Clinical Trial Details
— Status: Not yet recruiting
Administrative data
| NCT number |
NCT01609777 |
| Other study ID # |
HandSAFE |
| Secondary ID |
|
| Status |
Not yet recruiting |
| Phase |
N/A
|
| First received |
April 11, 2012 |
| Last updated |
May 29, 2012 |
| Start date |
June 2012 |
| Est. completion date |
January 2013 |
Study information
| Verified date |
May 2012 |
| Source |
University of Zurich |
| Contact |
Bastian Grande, MD |
| Email |
bastian.grande[@]usz.ch |
| Is FDA regulated |
No |
| Health authority |
Switzerland: Swissmedic |
| Study type |
Interventional
|
Clinical Trial Summary
A handover Tool for doctors and nurses improves the quality of handovers compared to
handovers that are being conducted without a tool.
In the present study the investigators will develop and evaluate a handover Tool for doctors
and nurses. The investigators seek to answer the following research questions:
1. Does the tool improve quality (i.e. efficiency and accuracy)?
2. Does the tool improve safety relevant attitude an perceived team collaboration?
Description:
Medical transfers in the ICU are a critical part of patient care. Ensuring consistency of
information that is passed on within the intensive care unit i.e. from shift to shift or
between different functional areas (eg ICU to surgery) is ensured. Incorrect, incomplete or
incomprehensible information in this context can have severe consequences and jeopardize
patient safety. Research on handovers from other high risk organizations that are associated
with a high risk of error, such as space flight control centers has shown potential
consequences that result from incomplete handovers. Apart from a flawed mental model about
the state of the system, the respective recipient of the handover are not able to anticipate
possible future events and respond accordingly. The main barriers to implement effective
handover in the medical setting are the following factors: The medical and clinical context
(constant background noise and lack of privacy); the organizational hierarchy and status
differences, which may lead the submitter to stress, as well as linguistic and cultural
barriers that may impede further communication.
To counter these barriers, a variety of memory aids (tools) have been designed to structure
the handover along defined cornerstones. Examples of such handover tools are LAURS(Listen,
Accept, Utilize, Reframe, Suggest) and SBAR (Situation, Background, Assessment,
Recommendation). These memory aids facilitate a problem-centered and consistent delivery of
information.
This however neglect a crucial fact: from a psychological perspective, the intensive care
unit presents a multi-team system. This means that different functional groups (Senior
doctors, assistant doctors and nurses) work together towards a common goal, ie the treatment
of a patient. However handovers occur mostly parallel with different functional areas, which
hampers the consistent exchange of information between the groups. This in turn may reduce
team effectiveness and lead to errors in the treatment of a patient.
For this reason, a handover tool not only supports the information flow within a function
group, but also between the various functional groups. The previous research on
communication between physicians and nurses suggests that the perceived psychological safety
is an important prerequisite for overcoming the perceived status differences, and thus for
effective and efficient teamwork. Another crucial variable for the joint achievement of a
goal is the degree of perceived team collaboration i.e. cooperation between doctors and
nurses. If these two parameters - psychological safety and team collaboration - are not met
or are insufficient, this may lead not only to lack of information, but also to reactance
against the other group. This in turn can lead to inefficient or faulty handovers and thus
fatally compromise patient safety.
The aim of the proposed study, therefore, is the development and evaluation is a tool -
handSAFE - designed to increase the problem-centered structure of handovers.
