Real-World Implementation of a Standardized Handover Program (I-PASS) on a Pediatric Clinical Teaching Unit
| Autor: | Kristy Parker, Katherine Baldwin, Mary Aglipay, Asif Doja, Kathleen Huth, Francine Hart, David Creery, Katherine A. Moreau |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Video Recording
Documentation Logistic regression Pediatrics Unit (housing) 03 medical and health sciences 0302 clinical medicine 030225 pediatrics Intervention (counseling) medicine Humans Prospective Studies 030212 general & internal medicine Duration (project management) Curriculum Clinical teaching Ontario Academic Medical Centers business.industry Patient Handoff Internship and Residency Continuity of Patient Care Reference Standards medicine.disease Identification (information) Logistic Models Handover Pediatrics Perinatology and Child Health Linear Models Medical emergency business |
| Zdroj: | Academic Pediatrics. 16:532-539 |
| ISSN: | 1876-2859 |
| DOI: | 10.1016/j.acap.2016.05.143 |
| Popis: | A standardized handover curriculum (I-PASS) has been shown to reduce preventable adverse events in a large multicenter study. We aimed to study the real-world impact of the implementation of this curriculum on handover quality, duration, and identification of unstable patients.A prospective intervention study was conducted. We implemented the I-PASS curriculum via faculty education and resident workshops. Resident handover on the clinical teaching unit was videorecorded, and written handover documents were collected for 2 weeks before and after the intervention. We examined the inclusion of key elements on handover documents before and after intervention using logistic regression models accounting for multiple handovers per patient. Duration of handover was compared using a linear regression model adjusting for number of patients. Qualitative content analysis was used to describe observable differences in verbal handover recordings and written critical care consultations.A total of 1275 handovers were included, comprising 364 inpatients. There was a significant increase (P .05) in 7 of 11 key elements and a significant decrease in written physical examination findings after the intervention. No significant change was found in handover duration. Qualitative video analysis revealed observable differences in handover collaboration and organization. After the intervention, patients with critical care needs overnight were correctly identified as requiring close monitoring during handover.Handover training resulted in consistent inclusion of key elements and was characterized by collaboration between participants and improved organization without significant increase in handover duration. Appropriate identification and response to clinically deteriorating patients was also found using the I-PASS model. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect