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Brief handovers in ER

Emergency   (1,683 Views 8 Comments)
by Opinions matter Opinions matter (New Member) New Member

Opinions matter works as a RN.

596 Visitors; 12 Posts

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What type of handovers are people using in the ER to improve communication when going on breaks?

I know SBAR and for out of department communication have used "Tickets to Ride".

Anybody got anything else that works great. It needs to be simple and quick as we have enough to do already but want to ensure patient safety.

Thanks

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17,770 Visitors; 1,840 Posts

We don't follow anything formal like that, especially when it is just for a break. I'm sure you know that in the ED, pt conditions can run the gamut from a minor injury or sore throat, to someone who is intubated and on multiple drips. If I had a full team of 5 patients (especially with one like the latter), I likely wouldn't be taking a break at that time anyway, but if I did, my report would consist of probably 30 seconds or less for those minor things, and whatever was necessary for the major stuff. If you try to give a lengthy formal report for 5 patients it will take you 20 minutes to give report for a 30 minute break.

My personal opinion is that the formal types of report are good for new nurses who are learning to focus in on the important stuff, or for the floor when handing off pts during shift change. Not so much in the ED...at least for me...particularly when you consider that assessments are focused and not head-to-toe for the majority of patients. I'm sure others will have a different opinion.

Edited by GM2RN

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Opinions matter works as a RN.

596 Visitors; 12 Posts

Thanks.Yep, I am familiar with those scenarios as am a 25 yr ER veteran but we are trying to implement better handovers,short but more structured to avoid errors and improve communication.Thanks for input.

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17,770 Visitors; 1,840 Posts

We have EMR in our ED, so when giving report on a complicated pt, I open the chart and go through it in a systematic way so as not to miss anything important. If I'm the one receiving report, I will look at the pt's record along with the nurse giving report so I can ask any questions that I might have, and I make sure to WRITE DOWN anything that I think I need to remember for the next 30 minutes. My memory isn't great and I find that the act of writing it down helps to solidify anything I need to remember quickly, plus I have it with me on paper if I'm not in front of the computer at the time. I'm sorry I can't be of any more help. I certainly do share your concern that errors not be made.

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MassED has 15 years experience and works as a ER.

1 Article; 20,132 Visitors; 2,636 Posts

I think SBAR would work well - but short and sweet, nice and condensed. This is the situation, what we're doing, what they're getting (or need to get while I'm on break), and then I'll be back. Short and sweet.

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dthfytr has 30 years experience as a ADN, LPN, LVN, RN, EMT-B, EMT-I and works as a Disabled.

12,223 Visitors; 1,159 Posts

Don't get breaks often enough or long enough to think about it. If I can grab a soda and guzzle it I'm happy. Seriously thinking of taking up smoking again so I can get more breaks. Sorry, I know that's not helpful. Usually it goes like this room 1 is a kidney stone, got MS, iv's open. Bed 2's a cardiac workup, looks benign. Bed 3's an admit, on cruise, been waiting 4 hours for a bed. Family's pi**ed. Bed 4 is waiting for discharge papers and Rx's, Bed 5 has the eye tray, woods lamp, drops and dye at bedside. C'ya.

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Nicky30 works as a Registered Nurse/Midwife.

3,203 Visitors; 125 Posts

In a single nurse ER I don't usually get any breaks unless the ward takes pity on me an decides to relieve me. It's nothing to deal with 10-20 patients a shift whether in/out, admission or short stays. I make sure I bring a coke with me and something to nibble on.

My hand overs are to the ward are generally in the SBAR format.

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5,248 Visitors; 446 Posts

my reports are usually "BedA is John Doe, you know him, usual complaint, wants his demerol and phenergan". "Bed B is Jane Doe, you know her, she is leaving AMA if she doesn't get her morphine". "Bed C is OD, narcaned, is now A&Ox4, co of back pain, wanting something for it". Have a nice night.

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