In this micro-lecture, APC Hon. Snr. Lecturer Sam Willis talks about the process of handing over a patient to a triage nurse or doctor at a hospital.
Hey guys. In today’s session, I’d like to talk to you about a hospital handover. Now, with all the efforts that you’ve gone through to arrive safely on scene, assess, diagnose, manage, treat, and provide all sorts of levels of care to your patient, you then have to convey to hospital, and then hand over to another healthcare professional.
Now, that handover is crucial for the patient’s safety and the quality of the care that they will receive. So, it’s really, really important that we do get the important key ingredients when we’re handing over to the nursing staff.
What you have to try and do when you’re handing over is to try and put yourself in that nurse’s position. Now, as paramedics we treat generally one patient at a time. But, as an emergency nurse, you are dealing with sometimes upwards of 10 or more patients at any given moment in time. That involves monitoring them, treating them, sending for X-rays, blood tests, responding to doctor’s orders, doing leadership things, taking patients to toilets.
Of course, they’re extremely busy people. So when you guys arrive with another patient, it’s really, really important that you use that 30-second window to make sure you convey the most necessary information.
Now, there is of course a number of different mnemonics that can help you to hand that information over. One of them that’s used quite commonly, it’s called IMIST-AMBO. That can hopefully make your life a lot easier.
Number one, put yourself in that nurse’s shoes. What do you want to hear the moment you walk in?
It might even be that there’s five ambulance crews already lined up, so you’re already overwhelmed. So, by putting yourself in the nurse’s shoes, you’re thinking to yourself, “Right, this nurse needs to know the key facts, three or four key facts,” and the rest of it’s already documented anyway – so they can go back and look at it later.
So, for me it’s usually a case of, “This is John.”
So, a name’s a good start.
“He’s 65 years of age.” Age, really, really important.
“Today, he was complaining of chest pain.”
So, chest pain is like a red flag to any healthcare professional.
“He does have a history of myocardial infarction.”
So, there you go, a history of myocardial infarction. “Today he’s been complaining of left-sided chest tightness described as his similar heart attack where he came to this hospital last year where they implemented him with a stent, they put a stent in. We’ve provided drugs, this is what we’ve given, these are his last set of observations.”
And that’s it. Everybody else really can wait until later on. So, by doing that, number one, you’re conveying the key messages, number two, you’re allowing the nursing staff to be able to take control of what they do with that patient, and you’re preventing overloading them.
Now, don’t get me wrong, nursing staff are really good at filtering and asking questions, but if you’re contributing to a safe system by providing just the key information they then will judge you as a good paramedic, the patient remains safe and the patient receives high quality of care quickly.
Now, of course the only exception to that is to make sure you provide any information that is pertinent such as allergies, drugs, that you think is deadly, deadly serious in that situation.
So, just to contrast what I’m saying, don’t start the situation off with, “This is a 65-year-old male. When we arrived he was on the couch watching TV. We asked him this question and asked him that question.” So, get straight to the point.
Okay, so that’s a snapshot of hospital handovers. You can always do more reading around it and you’ll get plenty of practice when you get to the workshops.
My name’s Sam (APC Hon. Snr. Lecturer) and I look forward to speaking to you lately.