Improving the handover and transport of critically ill pediatric patients

Brigit VanGraafeiland, Cynthia Foronda, Sarah Vanderwagen, Laura Allan, Meghan Bernier, Jennifer Fishe, Elizabeth A. Hunt, Justin M. Jeffers

Research output: Contribution to journalArticle

Abstract

Aims and Objectives: The aims of this project were to (a) determine barriers to current handover and transport process, (b) develop a new protocol and process for team-to-team handover, and (c) evaluate staff satisfaction with the new process. Background: The handover and transport of critically ill patients from the paediatric emergency department to the paediatric intensive care unit is a period of vulnerability associated with adverse events. Design: A mixed-methods study using a quasi-experimental design and qualitative approach. Methods: Focus groups were conducted to determine the barriers and facilitators of the current handover and transport process. Using these themes, a multidisciplinary team developed and implemented a new process including establishment of eight patient criteria for specialised transport and a standardised, interdisciplinary handover tool for team-to-team handover. Staff satisfaction was examined pre- and postintervention. Results: Content analysis of focus groups revealed five categories: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardisation and ambiguity between providers regarding acuity. Staff members reported improvements in their perceptions of satisfaction, safety, communication and role understanding associated with the new process. Conclusions: Standardisation through the establishment of severity of illness criteria and communication tools creates shared mental models and decreases risks to safety. A paradigm shift of team-to-team handover and transport is recommended. Relevance to clinical practice: This paper suggests the importance of improving communication during the handover and transport process through establishing standardised patient severity of illness criteria, use of standardised tools and team-to-team handover processes.

Original languageEnglish (US)
Pages (from-to)56-65
Number of pages10
JournalJournal of Clinical Nursing
Volume28
Issue number1-2
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Critical Illness
Communication
Pediatrics
Focus Groups
Safety
Pediatric Intensive Care Units
Hospital Emergency Service
Research Design

Keywords

  • child
  • communication
  • emergency
  • handover
  • intensive care
  • interprofessional
  • paediatric
  • transfer
  • transport

ASJC Scopus subject areas

  • Nursing(all)

Cite this

VanGraafeiland, B., Foronda, C., Vanderwagen, S., Allan, L., Bernier, M., Fishe, J., ... Jeffers, J. M. (2019). Improving the handover and transport of critically ill pediatric patients. Journal of Clinical Nursing, 28(1-2), 56-65. https://doi.org/10.1111/jocn.14627

Improving the handover and transport of critically ill pediatric patients. / VanGraafeiland, Brigit; Foronda, Cynthia; Vanderwagen, Sarah; Allan, Laura; Bernier, Meghan; Fishe, Jennifer; Hunt, Elizabeth A.; Jeffers, Justin M.

In: Journal of Clinical Nursing, Vol. 28, No. 1-2, 01.01.2019, p. 56-65.

Research output: Contribution to journalArticle

VanGraafeiland, B, Foronda, C, Vanderwagen, S, Allan, L, Bernier, M, Fishe, J, Hunt, EA & Jeffers, JM 2019, 'Improving the handover and transport of critically ill pediatric patients', Journal of Clinical Nursing, vol. 28, no. 1-2, pp. 56-65. https://doi.org/10.1111/jocn.14627
VanGraafeiland B, Foronda C, Vanderwagen S, Allan L, Bernier M, Fishe J et al. Improving the handover and transport of critically ill pediatric patients. Journal of Clinical Nursing. 2019 Jan 1;28(1-2):56-65. https://doi.org/10.1111/jocn.14627
VanGraafeiland, Brigit ; Foronda, Cynthia ; Vanderwagen, Sarah ; Allan, Laura ; Bernier, Meghan ; Fishe, Jennifer ; Hunt, Elizabeth A. ; Jeffers, Justin M. / Improving the handover and transport of critically ill pediatric patients. In: Journal of Clinical Nursing. 2019 ; Vol. 28, No. 1-2. pp. 56-65.
@article{cfeaa37473c9443087b4525b9c7708bd,
title = "Improving the handover and transport of critically ill pediatric patients",
abstract = "Aims and Objectives: The aims of this project were to (a) determine barriers to current handover and transport process, (b) develop a new protocol and process for team-to-team handover, and (c) evaluate staff satisfaction with the new process. Background: The handover and transport of critically ill patients from the paediatric emergency department to the paediatric intensive care unit is a period of vulnerability associated with adverse events. Design: A mixed-methods study using a quasi-experimental design and qualitative approach. Methods: Focus groups were conducted to determine the barriers and facilitators of the current handover and transport process. Using these themes, a multidisciplinary team developed and implemented a new process including establishment of eight patient criteria for specialised transport and a standardised, interdisciplinary handover tool for team-to-team handover. Staff satisfaction was examined pre- and postintervention. Results: Content analysis of focus groups revealed five categories: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardisation and ambiguity between providers regarding acuity. Staff members reported improvements in their perceptions of satisfaction, safety, communication and role understanding associated with the new process. Conclusions: Standardisation through the establishment of severity of illness criteria and communication tools creates shared mental models and decreases risks to safety. A paradigm shift of team-to-team handover and transport is recommended. Relevance to clinical practice: This paper suggests the importance of improving communication during the handover and transport process through establishing standardised patient severity of illness criteria, use of standardised tools and team-to-team handover processes.",
keywords = "child, communication, emergency, handover, intensive care, interprofessional, paediatric, transfer, transport",
author = "Brigit VanGraafeiland and Cynthia Foronda and Sarah Vanderwagen and Laura Allan and Meghan Bernier and Jennifer Fishe and Hunt, {Elizabeth A.} and Jeffers, {Justin M.}",
year = "2019",
month = "1",
day = "1",
doi = "10.1111/jocn.14627",
language = "English (US)",
volume = "28",
pages = "56--65",
journal = "Journal of Clinical Nursing",
issn = "0962-1067",
publisher = "Wiley-Blackwell",
number = "1-2",

