· Introduction of topic: Standardized nursing handoff sheet for new graduates
· Literature review of the topic/issue
· Literature review of the solution/interventions
Please find instructions and sample attached
CAP Instructions and Rubric
PAPER SHOULD CONTAIN THE FOLLOWING SUB-HEADINGS
· Introduction of topic
· Literature review of the topic/issue
· Literature review of the solution/interventions
Step-by-step directions :
1. Identify a problem, issue, concern, or area for improvement relevant to your clinical setting.
2. Educate yourself about the importance of your topic to nursing and your particular clinical placement. Whenever possible, you will want to include facts, statistics etc. relevant to your
3. Critically analyze the literature related to the area of concern.
4. Identify possible solutions to the selected area of concern, based on the evidence in the literature.
5. Review each for its strengths, weaknesses, and feasibility.
6. Select a solution.
CAP Instructions and Rubric
|Grading criteria for PAPER||Points||Comments|
· Introduces topic and provides overview of the issue (2 pts.)
· Discusses why this issue is pertinent to the particular unit/organization and what led student to choose the topic (2 pts.)
· Identifies unit, manager, etc. support for the project (1 pt.)
· Identifies how the project will specifically benefit the unit/organization (2 pts.)
Literature review: topic/issue
· Includes two recent articles (less than 5-7 years) from professional nursing or health sciences journals (2 pts.)
· For each article: provides brief summary and discusses how the article is pertinent and relevant to the topic/issue (4 pts./each article=8 total)
Literature review: solution/intervention
· Includes two recent (less than 5-7 years) articles from professional nursing or health sciences journals (2 pts.)
· For each article: provides brief summary and discusses how the article is pertinent and relevant to the solution or interventions (4 pts./each article=8 total)
· Articles support the student’s chosen solution or intervention (2 pts.)
· Clearly describes final project or intervention (2 pts.)
· Outlines specific steps to implement final project/solution, including timeline for how the project could be “rolled out” (4 pts.)
· Discusses how the project will address/improve the clinical issue (2 pts.)
· Discusses future follow-up, evaluation, and/or measurement of the impact of the project (3 pts.)
· Incorporates required content in a 4-5-page paper (not including title page and reference page) (2 pts.)
· Follows correct APA:
· Proper title page (1 pt.)
· Appropriate text spacing, font size, headings, and in-text citations (2 pts.)
· Formatted reference page (2 pts.)
· Writes clearly; uses correct grammar, spelling, and punctuation; avoids first person voice (3 pts.)
|Grading criteria for e-POSTER||Points||Comments|
· Clearly displays the topic or issue (2 pts.)
· Includes general information about the topic or issue
(2 pts.) *
· Communicates specifics about why it is pertinent to the particular unit or organization (2 pts.) *
· States institutional support (1 pt.)
*If applicable, poster uses appropriate graphic or visual which conveys national or local data, trends, organization or unit statistics, etc.
Literature review of the topic/issue
· Includes literature support of the topic or issue (1 pt.)
· Summarizes most important point(s) of each article (4 pts.)
· Clearly connects authors with literature points (1 pt.)
· Clearly outlines solution and presents as feasible (3 pts.)
· Includes literature support of chosen solution (2 pt.)
· Clearly connects authors with solution literature (1 pt.)
· Identifies and explains final project and attaches a copy of “work product” (in-service handouts, pamphlet, form, pocket card, for example) (4 pts.)
· Specifically describes how the final project would be implemented, including timeline for “roll-out” (2 pts.)
· Describes how the impact of the project could be measured or evaluated (2)
· Addresses the future implications of the project for the unit and/or nursing in general (2 pts.)
COMMUNICATING WITH VENTILATED PATIENTS 1
COMMUNICATING WITH VENTILATED PATIENTS 2
Communicating with Ventilated Patients
Communicating with Ventilated Patients
It may be hard to communicate with patients under mechanical ventilation as a member of an inter-professional team offering care. Ventilated patients are unable to communicate because of the presence of the endotracheal tube (ETT). However, such communication is important to ensure patient safety and comfort since patients under such conditions usually experience panic, anxiety, fear, pain, and dyspnea, among other types of discomfort. Furthermore, despite their conditions, mechanically ventilated patients desire and have the right to be heard and take part in the making of decisions on their health for the attainment of patient-centered care.
