Communication between patients and health professionals and amongst the staff of a particular hospital is essential in ensuring provision of better services to patients. Besides, breakdown in communication in any given health institution can result in fatalities or even worsening of patients’ conditions. Ineffective communication within a hospital setup also leads to transmission of inaccurate information about a patient and this could prove to be dangerous. The National Patient Safety Goal provides guidelines which enhance effective communication amongst healthcare providers. Such guidelines include ways of identification, communication and design considerations. The purpose of this essay is to examine the Jamaica Hospital Medical Centre Hand-over protocol and identify which critical steps are missing in it. These will help us in explaining possible outcomes of the omitted steps with a view of coming up with better resolutions
Of the steps, it is clearly stated that the minimum criterion for identifying the patient is by using his name and date of birth. This aids in administration of therapy to the correct patient while at the same time preventing fatalities due to wrong administration. The Jamaica hospital uses patient ‘ID band, medical record number and name as a criterion which is very commendable because many patients within a hospital set up might be sharing the same name hence; their identities may be confused resulting in wrong administration of medication and surgical procedures, ultimately leading to death or worsening of the condition of a particular patient. The Jamaica Hospital however, follows the protocol in this case therefore avoiding any confusion. Of much importance is the patient data. It should contain an accurate description of the diet that is; if the patient requires special diet, the amount and the time of consumption. Failure of inclusion of the special diet may lead to consumption of contraindicated food by the patient. Such foodstuffs may cause drug interactions that may inhibit or promote drug absorption. Consequently, this might affect the duration of action of a particular drug and its effects on given patient. The patient’s data should therefore provide clear guidelines on the diet and its time of consumption as it is the case in Jamaica Hospital protocol. These are some of the instances in which Jamaica Hospital follows the protocol however in many instances, it fails to do so:
According to Kurt, ‘’ Key fields of information might include: admitting diagnosis, planned interventions and issues requiring intervention by oncoming or receiving staff ‘’ (Kurt A 2007). Inclusive in the hand-over and specifically in the patient’s data therefore, should be the planned interventions or matters and issues that require timely interventions by the receiving staff. Obviously, new staff reporting to a shift would not be conversant with the common procedures in case vital signs and allergies reoccur. They need to be guided by planned interventions formulated by the staff operating in the previous shift in the event of allergic recurrence. Failure of which, may result in delay in attending to a given patient experiencing recurring allergic attacks. This might end up worsening the situation or even causing the death of the patient. The Jamaica Hospital System has a protocol for ensuring timely interventions by the surgical or procedural team, however, it generalizes and does not give specific planned interventions in cases of allergies or even implants It is worth mentioning that the primary survey of the patient or what is otherwise known as functional enquiry is an important tool in enhancing patient involvement during hand-over. Patterson wrote; “… it enables the nurse to put a face to the name, ensuring accurate identification of patient with information, allows the incoming nurse to ask questions and gives an opportunity to begin patient assessment” (Patterson D 2011, pp138). Even though the Jamaica Hospital Medical Centre hand- over system has some aspects of functional enquiry, it does not have a well defined question-answer system between the healthcare provider and the patient where the caregiver gets to ask the patient about all the important symptoms for example by using a questionnaire. The only questionnaire the system has is the one suited for purposes of the patient assessment preparation. This can prove to be very costly especially in future diagnosis when the patient presents with the same symptoms or even during surgery where a condition previously assumed by a patient ends up complicating the surgical procedure leading to the death of that particular patient. The Jamaica Hospital handover system does encourage some communication amongst healthcare providers which is essential in ensuring smooth transfer of the responsibility of patient care. However, it does not specify procedures for shift relief and the place of receipt of the handovers. According to Kurt: “Another key part of the handoff process is dialogue—active discussion between the staff members who are departing and those who are arriving” (Kurt A 2007). This if done, can serve to enhance dialogue amongst the care providers. Consequently, this prevents competence and ones knowledge of a vital condition not included in the handover system.
Being prepared in a hospital set up is very essential in preventing fatalities. The healthcare workers should always be equipped with whatever instruments, medication and clothing they need at any particular time. According to Patterson; “A protocol for checking the presence of adequate equipments and supplies in any given room should be included in any particular hand-over system as it is the case in the National Patients Safety Goals” (Patterson D 2011, pp 138). The Jamaica Hospital Medical Centre system has only a protocol for checking the patient assessment and indicators however, it has not included one for instruments, medication and clothing in its hand-over system. This could prove costly in cases such as emergency medical situations. In such cases, lives could be lost especially when the required equipments and supplies are not availed in time.
Another important component of a hand-over system according to the National Patient Safety Goal recommendations is that: “It should specify and define vital tests and provide the time length between their request and reporting” (Vij 2010, pp229). The Jamaica Hospital Medical Centre system has a protocol for general laboratory tests however, it does not specify the critical tests results and their timeline that is; those whose results are communicated regardless of the laboratory finding such as the radiograph during operation, ultra- sound examination of the fetus during ectopic pregnancy investigation and the cervical spine cross-table radiograph in post-traumatic cases. It comes in handy especially when urgent results are required in emergency situation. Moreover, a caregiver who is not aware of the urgency might take time with the results consequently endangering the life of patient. Besides the vital tests; “the handoffs should be equipped with a verification process to enable the receiver repeat-back, verify and clarify the information given” (NPSG.02.03.01, 2012). This process is present in the Jamaica Hospital Medical Centre even though some of its aspects are not clearly defined like the repeat back procedure. As a resolution therefore, the Jamaica Hospital Medical Centre should include the missing protocols in its handover system so as to enhance compliance amongst healthcare providers and ensure patient safety.
This essay has examined the Jamaica Hospital Medical centre hand-over system and adequately identified the critical steps and protocols which are missing. These protocols are consistent with the National Patient Safety Goals and the International Journal of Nursing Practice research paper on bedside communication in enhancing patient care. Moreover, it has come up with resolutions to solve the missing steps and protocols.