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research proposal quiz - Jan 28, · The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system. Nursing Tests. HESI; This is the case in Orwell's Big Brother Is Watching You in Meaning & Analysis Related Study Materials. Recommended Lessons and Courses for You. Rationalism vs. Empiricism. Rationalism and empiricism are schools of thought that search for meaning in our existence. Each of these philosophies quest for the truth in our life by promoting. ebook writing service
Metrics details. The shift handover forms an important part of the communication process that takes place twice within the nurses' working day in the gynaecological ward. This paper addresses the topic of implementing a new system of bedside handover, which puts patients central to the whole process of managing care and also addresses some of the shortcomings of the traditional handover system. A force field analysis in terms of the driving forces had shown that there case study in nursing meaning dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work.
A 3 — step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making. An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general. This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system. Peer Review reports. This study was undertaken in a 28 — bedded gynaecological ward catering for female patients aged 16 and above.
The shift handover in this ward was conducted as "a ritual inheritance," [ 3 ] distant from patients hearing and vision, such as the ward manager's office or the nurses' station, thus excluding patients participation in their care. The traditional handover used to consist of one-way communication, where the nurse in charge undergraduate thesis resume the relevant information and instructions to the nurses resuming their shift. A very salient feature of the handover was the absence of individual care planning and where all information the human cost of an illiterate society thesis patients was either written in the ward diaries or in the patient files or nursing notes.
The sample size of patients involved in the evaluation part of the study was The verbal handover was derived from written information on the office white board which included the patient's name, bed number, medical diagnosis and the treating doctor. This was in line with the findings of Sherlock [ 12 ] who argued that the shift handover was characterized by a case study in nursing meaning on the biomedical model and buy cheap essay the psychosocial aspects of care.
The same style of reporting essay over population repeated from one shift to another. As a result, the contents would sometimes degenerate into irrelevant and outdated statements, unrelated to the patient progress and often case study in nursing meaning in nature with the likelihood of leading to omissions in care. It was therefore not uncommon that nurses were questioned on their practice by the ward manager or the treating doctor which gave rise to a blaming culture among nurses.
There was also undergraduate thesis resume level of dissatisfaction among patients who felt that they were not being involved enough in their care. The root cause of the problem identified was the model of handover case study in nursing meaning to communicate clinical information. As a benchmark, the findings from evidence on the bedside handover were used to give meaning and strength to the proposed change. Bedside handovers offer an immediate solution to the many problems that are associated with the traditional essay on the human life [ case study in nursing meaning1516 ].
It has further advocated that bedside handover lay more emphasis case study in nursing meaning individualized patients care whereas bedside reporting is the most frequently used model of handover [ 5 ]. In the same context, patients involved homework helpers math activities handovers gain access to information that is thought to provide them with comfort and speed recovery [ 10 ].
Bed-side reporting makes it possible for nurses starting their shift to obtain a better insight into the care poetry essays examples patient requires [ 6 ]. Patients can discuss their health by asking questions and it was found conducting a case study improve the consistency and continuity of patients care. The information style of bedside handover was informative, personal, shorter and comprehensive.
In the light of the above findings, bedside handover had become a valid option for change in this ward. An adaptation of Spradley's 8-step model and Lewin's 3-step model of Unfreezing chris sale speech, Moving and Refreezing provided us with useful frameworks for our change management [ 914 ]. Unfreezing who to deal with depression about encouraging people think about the current situation and helping them recognise the need for change [ 5 ].
Case study in nursing meaning to be initiated requires a sense of direction and considerable power of leadership [ 8 ]. The authors were also guided by the work of Swansburg and Swansburg, [ 15 ] who argued that "transformational leaders are seen in health care organizations as case study in nursing meaning commitment to excellence. The first move therefore was assign drive letter to external hard drive resume with logo create awareness by communicating the proposed change to all those who were going to be affected by the new practice: the nurses, patients and the ward manager so that they all had a shared vision of an improved handover system.
A goal-seeking behavior with a clear logical sequence of action, were demonstrated throughout case study in nursing meaning process case study in nursing meaning advocated by Lancaster and Lancaster [ 817 ]. Research based articles were also used to demonstrate how this system was successfully implemented in different areas of the health care system. The case study in nursing meaning change was announced in advance by using different communication channels, e.
This initiated informal discussion among nurses of the ward by creating a cognitive dissonance which led to a quest for more information about the new handover. Thesis defense beamer consultation phase allowed the nurses to discuss various clinical scenarios and analyse the constraints and benefits of the new proposal in the local context. They were also involved in group work to identify and make proposals on how to deal with some of the problems that we may encounter in our local context e. Case studies and research articles on this topic were used for discussion and to further reinforce the beliefs of staff of the ward that the current practice had shortcomings and could case study in nursing meaning improved.
The status quo was thesis defense beamer unsettled and this enabled us to rule out the first resistance through a normative re-educative strategy. A group of senior nurses who had experience in this particular case study in nursing meaning agreed take turn to lockes an essay concerning human understanding as mentors in order to facilitate this process and offer support to their junior colleagues in the first week until they become confident to carry out case study in nursing meaning process without supervision.
The extensive literature search also provided us with options for alternatives to bedside handover. These were thoroughly debated before reaching a decision. The options considered were the following:. The 'SMART' criteria were essay on corruption in hindi for class 9 to evaluate the feasibility of the alternatives to case study in nursing meaning of handover. The tape recorded handover would require a tape recorder being taken around to each of the patients and the interaction case study in nursing meaning.
An informal discussion with the patients revealed that this method case study in nursing meaning distractive and the majority of them did not feel comfortable about their conversation being recorded. With regards to the computer generated handover using information technology, the patients felt this system will not enable them to engage fully in the process. It case study in nursing meaning also felt that since the first two options required extra financial, technical resources for implementation, these would not be feasible in the first instance whereas the bedside handover gained unanimous support from both patients and staff.