This topic is important to contribute to the area of nursing to limit the gap of knowledge regarding relevant methods and strategies of communication for proper communication with ventilated patients. Research reveals that the care process for ventilated patients is undermined when there is a lack of communication between the patient and the caregivers. The presence of a communication barrier coupled with the health issue put the patients in a state of hopelessness. Identifying relevant communication methods for communicating with ventilated patients is important to eliminate feelings of fear, pain, and insecurity over the severity of their conditions.
Additionally, the identification of such communication methods will be useful towards the attainment of positive care outcomes in health care organizations that provide intensive care to critically ill patients. Organizations that consider such communication are bound to stand out as the leading in quality health care providers within their locales. Proper communication with ventilated patients will contribute to the research and study of the experiences of patients under mechanical ventilation and will enhance evidence-based care for such patients.
Literature Review (Topic)
Over the years, scholars and professionals in the healthcare industry have researched the issue of communicating with ventilated patients. One such research is documented in The Ventilated Patient’s Experience, which seeks to find out if there exists a relationship between the use of effective communication tools with ventilated patients with satisfaction with care among the patient and family (Fink, Makic, Poteet and Oman, 2015). The authors of the article indicate that anxiety, pain, and fear are some of the emotions that patients under mechanical ventilation have to deal with.
Furthermore, upon recovery, these patients deal with traumatic memories that may be realistic, delusional, or emotional. Such memories of their time in intensive care place the patients at risk of psychological problems and post-traumatic stress disorder (PTSD) that may linger for as long as they live affecting their quality of life. According to the authors, the emotional pain that was reported most among adult trauma patients’ emotional memories was pain, followed by frustration and anxiety (Fink, Makic, Poteet and Oman, 2015). The loss of ability to communicate leaves ventilated patients feeling powerless and out of control of their situation. There is a need for optimal communication methods and strategies to limit the stress and anxiety of ventilated patients.
Another research is one by Aziza Salem and Muayyad Ahmad, who attempt to find out the issues related to ventilated patient communication (Salem and Ahmad, 2018). The authors aim to contribute to the development of relevant communication strategies and methods for effective communication with patients under mechanical ventilation. A major concern for nurses in inter-professional teams is how to communicate with such patients.
The research reveals that similar to other patients, ventilated patients desire to take part in the process of their care and the communication barrier in form of ETT makes them perceive that they have lost control over their treatment and they end up feeling frustrated (Salem and Ahmad, 2018). Nurses spend limited time when interacting with patients in intensive care and this revealed that there is ineffective communication between such patients and their caregivers. Over 60% of patients indicate that they desired to know about their health progress while under ventilation (Salem and Ahmad, 2018). The article reveals the need for effective communication with these patients as it promotes patient recovery by bringing about a sense of safety and security.
Literature Review (Solution)
Hoom, Elbers, Girbes, and Tuinman (2016) acknowledge the communication issue that arises when caring for patients who are ventilator dependent because of intubation. According to the authors, various assistive communication tools being in place but they are not often used on patients under intensive care (Hoorn, Elbers, Girbes and Tuinman, 2016). The article acknowledges the relationship between ineffective communication with severe emotional reactions among ventilated patients.
This article is relevant to solving the issue of communicating with ventilated patients as it offers an algorithm that standardizes the approach of choosing the relevant augmentative and alternative (AAC) methods. According to the article, AAC represents forms of communication that are not limited to oral speech that express messages (Hoorn, Elbers, Girbes and Tuinman, 2016). One of the communication techniques offered in the article is communication boards made up of icons and pictures to represent basic needs (Hoorn, Elbers, Girbes and Tuinman, 2016). Other communication strategies include; the use of a speaking tracheotomy tube with an inflated cuff, the use of electro larynx, and high-tech communication intervention.
