Hand-Off Communication Among State Tested Nurse Aide Staff in Long-Term Care
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Publisher:The Ohio State University
Series/Report no.:The Ohio State University. College of Nursing Doctor of Nursing Practice Final Document Projects
Communication among caregivers is an essential and critical component to quality patient care and outcomes. Hand-off is a multifaceted, essential communication process that impacts continuity of patient care and needs to be accurate, clear, specific and timely. Development of innovative strategies to promote effective hand-off communication may contribute to safer care environments and improve resident outcomes related to falls. An information technology-based program for hand-off communication among State Tested Nurse Aides (STNAs), Resident Information Care Essentials (RICE), was assessed to determine its effectiveness in decreasing the rate of falls among the residents in a long-term care facility. Characteristics associated with the residents who fell at the long-term care facility were also assessed. The investigation utilized a quasi-experimental interrupted time series research design to evaluate the use of RICE on a selected unit within a long-term care facility. Retrospective fall reports for two units within a long-term care facility were analyzed from January 2011 to December 2011, inclusive to determine the unit with the higher rate of falls. The unit with the higher rate of falls was selected as the study unit, and utilization of RICE for hand-off communication was implemented on that unit. After selection of the study unit retrospective fall reports, resident charts, and RICE for all residents of that unit who sustained a fall (as defined by the CMS, 2011) were analyzed on a monthly basis for the 2-months preceding and following implementation of RICE. Data were analyzed utilizing an independent samples test assuming Poisson distributed data in each time period. The p-value was set at 0.05. Statistical analysis was completed utilizing a generalized linear model routine in SPSS. There was no evidence of a significant difference in the fall rate. Prior to RICE implementation16 residents fell for a total of 24 falls and after RICE implementation 10 residents for a total of 28 falls. Descriptive statistics were utilized to describe the characteristics associated with the falls and residents who fell after implementation of RICE. This study represents a beginning in researching the impact of an electronic mode for hand-off communication among STNA staff in a long-term care setting. Due to a national focus on improving the effectiveness of hand-off communication additional research needs to be conducted to focus on strategies to improve hand-off communication in a wide variety of healthcare settings at all levels of patient care.
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