Key Findings Knowledge is exchanged during handoffs on Medical and Surgical units Information and knowledge distribution differ between Medical and Surgical units Knowledge can be increased by linking handoff content to patient care goals and problems

Data, Information, Knowledge & Wisdom in Nursing Change of Shift ReportsLory J. Maddox, MSN, MA, RN, Susan A. Matney, MSN, RN, FAAN, Nancy Staggers, PhD, RN, FAAN

exchanged during handoffs on Medical and Surgical uknowledge distribution differ

Knowledge can be increased by linking handoff content to patient care goals and

exchanged during handoffs on Medical and Surgical unitsknowledge distribution differ between Medical and Surgical units

Knowledge can be increased by linking handoff content to patient care goals and problems

Coded when nursing judgment or critical thinking was articulated“I was worried about her blood sugar so I had her drink a whole thing of orange juice. She wasn’t eating, so I needed to at least get something down her.”

Knowledge

Little meaningDiscrete facts without context

Knowing why things should be done or not done

Coded when an observation was reported without a nursing judgment“Regular diet” “Age is 63” “Past history of diabetes”

Information

Wisdom

Data

Discussion

• Nursing handoffs across Medical and Surgical Units comprise similar amounts of knowledge and information

• No explicit information or knowledge about plans of care, nursing diagnoses, multidisciplinary goals or patient problems during handoffs

• Electronic health records must be designed to support both standardization and purposeful tailoring for different patient care units

Results

1718 entries coded 59% Information (n=1010) phrases 41% Knowledge (n=708) phrases

Total of 15 subcategories defined

Background

Change of shift reports are a critical exchange of patient information Preventing errors and improving patient care quality require knowledge and critical thinking

Problem

Definitions for handoffs focus on information transfer; nurses are considered knowledge workers No research is available on the knowledge content of nursing handoffs

Research Question

Is there evidence of knowledge exchange during patient care handoffsand if present, how is this knowledge is expressed?

Methods

Design: Secondary data analysis using deductively driven, directed content analysis of 93 patient care handoffs

Settings: 2 acute care hospitals in the Western USA Participants: 23 female and 3 male nursesAverage age = 37 yearsModal education level = Bachelor’s degree Experience = 6 months to 20 years