A solution for the ineffective communication between ventilated patients and the nurses offering them care is the use of communication devices (Zaga, Berney and Vogel, 2019). One of the relevant communication devices for these patients is a picture board, which contains pictures of the basic needs the patient might want. According to Zaga, Berney and Vogel (2019), picture boards ease the level of frustration among ventilated patients. To further improve the quality of care for patients under intensive care, nurses should pass on relevant communication techniques in their reports when exchanging shifts.
Research indicates that the use of the Critical care Pain Observation Tool (CPOT) has been shown to improve pain assessment and management for ventilated patients (Zaga, Berney and Vogel, 2019). Furthermore, the use of AAC should be planned rather than unplanned for patient satisfaction with care. Zaga, Berney and Vogel (2019) indicate that the use of communication strategies and methods is important and beneficial towards the improvement of patient care and outcomes overall. As a result, nurses should be educated on the need for communication with ventilated patients and the negative impacts of lack of communication with these patients. Additionally, nurses should be educated on how to make use of AAC to facilitate effective communication with patients who cannot talk because of being mechanically ventilated.
Effective communication with ventilated patients requires sensitivity towards the need for effective communication with these patients and the communication strategies and tools that make it possible. A health care organization can organize a teaching intervention for nurses, which they will attend in their time off work. These interventions will be aimed at teaching nurses the need for communication with patients under intensive care and how to use the tools and strategies in place to enhance communication between them and these patients. The intervention will be done in two segments, where the first will involve sessions that will handle the need for effective communication with ventilated patients while the second will have sessions to handle the use of communication strategies and tools.
This intervention will take approximately two weeks to complete and nurses will be grouped according to the shifts they will be handling in the two weeks. This teaching intervention will be important towards the attainment of effective communication with ventilated patients and will consequently improve the patient care process and outcomes. Teaching nurses to use communication strategies and methods for effective communication with patients will promote the reputation of the health care organization as one that offers quality care regardless of the situation. At the end of the intervention, the nurses will be better equipped to care for patients who are unable to communicate orally because of being mechanically ventilated.
The patients under critical care will be less emotionally stressed and will regain control of the care process for their health. Consequently, the hospital will have attained the universal health care goal of patient-centered goal. In this case, an evaluation will involve analyzing the length of hospital stay for critically ill patients because effective communication with such patients is bound to limit it. Moreover, the evaluation will involve analysis of ventilated patients’ emotional reactions while receiving care. On the other hand, the relevant follow-up will involve research into the improvements and developments made in terms of communication strategies and methods for communicating with ventilated patients and incorporating them into the existing strategies and methods.
Fink, R. M., Makic, M. B. F., Poteet, A. W., & Oman, K. S. (2015). The ventilated patient’s experience. Dimensions of Critical Care Nursing, 34(5), 301-308.
Salem, A., & Ahmad, M. M. (2018). Communication with invasive mechanically ventilated patients and the use of alternative devices: integrative review. Journal of Research in Nursing, 23(7), 614-630.
Ten Hoorn, S., Elbers, P. W., Girbes, A. R., & Tuinman, P. R. (2016). Communicating with conscious and mechanically ventilated critically ill patients: a systematic review. Critical Care, 20(1), 1-14.
Zaga, C. J., Berney, S., & Vogel, A. P. (2019). The feasibility, utility, and safety of communication interventions with mechanically ventilated intensive care unit patients: A systematic review. American journal of speech-language pathology, 28(3), 1335-1355.
USEFUL NOTES FOR:
Standardized nursing handoff sheet for new graduates
As a nursing student, you may be assigned to take care of a patient. You’ll need to know how to handoff the patient from one nurse to another. The standardized nursing handoff sheet has been developed by the American Association of Critical-Care Nurses (AACN) in order to help new nurses and experienced nurses alike with this process. It’s also important because it helps ensure that your patients receive the highest quality care possible throughout their hospital stay
Medication(s) (prescribed and/or over-the-counter):
Ongoing treatments in the hospital or home care facility, including nursing notes and appointments.
