Developing Resilience, Foresight & Intuition During Clinical Handovers

Sammanfattning: Over the past number of years, there has been an international focus on improving communication amongst clinicians during transition points in care. Although clinicians achieve successes in bridging gaps during clinical handovers the focus of research continues to be on communication problems amongst team members and its association to healthcare errors. As such, there are a limited number of studies relating to how clinicians are demonstrating expertise and bridging gaps to mitigate foreseeable risks and improving patient safety. This qualitative-based study explored the techniques that rural intensive care nurses use to develop their foresight and intuition during clinical handovers. Clinical handover refers to “the transfer of information and professional responsibility and accountability between individuals and teams, within the overall system of care” (Australian Medical Association, 2006, p. 10). Twelve rural intensive care nurses were individually interviewed in addition to forty-four observations during handovers at change of shift or during other transitions in care (e.g. clinical handovers in the unit or transfer of care to another clinical area). There were a variety of techniques identified that nurses knowingly (or unknowingly) use to develop their foresight and intuition abilities. Specifically, these nurses seek to understand and scrutinize clinical data and measures; they identify with an and develop their own ‘gut/sixth’ sense by asking their colleagues anticipatory questions about what do they sense is happening with a patient; they strategize courses of action with colleagues; and lastly they incorporate the lessons that have been learned at a local level into their own practice.