Professional Documents
Culture Documents
P,, - Tbry T"D Fo"" On TB, Fact Tbat of All TB,: '.Li1D Ijllppwt'D
P,, - Tbry T"D Fo"" On TB, Fact Tbat of All TB,: '.Li1D Ijllppwt'D
Data revealed that the information handed over varied from nurse to nurse, and that the
handover process was influenced by many contextual. patient and nurse factors. Some of the
contextual factors were the time available to conduct handover and the pace of the ward at the
time. Additionally, patient information that was handed over varied due to the nurse's
knowledge levelsmof the individual patient's condition and their personal understanding of
the patient. Nurses who had returned from days off, and agency or casual nurses who had
only worked on the ward for a short period, had limited information about the patients and
were unlikely to be able to handover information in a substantial way. Consequently,
information handed over tended to be incomplete. The increasing use of agency and casual
nurses and the large numbers of nurses involved in each patient's care exacerbated
the problem. It seemed that due to the changing context of practice, nurses felt more
comfortable communicating: infcnuation verbally. However, this information was more
prone to being lost when held and handed over in the oral culture. The following excerpts
from interviews illustrate these points.
Ill('(/IJ sOllle oJ I/.ll' pcople [mulC5] 1 lPo,.k (pith
Ilrc sldflilJ~ offfind some illo:perituad, ... like slartifl!
l offdt coon/i/llltiltg /lnd Ihry mill rillxr boud oper
loo llIudJ J<!IJorllldlioH or cist' somdiml's lIJcy dOli'I
hi/lid OPl''' wOllgl,. Ana Ifml you htlllt' SOUlt' propit', /
kllOIP 11,1ms Ollt' lady [rrIerl'il/51 10 a colll'dgut'], s/,l'
Il'dS 11 !ollely lady, /'lll slJC rcally, yOll (lWIt' oul [of
ththlludol'l.'r room]lIIra you rl'dlly I,dd, s/il/ 110 itlcd
invo!lletl."
"[SldtCS his l1!1t mrd lIIl'diml diagJlosisJ ... sorry
1dOll'l k"oll" IJtS come from mlOl/m Ulard mrd the
pmo1r (pho /lookcd him ill did Hot bt01P (pIJ"t opem
tioll JJt llJl15 coming injOI:"
Additionally, the fragmented c communication
between nurses and doctors added
to this problem.
No, you'pe gal to dJlIse I/JCIlI [referrill~ to the
doe/ors], sOmttimfs you jj"d Ollt fr01l1 II)t Pflliwl,
1/,0' SIlY "01" rill going '}oIIlt' ill IIJr 1Il0nrillu" t/nd
t/lllls lhc first lilUe you'Pt' Ildl!ll/1y 1,Ct'tJ lold.
There were many instances where nurses'
knowledge about the patient remained
"uncertain". fvloreover, lllln;es' acceptance
of uncertainty and "not knowing specifics
about palierlt care" left them vlllner"ble as
TABELLLL
Tape recorded handovers
Due to the rostering system and lack of
shift overlap time, tape-recorded handovers
were introduced to communicate
patient information. While this type of
handover had practical benefits, as no face
to face contact is required, it also hindered
communication, as its use tended to modify
and alter the efficacy of the handover
process. More specifically, nurses found
that they tended to handover information
in a more impersonal way, focusing on
tasks rather than on patient progress. This
type of handover tended to be brtefer and
did not reveal fully the patient's overall
condition. Additionally, some nurses used
abbreviations that were not understood by
other staff. Due to the time lapse between
Table I.