Volume 20, Issue 6 (September 2022)
Nursing and Midwifery Journal 2022, 20(6): 459-468 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Dadashzadeh A, Dehghannezhad J, Heydarpoor Z, Gilani N, Fathollahzadeh A, Rahmani A. INVESTIGATING THE PATIENT HANDOVER PROCESS IN THE EMERGENCY DEPARTMENT FROM THE PERSPECTIVE OF PRE-HOSPITAL EMERGENCY PERSONNEL. Nursing and Midwifery Journal 2022; 20 (6) :459-468
URL: http://unmf.umsu.ac.ir/article-1-4499-en.html
URL: http://unmf.umsu.ac.ir/article-1-4499-en.html
Abbas Dadashzadeh1 
, Javad Dehghannezhad1 , Zhilla Heydarpoor *2 , Neda Gilani3 , Abbazar Fathollahzadeh4 , Azad Rahmani5
, Javad Dehghannezhad1 , Zhilla Heydarpoor *2 , Neda Gilani3 , Abbazar Fathollahzadeh4 , Azad Rahmani5
1- Assistant Professor of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Pediatric Nursing, Tabriz University of Medical Sciences, Tabriz, Iran ,haydarpoor22@yahoo.com
3- Assistant Professor of Biostatistics, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
4- Ph.D of Health in Disaster and Emergencies, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5- Professor of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
2- Department of Pediatric Nursing, Tabriz University of Medical Sciences, Tabriz, Iran ,
3- Assistant Professor of Biostatistics, School of Health, Tabriz University of Medical Sciences, Tabriz, Iran
4- Ph.D of Health in Disaster and Emergencies, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
5- Professor of Nursing, School of Nursing and Midwifery, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract: (2637 Views)
Background & Aims: Proper implementation of the patient handover process by prehospital personnel to the hospital emergency personnel plays an important role in ensuring continuity of care of the patients and guaranteeing their safety. The aim of this study was to investigate the opinions of the prehospital emergency personnel on the status of the patient handover process to the hospital emergency department.
Materials & Methods: The present study is a descriptive study that was carried out by census selection method on 150 prehospital emergency personnel in Tabriz in 2018. The data collection tool was a researcher-made questionnaire that evaluates the patient delivery process in 6 areas, including: clinical delivery of the patient, communication between the hospital emergency staff and the pre-hospital, information related to registration, confirmation and reporting of the forms, facilities related to patient delivery, existing standards during patient delivery, and the performance of the triage section of the emergency department. Validity of the study was calculated by the form and content method and its reliability was calculated with Cronbach's alpha coefficient (0.80).
Results: In the examination of the average scores of the six areas effective in the patient delivery process, the highest score was related to the performance area of the triage part of the emergency department with a mean of 50.92 ± 13.78 (minimum score of 12 and maximum score of 60), and the lowest score was related to the hospital facility with a mean of 15.10 ± 4.52 (minimum 10 and maximum 50). Lack of adequate parking spaces for ambulances in front of the emergency department of the hospital, lack of stretchers and wheelchairs at the entrance of the emergency department for patient transfer, overcrowding in the emergency department, and the condition of special departments in terms of empty beds and the number of medical staff were among the most important factors that had an impact on the patient delivery process.
Conclusion: Based on the findings of the present study and from the perspective of the prehospital emergency personnel, the status of the patient handover process to the hospital emergency department is moderate, and this can be a reason for incorrect transfer of the patient's medical information and the lack of optimal continuity of patient care. In this regard, proper patient delivery training for hospital and pre-hospital emergency personnel, and effective cooperation between hospital and pre-hospital emergency centers in removing obstacles and developing comprehensive national guidelines on the patient delivery process are necessary and essential.
Materials & Methods: The present study is a descriptive study that was carried out by census selection method on 150 prehospital emergency personnel in Tabriz in 2018. The data collection tool was a researcher-made questionnaire that evaluates the patient delivery process in 6 areas, including: clinical delivery of the patient, communication between the hospital emergency staff and the pre-hospital, information related to registration, confirmation and reporting of the forms, facilities related to patient delivery, existing standards during patient delivery, and the performance of the triage section of the emergency department. Validity of the study was calculated by the form and content method and its reliability was calculated with Cronbach's alpha coefficient (0.80).
