Are your handovers effective?

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What does the nurse in charge of the shift start the shift with and end the shift with?

Yes, handover. Probably one of the most important parts of the day that ensure consistency and continuity in care.
When I sat down to write this blog, I went straight back to my student nurse days and reflected on what handover looked like and how we ensured that information was handed over to the next shift.

My first job as a qualified nurse was on an all-female orthopedic ward which was a Nightingale design. For those of you that know what this ward design looked like great, for those that don’t, it was an open ward with beds down each side separated by a locker and curtains. The curtain may even have just been a mobile dignity screen.

So, now you have that picture, let me walk you through what the handover looked like. We walked around the ward from bed to bed and stood at the bottom and openly discussed what had happened on that shift in front of each person for all to hear. I cringe now looking back. So, when Joan was in bed one had a diagnosed with bone cancer, and she didn’t want May in the bed next to her to know, so May got to know.

I’m glad things have moved on from then.

When it comes to a good handover that ensures consistency and continuity for the person being cared for, what are the sorts of things that you need to consider?

Firstly, do you pay your staff to attend the handover? I know that’s an odd thing to say, yet many care homes don’t. So, you are already making handover rushed and a thing just to do and not an effective part of providing great care. Staff have their coats on and have a foot halfway out of the door potentially.

My next question would be, who comes to the handover? It could just be the nurse in charge or the senior carer who leads the shift. It could be team leaders too. Maybe, everyone on the shift? Consider workload, who is covering the floor, who is answering call bells? If it is just the nurse or senior, how do they ensure that the information is passed on to the whole team and at what point in the shift does this occur? Does this give the staff on the floor an adequate level of knowledge to undertake their role effectively?

Now here is another great point to think about and one that shows great leadership. Does the deputy manager or even the registered manager attend a handover during the day? How do they know the bigger picture of what is going on so that it can feed their strategic oversight?

Let’s move on. What do you talk about? How do you make the handover specific and purposeful? A great way to do this is to ask both these questions. Ask for what purpose and write it all down and then ask how specifically, again write it all down. This will help you get the bigger picture and the detail.

How do we record handovers? How do we ensure that we have evidenced what has happened and what needs to happen to provide safe and effective care? May social care businesses have digital documentation provision now and many systems have a handover section, yet these are only effective if used correctly. So how do you measure the usage to ensure it is effective? Where there isn’t a digital record, what information do you capture, I can guarantee you that ‘slept well’ doesn’t cut it anymore. How do you ensure that you are compliant with GDPR? It’s not ok for staff to go home with scraps of paper in their pockets with individuals’ data on…

Hopefully, this short blog will have started you thinking about your handovers and how you can improve them.

Whilst thinking about this blog, I had a little wander around the internet and found this great resource on the NHS England site that gives great ideas and structure. Yes, it is for community NHS services and could easily be amended. It might be something that gives your team inspiration as to how you could improve your handovers so that the outcome is exactly what it needs to be which is consistently effective great care.

Useful Resources – Productive Community Hospital Handover