care. Cognitive lapses are a consequence of the nurse experiencing cognitive overload, which impedes the nurse's ability to recall relevant information during and after the hand‐off communication. The primary cognitive and human factor contributing to cognitive overload in the hand‐off is language. The purpose of this study was to examine the meaning of the language used to communicate the nurse‐to‐nurse change of shift hand‐off occurring at bedside and nonbedside on a medical‐surgical unit in an urban medical center. A qualitative descriptive design was used. The sample was 10 audio‐recorded hand‐offs (five bedside and five nonbedside), with a total of 19 nurses participating. A natural language process program was used to analyze the data. The hand‐off is a narrative story centered on communicating patient information delivered with a high degree of confidence. The hand‐off is focused on past and current events with minimal focus on future or anticipated events. The drive to communicate is minimally based on concern, fear, or danger. There is a difference in the language used to communicate the nursing hand‐off message at bedside as compared to the nonbedside hand‐off.

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Running Memory for Clinical Handoffs: A Look at Active and Passive Processing

Abstract: The results have implications about how training should be developed to aid less experienced personnel identify what information should be included in a handoff and what should not.

Cited by 8 publications

References 56 publications

A Systematic Review and Meta-Analysis of Direct Objective Measures of Situation Awareness: A Comparison of SAGAT and SPAM

A Systematic Review and Meta-Analysis of Direct Objective Measures of Situation Awareness: A Comparison of SAGAT and SPAM

Communicating Data, Information, and Knowledge in the Nursing Handoff

Examining the meaning of the language used to communicate the nursing hand‐off

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