Results: In the examination of the average scores of the six areas effective in the patient delivery process, the highest score was related to the performance area of the triage part of the emergency department with a mean of 50.92 ± 13.78 (minimum score of 12 and maximum score of 60), and the lowest score was related to the hospital facility with a mean of 15.10 ± 4.52 (minimum 10 and maximum 50). Lack of adequate parking spaces for ambulances in front of the emergency department of the hospital, lack of stretchers and wheelchairs at the entrance of the emergency department for patient transfer, overcrowding in the emergency department, and the condition of special departments in terms of empty beds and the number of medical staff were among the most important factors that had an impact on the patient delivery process.
Conclusion: Based on the findings of the present study and from the perspective of the prehospital emergency personnel, the status of the patient handover process to the hospital emergency department is moderate, and this can be a reason for incorrect transfer of the patient's medical information and the lack of optimal continuity of patient care. In this regard, proper patient delivery training for hospital and pre-hospital emergency personnel, and effective cooperation between hospital and pre-hospital emergency centers in removing obstacles and developing comprehensive national guidelines on the patient delivery process are necessary and essential.
References
1. Arora V, Johnson J, Meltzer D, Humphrey H. A theoretical framework and competency-based approach to improving handoffs. BMJ Qual Saf 2008;17(1):11-4. [DOI:10.1136/qshc.2006.018952] [PMID]
2. Alimenti D, Buydos S, Cunliffe L, Hunt A. Improving perceptions of patient safety through standardizing handoffs from the emergency department to the inpatient setting: a systematic review. J Am Assoc Nurse Pract 2019;31(6):354-63. https://doi.org/ 10.1097/JXX.0000000000000160 [DOI:10.1097/JXX.0000000000000160] [PMID]
3. Gonzalo JD, Yang JJ, Stuckey HL, Fischer CM, Sanchez LD, Herzig SJ. Patient care transitions from the emergency department to the medicine ward: evaluation of a standardized electronic signout tool. Int J Qual Health Care 2014;26(4):337-47. [DOI:10.1093/intqhc/mzu040] [PMID]
4. Hadinejad Z, Talebi H, Masdari F. Trauma epidemiology among rescued elderly clients in pre-hospital emergency Department of Mazandaran. Iran J Ageing 2017;12(3):372-83. [DOI:10.21859/sija.12.3.372]
5. Na Y-J, Lee K-Y. Differences in performance and importance of handover items between 119 paramedics and emergency department staff. Korean J Emerg Med Serv 2021;25(1):105-24. [DOI:10.14408/KJEMS.2021.25.1.105]
6. Chladek MS, Doughty C, Patel B, Alade K, Rus M, Shook J, et al. The Standardisation of handoffs in a large academic paediatric emergency department using I-PASS. BMJ Open Qual 2021;10(3):e001254. [DOI:10.1136/bmjoq-2020-001254] [PMID] [PMCID]
7. Tortosa-Alted R, Reverté-Villarroya S, Martínez-Segura E, López-Pablo C, Berenguer-Poblet M. Emergency handover of critical patients. A systematic review. Int Emerg Nurs 2021;56:100997. [DOI:10.1016/j.ienj.2021.100997] [PMID]
8. Yong G, Dent AW, Weiland TJ. Handover from paramedics: observations and emergency department clinician perceptions. Emerg Med Australas 2008;20(2):149-55. [DOI:10.1111/j.1742-6723.2007.01035.x] [PMID]
9. Audebert H, Fassbender K, Hussain MS, Ebinger M, Turc G, Uchino K, et al. The PRE-hospital stroke treatment organization. Int J Stroke 2017;12(9):932-40. [DOI:10.1177/1747493017729268] [PMID]