Date and time of report
Date and time of report:
Time zone of hospital: -8 (Eastern Standard Time)
Time zone of nursing school: -6 (Pacific Standard Time)
Time zone of student: +2 (+/- 2 hours)
Patient’s name, age, gender and social security number
Contact information for patient’s family
Name of patient
Address of the patient’s family members
Phone number for each family member, including home and work numbers.
Name of friend who is caring for the patient at this time, if applicable (a friend can be someone other than a relative).
Address of your neighbor who lives closest to you (if you live in an apartment building or condo).
Patient admission dates and current status (stable, unstable)
Here are the important information to include in your handoff sheet:
Date and time of report. This is when the patient was first brought into your care and how long they have been there since then. If they have been admitted, this should include a brief description of why they were admitted (e.g., unstable vital signs). You can also note any visitors who have come by during this time period, including whether or not they were able to see/speak with the patient before leaving (if applicable).
Contact information for patient’s family members so that you are able to provide updates about their condition if necessary—this can help reduce anxiety caused by uncertainty about what’s going on outside your office walls! It’s also helpful if you know where people from outside agencies like social workers or financial counselors live so that when needed we can easily reach them quickly without wasting gas money driving around town looking for an open house sign along every street corner.”
Patient’s diagnosis and key issues/concerns
The patient’s diagnosis, key issues/concerns and family/friends are listed below.
Patient’s name: __________
Patient’s age: _________
Current vital signs (last time and result): ______cmh2o, ______bpm/min
Patient’s current vital signs, including last time and result
The nurse’s handoff sheet should include the patient’s current vital signs, including last time and result. Vital signs are important for assessing the patient’s condition and can be taken manually or automatically by a caregiver who is trained in taking them. Vital signs must be taken at least every 4 hours if possible; however, they may be obtained more frequently depending on your clinical practice guidelines (see below).
Latest laboratory test results (complete blood count, blood type, electrolytes, heart rate)
Interpretation of lab results:
Abnormalities are indicated by a “*”. If the result is abnormal, you should notify your supervisor immediately. If you are unsure about the meaning of your result, call for further information from your supervisor or laboratory director.
What to do if there are any abnormal lab test results:
Notify your boss immediately so that appropriate action can be taken. If no changes were made in care and treatment during this time frame, then no further action is necessary unless other conditions arise (e.g., allergies).
Recent neuro-vital signs
Neuro-vital signs are important for assessing a patient’s condition. They include: blood pressure, heart rate, respiratory rate and temperature. The nurse should note the current neuro-vital signs on the handoff sheet so that it is clear to other nurses who will be caring for this patient in the future.
Latest medications given, including routes taken (intravenous, oral), dosages and times of administration; identify the date of prescriptions for narcotics and anti-anxiety medications.
List all medications, including dosages and times of administration.
Include the date of prescriptions for narcotics and anti-anxiety medications.
Include any allergies or adverse reactions to medications.
Current ongoing treatments (IV fluids, oxygen)
IV fluids are given to patients who are dehydrated.
IV fluids can be given at home, or in the hospital.
IV fluids are given through a catheter.
IV fluids can be given with a pump, or by gravity (phlebotomy).
Having a standardized nursing handoff sheet can help with patient care.
The nursing handoff sheet is a great way to help you keep track of important information, such as what medications are being used and their dosages. You can also use it for other things such as making sure that all lab results or x-rays are sent to the right place. The nursing handoff sheet also helps with communication between nurses who work together on different shifts so they know which patient needs attention first. It’s especially useful when there are multiple doctors involved in care planning or treatment plans, since each doctor has his own specialty area – so having this handy tool will help them all stay organized!
The best part about having a standardized nursing handoff sheet is that it keeps everyone informed on what steps need to be taken next – whether it’s communicating with other nurses or doctors (or even family members) outside of your immediate circle.”
We hope that this guide has given you some insight into the nursing handoff sheet. We recommend making your own handoffs, so that patients are not just handed off from one nurse to another without a moment’s thought. The best part? It only takes a few minutes to get started!
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