The intensive care unit handover: the most stressful part of the shift

Jigajinni, Suyogi; Sultan, Pervez

doi:10.12968/hmed.2010.71.sup2.46506

Cited by 4 publications

(4 citation statements)

References 5 publications

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“…One of the consequences of work‐related stress is the erosion of compassion: doctors who have a high level of occupational well‐being with positive work‐related experiences provide more comprehensive levels of patient care 24 . In recognition of the importance of doctor well‐being, medical colleges are providing well‐being programs for trainees and fellows, and medical schools are introducing self‐care modules into their curriculums 9 . The Royal Australian and New Zealand College of Obstetricians and Gynaecologists (RANZCOG) has responded to this crisis by establishing a training support unit and a well‐being coordinator to support all RANZCOG staff and members.…”

Section: Discussionmentioning

confidence: 99%

“…24 In recognition of the importance of doctor well-being, medical colleges are providing well-being programs for trainees and fellows, and medical schools are introducing self-care modules into their curriculums. 9 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists…”

Section: Describes Medical Hierarchies As Representing the 'Berlinmentioning

confidence: 99%

“…8 Nowhere is the junior doctor more likely to face such criticism than in the setting of acute service clinical handover. 9 Handover is an essential element of clinical communication. The importance of handover in maintaining patient safety is enshrined into the National Standards, where Standard 6, Communication for Safety, explicitly defines handover as being a 'high risk situation in which effective communication and documentation is required'.…”

Section: Introductionmentioning

confidence: 99%

“…Performance anxiety also plays a role, with junior doctors expressing fears regarding public criticism as a contributory factor 8 . Nowhere is the junior doctor more likely to face such criticism than in the setting of acute service clinical handover 9 …”

Section: Introductionmentioning

confidence: 99%

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A qualitative analysis of adding kindness into the ISBAR handover tool

Senneville

Brewin

Thomas

et al. 2022

Aust NZ J Obst Gynaeco

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Background The COVID pandemic has highlighted the stresses experienced by our medical workforce, with worldwide publications attesting to high rates of depression, anxiety and burnout, particularly in junior doctors. Many studies focus on reporting on the prevalence of mental health issues, but not many report on interventional strategies. One of the most stressful interactions in the day of a junior doctor is the medical handover. The incorporation of kindness into clinical handover has coined the term ‘KISBAR’ to underline the importance of delivering handover in a kind manner. Aim The aim is to analyse the efficacy of a novel intervention by introducing an emotional support representative to participate in the morning labour ward handover. Methods We undertook an ethnographic constructivist qualitative research project in a tertiary hospital in Perth, Western Australia, using focus groups to explore the views of junior medical staff on the KISBAR handover tool in the specific context of labour ward handover. Fifty per cent of the total junior doctors from the hospital participated in this study. Results Four dominant themes arose from analysis of the focus group discussions: (i) inherent stress experienced by junior doctors during the labour ward handover process, (ii) support strategies for junior doctors during labour ward handover; (iii) role modelling and the hidden curriculum aspects of communication from senior doctors at labour ward handover; and (iv) benefit of having an emotional support person present for labour ward handover. Conclusion Our study confirmed the benefit of having an emotional support person present at labour ward handover: improved perception of safety and an environment that junior doctors found to be supportive. This is a novel and reproducible interventional strategy which is applicable to various obstetric units around Australia.

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Section: Discussionmentioning

confidence: 99%

Section: Describes Medical Hierarchies As Representing the 'Berlinmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

A qualitative analysis of adding kindness into the ISBAR handover tool

Senneville

Brewin

Thomas

et al. 2022

Aust NZ J Obst Gynaeco

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Good Communication During Clinical Handovers: The Students’ Perspective

Bhattacharjee

John²,

Vijayakamar³

2022

American Journal of Medical Quality

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Eye tracking during a simulated start of shift safety check: An observational analysis of gaze behavior of critical care nurses

van der Geest,

Chau,

Wendel-Garcia

et al. 2024

Journal of the Intensive Care Society

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Background: The handover and associated shift start checks by nurses of critical care patients are complex and prone to errors. However, which aspects lead to errors remains unknown. Fewer errors might occur in a structured approach. We hypothesized that specific gaze behavior during handover and shift start safety check correlates with error recognition. Methods: In our observational eye tracking study, we analyzed gaze behavior of critical care nurses during handover and shift start safety check in a simulation room with built-in errors. Four areas of interest (AOI) were pre-defined (patient, respirator, prescriptions, monitor). The primary outcome were different gaze metrics (time to first fixation, revisits, first visual intake duration, average visual intake duration, dwell time) on AOIs. Parameters were analyzed by taking all errors in account, and by dividing them into minor and critical. Results: Forty-three participants were included. All participants committed at least a minor error ( n = 43, 100%), at least one critical error occurred in 29 participants (67%). Taking all errors into account, longer time to first fixation and more revisits were associated with an increased risk of missing errors (Time to First Fixation: OR 1.099 (95% CI 1.023–1.191, p = 0.0002), Revisits: OR 1.080 (95% CI 1.025–1.143, p = 0.0055)). Conclusion: Error detection during shift start safety check was associated with distinct gaze behavior. Nurses who recognized more errors had a shorter time to first fixation and less revisits. These gaze characteristics might correspond to a more structured approach. Further research is necessary, for example by implementing a checklist, to reduce errors in the future and improve patient safety.

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The intensive care unit handover: the most stressful part of the shift

Cited by 4 publications

References 5 publications

A qualitative analysis of adding kindness into the ISBAR handover tool

A qualitative analysis of adding kindness into the ISBAR handover tool

Good Communication During Clinical Handovers: The Students’ Perspective

Eye tracking during a simulated start of shift safety check: An observational analysis of gaze behavior of critical care nurses

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