Improving JMO clinical handover at all shift changes - ARCHI

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Some basic information you should consider when handing over different patient types.The information in the following table shows the type of information for six broad patient types that should beconsidered to ensure a concise, but comprehensive and effective handover.Medical (with multiple co-morbidities) Surgical Emergency DepartmentI– What is your name?– What is your surname?– What is your position in the Hospital?– Which Hospital are you calling from?– Which part of the Hospital are you calling from?No changeNo changeS– Why are you calling me?– What is the patient’s name(first name followed by surname)?– How old is the patient?– What gender is the patient?– What is/are the problem/s or diagnosis/es?No changeAdd:– Has the patient been admittedor accepted by a specialty team.– Is the patient scheduled underthe Mental Health Act, do theyneed a nurse special?B– What is/are the presenting symptom/s?– How bad are these symptoms?– What relevant problems has the patient hadpreviously?– What medications is the patient on?– What allergies does the patient have?– Does the patient smoke, drink or usebenzodiazepines?– Why does the patient need to be treated inhospital rather than at home or in the clinic?Remove:– “How bad are thesesymptoms”Add:– Has the patient hada recent surgery?If so, what surgeryand when?– When did the patientlast eat or drink?Add:– What is their pre-morbidstatus and social situation?– Any important linkages without of hospital care / GeneralPractice.A– What are the patient’s vital signs (appearance,comfort, BP, pulse rate and rhythm, JVP,respiratory rate, temperature and urine output)?– What are the salient clinical signs that supportthe diagnosis and indicate the severity?– What are the key investigations/ procedures –planned or results?– What are the problems and treatments youhave begun in order of importance?– Is the patient/carer up to date with thediagnosis and treatment plan?Add:– Is the patient havingDVT prophylaxis?– What intravenousfluidsare beingadministeredand at what rate?– What antibiotics arebeing administered?– What analgesia isbeing utilised?Add:– Are they fasting, or limitedoral intake?– Can they take oral medications?– Any outstanding consultationsor reviews– Where should the patientgo when they finish in ED?– Is the transfer paperworkcomplete?RYour recommendations for ongoing care withclear timeframes that facilitate the transfer ofresponsibility and accountability for patient care.Read back to prevent misconceptions and clarifywhat you have understood.No changeNo change18 NSW Health Improving JMO clinical handover – Implementation Toolkit
Most of the fundamental information is standard, regardless of the patient type, but please pay attention to the keydifferences identified against the standard medical patient example.Obstetrics and Gynaecology Mental Health PaediatricsNo change No change No changeAdd:– Is the patient in the ED, Ward, Community?– Is the patient in seclusion?– Is the patient under the Mental Health Act?No changeAdd:– Is the patient pregnant?– How many weeks gestation?– If in labour, what is the Cervixdilation?– Information relating to theCTG traceRemove:– “How bad are these symptoms”– Why does the patient need to be treated in hospitalrather than at home or in the clinic?Add:– How long has this patient been in care?– Do they have a primary carer?– Accommodation?– How/why did this person get brought to hospital?– Substance abuse?Add:– What is the patient’s current mental state?– Are they distressed, suicidal or wanting to harm others?– If in the ED what was the result of the examination bythe medical officers?– Key MSE findings?– What risks (to self/others) have been identified?Add:– Birth history (antenatal,perinatal etc)– Developmental &growth assessments(growth charts)– Social/family issues– Vaccination statusNo changeNo changeAdd:Specific recommendation relating to:– Location for treatment– Medications– What other teams should be involved?No changeNSW Health Improving JMO clinical handover – Implementation Toolkit 19
Page 2 and 3: NSW DEPARTMENT OF HEALTH73 Miller S
Page 4 and 5: ContentsAt a glance................
Page 8 and 9: Key elements for implementation1. A
Page 10 and 11: • Senior Medical Officers involvi
Page 12 and 13: 3.1 Handover happensClinical handov
Page 15 and 16: AppendicesAppendix AA clear case fo
Page 17 and 18: The implementation of structured an
Page 19: Appendix DClinical information to c
Page 23 and 24: The framework below is a framework
Page 25 and 26: Existing guides:IMPLeMeNTATION TOOL
Page 27 and 28: CD and Video supportJMO clinical ha
Page 29 and 30: Useful referencesThe JMO clinical h
Page 31 and 32: The Acute Care Taskforce tested all
Page 33 and 34: This document can also be downloade

Improving JMO clinical handover at all shift changes - ARCHI

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