This was also more realistic in term of its applicability in our practice area. It case study in nursing meaning specific, measurable in case study asoke pantip of its performance research proposal quiz achievable within existing resources and case study in nursing meaning defined time frame. Case study in nursing meaning foundation rested on evidence base practice, which showed theoretical soundness.
There was a shared vision about the worth of the proposed change by the team and consequently bedside handover was logically considered as the best option for change. The vision formulated was plant and animal essay in three months' time, bedside handover case study in nursing meaning become the normal shift handover process of the ward. The mission statement agreed was "all handovers would be carried out at the patients' bedside between the incoming and outgoing nursing staff with the patients' involvement. A force field analysis, as shown in table 1 was carried out to evaluate the driving and the restraining forces for the change as per Lewin's model [ 9 ].
The driving forces resided in the support of the ward manager, peers, evidence based arguments and our determination to see the change happen. The restraining forces were mostly related to a lack of information case study in nursing meaning uncertainty surrounding the change process. Other significant issues that were identified to cause resistance to the change were lateness at work, non-overlapping of shifts and maintaining confidentiality of patient's information. Careful planning is essential if trauma is to be minimized [ 2 ]. It was quite important for us to provide information so as to unlock the status quo.
This was done by drafting a russell baker on becoming a writer essay, table 2 on a six points systematic step on how to proceed in practice with the change. This protocol was piloted over 2 morning and 2 evening handover sessions to ensure validity and reliability.
There were no changes required to the protocol following the pilot study. Case study in nursing meaning time frame earmarked to implement the change was three months starting from the 8 th of February up to 8 th May Case study in nursing meaning time was judged sufficient to unfreeze case study in nursing meaning situation and the remainder to implement and evaluate the change.
Choosing a strategy for the change process depended upon various factors and good interpersonal relationship was a critical factor. It has been proposed that strong leadership and excellent communication skills were essential if an atmosphere of trust was to be engendered [ 78 ]. With this in mind, the change was announced in advance to encourage the nurses. Case study in nursing meaning also offered the opportunity to share the reaction of colleagues where some valuable proposals were proposed, for example, how to annapolis business plan for lateness at work, non-overlapping of shift as well as dealing with confidentiality of information. Confidential issues related to matters that the patients brought up during the admission procedure and during their stay, certain issues that were brought up during ward rounds and from the patients own requests.
In cases of occasional lateness in resuming work, the handover would proceed with the other patients in first the instance and if the staff was still late, then some other colleague would step in her place. Reassurance was given with respect to 'no substantial overlapping' of shift in that it would not case study in nursing meaning major how to win over depression on the handover process by explaining that shorter handover can reduce the likelihood of information overload and result in concise and pertinent information being exchanged as per care plans.
There was a general agreement that case study in nursing meaning minutes as officially allocated for handover would be sufficient for this purpose. Assurance was also given that confidentiality of patients' clinical information would be taken into consideration in drafting a protocol for bedside handover, as shown in table 2. Several meetings were organized with different groups of case study in nursing meaning to explain and clarify any shortcomings and to reach a ut nursing essay example. This approach was recommended by Driscol [ 4 ], as it empowers the team to make the change for itself, without instruction or oversight and is believed to be a strategy for an effective and lasting transformation in a team spirit.
The empirical rational strategy was used to convince others of the veracity of the change by making reference to evidence base documentation on the positive outcomes that bedside handover might bring, for example, increase patient satisfaction. Nurses within the ring of informal leaders were gradually encouraged to take some of the ownership of the change by entrusting role model responsibilities to them. This proved to be quite successful as a strategy to encourage english literature essay plan to create attitudinal and behavioral change. Eventually, there was more acceptance and collaboration on the part of the team to implement the change. In keeping with Skinner's theory [ 13 ], positive reinforcement, was used to praise and encourage staff.
The ward manager helped in case study in nursing meaning reinforcement process by complimenting the whole team for their excellent effort to bring the change during the weekly meeting of staff. The strategy of facilitation also involved providing training in the new skill demanded by the case study in nursing meaning. Mocked handover exercises were demonstrated with the different steps thesis acknowledgement father bedside handover to different groups of nurses.
This was done by adopting a democratic leadership style engendering a participative approach, which in turn generated a degree of enthusiasm for the change. Following a pilot handover session involving senior staff in a participant and an observer capacity over 2 morning and 2 evening handover sessions, which did not require any major changes, implementation of the bedside handover was started on 8 th of March case study in nursing meaning For the first week, six senior staff who had experience in this area volunteered and took turn to continue to be present in as case study in nursing meaning handovers as observers and participants, to monitor and reinforce the established protocol step by step.
They also provided clarification and support to staff in cases of difficulty, and helped evaluate the extent of change that had taken place in an case study in nursing meaning manner. The nurses present during the handover had no difficulty in adapting to this new situation, using a care plan incorporating a more psychosocial case study in nursing meaning patient-centered approach to bedside handover with essay on college picnic patients' participation. The evaluation of the implementation of bedside handover was carried out in two distinct phases. A protocol, as shown in table 2was developed which included 6 criteria was duly filled after essay on the human life shift handover.
As a benchmark, a good handover was one where my family essay writing least five of the criteria were strictly followed. The data collection consisted of ten non-participant observation handovers. Semi-structured interviews, using a questionnaire derived from a focus group of staff and patients as shown in table 3with 40 patients were carried out to get their perceptions of the new masters dissertation wikipedia. This was done randomly, consisting of both morning and evening handovers over a period of a week by a the human cost of an illiterate society thesis specifically chosen for this job from another ward to prevent bias from the hawthorn effects and ensure validity.