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Standardized Handoff Checklist in Acute Care
Problem Description
Acute care refers to the short-term but active medical care the patient receives during an urgent health condition. It is opposite to the long-term or chronic that supposes that patients receive regular medical supervision to support their health. Therefore, acute care allows for saving the lives of those patients whose health state is endangered by the sudden aggravation of symptoms of their medical condition or injury that requires a quick reaction from the medical personnel. It explains the need to make the acute care sphere critical in the public health system. Patient safety and high-quality acute care is the healthcare systems problem that requires a solution. Using a standardized handoff checklist for acute care ensures the improvement of cooperation between different healthcare units, creating a precise database of measurements to provide high-quality and safe care.
The facilities that provide people with acute care include all types of hospitals, hospices, home health agencies, and ambulatory health care facilities. The medical personnel should be prepared to provide patients with acute care in urgent cases regardless of the specialization of the health care unit. At the same time, not all healthcare facilities can ensure a high level of specialized acute care, including coronary care, intensive care, or neonatal intensive care, which is a clinical problem. Therefore, patients require stabilization of their state and transfer to a well-equipped healthcare facility that can provide them with the necessary medical assistance. Since all patients in a critical health state, regardless of their insurance, have the right to receive acute care in the United States, this problem affects all populations. It foregrounds the significance of improving the readiness of all healthcare facilities in the United States to provide people with a high level of medical assistance in critical situations.
PICOT
Population/ Patient Problem
Regardless of their citizenship and healthcare insurance, all people are eligible for acute care. As a result, there are no demographic peculiarities of the patient in the critical care unit. The main characteristic that all patients in the acute care setting share are the health state that endangers their lives regardless of the reasons that lead to it (Hall et al., 2020). Therefore, the severe health condition that can lead to a persons death is characteristic of all patients in the acute care unit.
Intervention
The standardized handoff checklist in acute care improves the quality of communication between healthcare personnel. For instance, anesthesia providers work with many patients daily, increasing the chance of missing critical information or misunderstanding it (Barry et al., 2017). Using checklists is an effective way to improve the quality of teamwork because it coordinates all professionals actions and increases staff satisfaction. It gives all team members the feeling that they are pursuing the common goal and that their contribution is measured adequately (Hall et al., 2020). In addition, the actions of the medical personnel are quicker and more precise when they use the schedule, which is a crucial element in acute care. According to the estimates, the quality of critical care increases almost by 40% after the implementation of handoff checklists for all healthcare professionals in the unit (Barry et al., 2017). Therefore, using the unit-based standardized handoff checklist allows the medical personnel to improve their teamwork and make their actions more coordinated and precise.
Comparison
Not all healthcare professionals in the acute care unit support the implementation of the standardized handoff checklist due to its length, complexity, and low efficiency in the short-term perspective. The results of the performance of the standardized checklist are not evident to the nurses who work in the Post Anesthesia Care Unite, as the investigation shows (Sosebee et al., 2017). It is possible to illustrate the doubts that healthcare professionals have concerning the effectiveness of standardized handoffs using the following words from the article:
Sixteen weekday and 16 night and weekend handoffs were compared. There were no significant differences in basic characteristics. Most quality measures were similar on weekdays compared with nights and weekends. Surgeons demonstrated better report delivery skills and engagement on nights and weekends (P =.002 and P =.04, respectively), whereas OR anesthesiologists scores were similar during both time frames (Barry et al., 2017, p. 1035).
These results of the study show that the short-term period of implementation of the standardized handoffs does not lead to significant improvement in the work of the acute care unit. Neither nurses nor surgeons see the evident difference in the use of these handoffs. Though, in both cases, healthcare professionals tend to regard it as extra work they have to complete without seeing evident practical results, which is annoying for them and leads to opposition to change (Barry et al., 2017). It is possible to hypothesize that making the test period longer for the standardized handoffs and motivating healthcare workers to use them on a regular basis might lead to better results in the long-term perspective.
At the same time, they supervise the patients whose health state is already stabilized after surgery, which means there is no need for a quick reaction. Using standardized handoff checklists might save peoples lives if their state aggravates dramatically, and the previously gathered data might facilitate the response of the acute care unit, giving them more information about the patient.
The alternative to using the standardized handoff checklist is to use the old, less centralized ways of gathering information concerning the patients health state. In this case, the chances for a slower reaction in the acute care unit increase significantly because they require time to find the data concerning the health history of the particular patient (Sosebee et al., 2017). Moreover, as was already mentioned in this paper, acute care unit professionals often work with multiple patients. The chances for human mistakes due to lack of concentration on the particular patient and their problems increase when doctors and nurses from the acute care unit have to remember the anamnesis of several people simultaneously.
Outcome
To conclude, introducing the standardized handoff checklist in acute care units might reduce the likelihood of adverse events and the omission of vital patient information in three months. The comparatively prolonged period of supervision might show that the implementation of the standardized checklist makes the work of the acute care team more structured and centralized (Hall et al., 2020). As a result, all team members have access to the necessary information concerning the patients health state and history in critical situations. It improves the quality of healthcare services and reduces the chances of adverse outcomes for the patient.
Search Strategy Narrative
For this research; two databases were used: PubMed and Bookshelf. They provide the readers with scholarly, peer-reviews, and reputable sources on the topics connected with healthcare. Therefore, the information from the articles taken from PubMed and Bookshelf is the authoritative source for further investigation on the subject of acute care. The use of the keywords for searching the pieces on the discussed topic and the limits ensure that the information is relevant and, therefore, can be used in the research paper. The limitation is the publication date, and the articles used for this investigation were published after 2017. The keywords for search in PubMed and Bookshelf are standardized handoff report, PACU, and acute care. The combination of these keywords searches the articles in both databases relevant to the discussed theme about the utilization of standardized handoff reports in acute care units. The peculiar detail is that Bookshelf does not provide academic sources that feature all keywords. Still, it features articles discussing the concepts required for the investigation separately, making them eligible for the research.
Table 1
Table 2
References
Barry, M. E. et al. (2017). Leveraging telemedicine infrastructure to monitor quality of operating room to intensive care unit handoffs. Acad Med. 92(7), 1035-1042. Web.
Hall, K. K. et al. (2020). Making healthcare safer III: A critical analysis of existing and emerging patient safety practices. Rockville (MD): Agency for Healthcare Research and Quality.
Sosebee, T. et al. (2017). Exploring acuity-adaptable care in a rural hospital. J Nurs Adm. 47(11), 565-570. Web.
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