Safe, accurate and concise exchanges of information to transfer accountability and responsibility of patient care from one clinician to the next are an essential part of quality patient care. In Australia clinical handover is one of the key domains evaluated by the Australian Council on Healthcare Standards (ACHS) during accreditation. Auditing data collected in the inpatient cancer ward at the Princess Alexandra Hospital showed only approximately 40% compliance with safe clinical handover practices. Therefore the division of cancer services committed to a clinical handover project which aimed to improve uniformity of clinical handover practices and increase patient safety and satisfaction through engagement in planning and communication of care.
In a collaborative effort the division of cancer services formed a working party to review the literature and develop an acronym that could be used in all units within the division. The inpatient oncology unit recruited one direct care nurse to lead the project with the support of an advanced practice nurse. Preparation began in August 2014. The acronym ISBARS was developed comprising of; introduction, situation, background, assessment, recommendation and safety scan phases, with specific information required to be exchanged at each phase. The education team provided staff education during the month of December and the project commenced in the clinical area in January 2015.
Evaluation of the project began immediately through independent observational auditing. Data was collected weekly then monthly and displayed in the clinical area for staff and patients to view, with fluctuating results. Incident reporting has shown an increased awareness of handover errors and a decrease in Nurse Sensitive Indicators (NSIs) are being investigated for correlation at time of abstract submission. Patient and staff satisfaction is being reviewed through Best Practice Australia Surveys.