}

TY - JOUR

T1 - Improving the handover and transport of critically ill pediatric patients

AU - VanGraafeiland, Brigit

AU - Foronda, Cynthia

AU - Vanderwagen, Sarah

AU - Allan, Laura

AU - Bernier, Meghan

AU - Fishe, Jennifer

AU - Hunt, Elizabeth A.

AU - Jeffers, Justin M.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Aims and Objectives: The aims of this project were to (a) determine barriers to current handover and transport process, (b) develop a new protocol and process for team-to-team handover, and (c) evaluate staff satisfaction with the new process. Background: The handover and transport of critically ill patients from the paediatric emergency department to the paediatric intensive care unit is a period of vulnerability associated with adverse events. Design: A mixed-methods study using a quasi-experimental design and qualitative approach. Methods: Focus groups were conducted to determine the barriers and facilitators of the current handover and transport process. Using these themes, a multidisciplinary team developed and implemented a new process including establishment of eight patient criteria for specialised transport and a standardised, interdisciplinary handover tool for team-to-team handover. Staff satisfaction was examined pre- and postintervention. Results: Content analysis of focus groups revealed five categories: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardisation and ambiguity between providers regarding acuity. Staff members reported improvements in their perceptions of satisfaction, safety, communication and role understanding associated with the new process. Conclusions: Standardisation through the establishment of severity of illness criteria and communication tools creates shared mental models and decreases risks to safety. A paradigm shift of team-to-team handover and transport is recommended. Relevance to clinical practice: This paper suggests the importance of improving communication during the handover and transport process through establishing standardised patient severity of illness criteria, use of standardised tools and team-to-team handover processes.

AB - Aims and Objectives: The aims of this project were to (a) determine barriers to current handover and transport process, (b) develop a new protocol and process for team-to-team handover, and (c) evaluate staff satisfaction with the new process. Background: The handover and transport of critically ill patients from the paediatric emergency department to the paediatric intensive care unit is a period of vulnerability associated with adverse events. Design: A mixed-methods study using a quasi-experimental design and qualitative approach. Methods: Focus groups were conducted to determine the barriers and facilitators of the current handover and transport process. Using these themes, a multidisciplinary team developed and implemented a new process including establishment of eight patient criteria for specialised transport and a standardised, interdisciplinary handover tool for team-to-team handover. Staff satisfaction was examined pre- and postintervention. Results: Content analysis of focus groups revealed five categories: need for improved communication, cultural dissonance among units, defects in system and processes, need for standardisation and ambiguity between providers regarding acuity. Staff members reported improvements in their perceptions of satisfaction, safety, communication and role understanding associated with the new process. Conclusions: Standardisation through the establishment of severity of illness criteria and communication tools creates shared mental models and decreases risks to safety. A paradigm shift of team-to-team handover and transport is recommended. Relevance to clinical practice: This paper suggests the importance of improving communication during the handover and transport process through establishing standardised patient severity of illness criteria, use of standardised tools and team-to-team handover processes.

KW - child

KW - communication

KW - emergency

KW - handover

KW - intensive care

KW - interprofessional

KW - paediatric

KW - transfer

KW - transport

UR - http://www.scopus.com/inward/record.url?scp=85052402193&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85052402193&partnerID=8YFLogxK

U2 - 10.1111/jocn.14627

DO - 10.1111/jocn.14627

M3 - Article

C2 - 30016565

AN - SCOPUS:85052402193

VL - 28

SP - 56

EP - 65

JO - Journal of Clinical Nursing

JF - Journal of Clinical Nursing

SN - 0962-1067

IS - 1-2

ER -