Compliance to clinical handoff communication and its impact on patient safety in hemodialysis units

Introduction: Patient safety is becoming a focus & priority of every healthcare authority and organization, as they impact outcomes of patients and healthcare effectiveness and efficiency, as evident from the emphasis on international patient safety goals. Clinical handoff communication continues to receive widespread attention from healthcare givers as it emphasizes the clinical crucial time for patient outcomes. This is why the health care providers are involved proactively in proper handoff during shift & during care at the hemodialysis unit by adhering ISBAR (Identification Situation Background Assessment & Recommendations) format & timely intervention which influences the compliance status of patient safety. The hemodialysis unit at Apollo Hospitals, Bhubaneswar has a policy of effective handoff with strict ISBAR format and intervened accordingly to comply the patient safety. The aim of this study was to assess compliance with clinical handoff communication & to assess the impact of clinical handoff communication on patient safety. A handoff is largely dependent on the interpersonal communication skills of the caregiver as well as the knowledge and experience level of the caregiver. There is reported variability in quality, lack of structure in how handoffs usually occur, and variances in shift handoffs. Methodology: In June 2022 there was an increase in the consultant complaints about the nursing care for the patient in hemodialysis unit .all the staff nurses were reinforced about the clinical handoff and communication using ISBAR.A quantitative descriptive survey was conducted in the month of July, August and September to assess the compliance to the clinical handoff and ISBAR format communication and its impact on patient safety among the In-Patient hemodialysis patients at Apollo Hospitals, Bhubaneswar .Using purposive sampling technique 150 In-Patients hemodialysis patients were selected for the study .The data was collected using Accuracy and completion of clinical handoff check tool(ACT). Results: With constant reinforcement on clinical handoff and ISBAR there was a steady increase in compliance to clinical handoff with 47% in July 87.50 in august and 94% in September and ISBAR with 51%in July 75%in August and 84% in September .The impact of the compliance on patient safety was assessed on the basis of clinical action after clinical handoff and patient outcome .The analysis shown that clinical action after clinical handoff was improved from 64% in July, 75% in August and 79.50% in September and patient outcome increased from 58% in July, 71%in august and 77.50% in September Conclusion: Patient handoffs are a necessary component of current medical care. When healthcare professionals are not communicating effectively, patient safety is at risk for several reasons: lack of critical information, misinterpretation of information, unclear orders over the telephone, and overlooked changes in status. So it’s required to follow a standard format during handoff communication to comply the patient safety. The ISBAR (Introduction, Situation, Background, Assessment, Recommendation) framework, endorsed by the World Health Organization, provides a standardized approach to communication that can be used in any situation. In the complex clinical environment of healthcare today, ISBAR is suited to a wide range of clinical contexts and works best when all parties are trained in using the same framework. So it’s important to sustain the best practices of clinical handoff communication & all health care team need continuous follow-up & compliance checks through ACT (Accuracy& completion of hand-off check Tool).