10. Aase K, Soeyland E, Hansen BS. A standardized patient handover process: Perceptions and functioning. Saf Sci Monit 2011;15(2):1-9. [Google Scholar]
11. Di Delupis FD, Mancini N, Di Nota T, Pisanelli P. Pre-hospital/emergency department handover in Italy. Intern Emerg Med 2015;10(1):63-72. [DOI:10.1007/s11739-014-1136-x] [PMID]
12. Gardett I, Scott G, Clawson J, et al. 911 Emergency communication nurse triage reduces EMS patient costs and directs patients to highsatisfaction alternative point of care. Ann Emerg Dispatch Response 2015;3:8-13. [Google Scholar]
13. Day D. Keeping patients safe during intrahospital transport. Crit Care Nurse 2010;30(4):18-32. [DOI:10.4037/ccn2010446] [PMID]
14. Dawson S, King L, Grantham H. Improving the hospital clinical handover between paramedics and emergency department staff in the deteriorating patient. Emerg Med Australas 2013;25(5):393-405. [DOI:10.1111/1742-6723.12120] [PMID]
15. Bost N, Crilly J, Patterson E, Chaboyer W. Clinical handover of patients arriving by ambulance to a hospital emergency department: a qualitative study. Int Emerg Nurs 2012;20(3):133-41. [DOI:10.1016/j.ienj.2011.10.002] [PMID]
16. Kalyani MN, Fereidouni Z, Sarvestani RS, Shirazi ZH, Taghinezhad A. Perspectives of patient handover among paramedics and emergency department members; a qualitative study. Emerg (Tehran). 2017;5(1):e76. [] [PMCID]
17. Shah Y, Alinier G, Pillay Y. Clinical handover between paramedics and emergency department staff: SBAR and IMIST-AMBO acronyms. Int Paramedic Pract 2016;6(2):37-44. [DOI:10.12968/ippr.2016.6.2.37]
18. Yegane SAF, Shahrami A, Hatamabadi HR, Hosseini-Zijoud S-M. Clinical information transfer between EMS staff and Emergency Medicine Assistants during handover of trauma patients. Prehosp Disaster Med 2017;32(5):541-7. [DOI:10.1017/S1049023X17006562] [PMID]
19. Salehi S, Zarea K, Mohammadi A. Patient handover process problems between emergency medical service personnel and emergency department nurses. Iran J Emerg Med 2017;4(1):27-34. [DOI:10.22037/ijem.v4i1.13668]
20. Fairbanks RJ, Bisantz AM, Sunm M. Emergency department communication links and patterns. Ann Emerg Med 2007;50(4):396-406.
https://doi.org/10.1016/j.annemergmed.2007.03.005 [DOI:10.1016/j.annemergmed.2007.03.005.] [PMID]
21. Ye K, McD Taylor D, Knott JC, Dent A, MacBean CE. Handover in the emergency department: deficiencies and adverse effects. Australas Emerg Nurs J 2007;19(5):433-41. [DOI:10.1111/j.1742-6723.2007.00984.x] [PMID]
22. Owen C, Hemmings L, Brown T. Lost in translation: maximizing handover effectiveness between paramedics and receiving staff in the emergency department. Emerg Med Australas 2009;21(2):102-7. [DOI:10.1111/j.1742-6723.2009.01168.x] [PMID]
23. Meisel ZF, Shea JA, Peacock NJ, Dickinson ET, Paciotti B, Bhatia R, et al. Optimizing the patient handoff between emergency medical services and the emergency department. Ann Emerg Med 2015;65(3):310-7. https://doi.org/ 10.17705/1CAIS.03905
https://doi.org/10.1016/j.annemergmed.2014.07.003 [DOI:10.17705/1CAIS.03905] [PMID]
24. Hovenkamp GT, Olgers TJ, Wortel RR, Noltes ME, Dercksen B, Ter Maaten JC. The satisfaction regarding handovers between ambulance and emergency department nurses: an observational study. Scand J Trauma Resusc Emerg Med 2018;26(1):1-6.
https://doi.org/10.1186/s13049-018-0545-7 [DOI:10.1186/s13049-018-0545-7.] [PMID] [PMCID]
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Contact Information
Address: Urmia University of Medical Sciences, Deputy of Research and Technology,Djahad Ave.,
Urmia-5714783734, IRAN
P.O. Box: 1138,
Tel: 044 - 331937224
Fax: 044 - 32240642
E-Mail:
j.nur.mid
gmail.com, unmfumsu.ac.ir