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When reviewing the literature for your evaluation plan and… When reviewing the literature for your evaluation plan and different types of evidence for your project, what gaps in the findings did you encounter? How could these gaps influence other researchers?  Literature Review BEENA SHAJIGrand Canyon UniversityNUR 550Ms Diana RuizDecember 17, 2021                                                                                                                                                                         In healthcare practice, clinical handover is considered one of the crucial responsibilities that medical professionals rely on, especially for nurses. Suppose all of the relevant clinical records of a patient are not transmitted effectively and appropriately when a nurse transfers over responsibilities for care to another. In that case, use, there is a high possibility of clinical e, errors which might lead to undesired coin-hospital incidence of in-hospital death, which might lead to disciplinary issues in the healthcare and the organization’s reputation of the organization and the healthcare system. Considering this aspect, healthcare professionals must pass the precise medical record to assure consistency of treatment and patient safety. The PICO question for delving deep into the abovementioned topic is the following. “Can the use of electronic SBAR handover tools minimize in-hospital deaths, in a cohort of in-patients suffering from cardiovascular/heart disease, in comparison to sign-out sheets, within a year?”                                                                                                                                                       Search methods             Search methods implemented in this project included keywords, truncate, ions, and Boolean operators. First, the database search was conducted incorporating a few customization options. For example, the time frame was set from 2010 to 2021 so that all the latest articles published on a relevant topic could be obtained. Secondly, “only English” as the language of the articles and “full text” availability were ticked while searching for the articles.             The keywords placed in the search bar included ‘SBAR’, ‘patient safety, ‘nursing care’, ‘communication’, ‘cardiovascular’, ‘heart disease’, ‘sign-out sheets’, ‘handover tools’ and ‘in-hospital deaths’. It has been extensively evidenced that the use of keywords helps researchers in obtaining more articles in their specific subject of interest and thus can be used as a required search method for research. Truncation of the keywords is another useful technique incorporated in this research. Boolean operators mainly AND OR were used between the synonyms of keywords while searching the selected databases for relevant articles. These conjunctions helped in the research by combining and excluding the keywords and thus resulted in more productive and specific results throughout the process.                                                                                                                                                Synthesis of the literature             According to the research conducted by Streeter and Harrington (2017), a qualitative methodology was implicated to find out the communication behaviors needed by the health professionals for accurate patient handover. The research was based on a primary healthcare setting, and the recruited participants applied handoff intervention. The authors have concluded that exchanging information behavior and social-emotional communication patterns are two examples of practical nursing handoff activities. This article is helpful and relevant for present research since it clarifies the actions required for a good handover.            According to the article presented by Haig, Sutton, and Whittington (2006), implemented a qualitative method to explore specific ways to spread the use of SBAR through sharing a mental model. The researchers have come up with the findings that SBAR is easy to learn and use, which increases the quality of treatment. This investigation aimed to explore how sharing mental models influenced SBAR usage. This article indicated that SBAR helps establish a safe environment for older patients and lowers the in-hospital fatalities, which assists the current project.            The research done by Achrekar et al. (2016) investigated the usefulness of SBAR in nursing practice. This research aimed to introduce and assess compliance with the SBAR form documentation. The authors implemented a quantitative approach. It contributes to this Endeavor by demonstrating the benefits of employing SBAR to improve patient safety.             The study conducted by Shahid and Thomas (2018) aimed to go over the issues that healthcare professionals issues while communicating with one another and utilizing the SBAR communication tool. It was qualitative research. Distraction and the exchange of patient-centered health information are emphasized as challenges. The SBAR tool is helpful since it allows joint decision-making and increases patient satisfaction. This article is essential since it explains the difficulties in patient-professional communication and how the SBAR tool may help.             As per the research conducted by Kitney et al. (2018), it was aimed to put SBAR handover ideas into practice in perioperative settings. The method included a qualitative observational approach. The researchers have indicated that overall ISBAR compliance improved among the participants with time. This research is necessary because it demonstrates that SBAR handover principles are applicable across the patient care journey and aids in the improvement of nursing practice.             The goal of this study conducted by Cornell et al. (2014) was to test how often the SBAR tool was used during multidisciplinary rounds and shift reports. The researchers concluded that SBAR could assist in the creation of more consistent and targeted shift reports. It can also help you save time during multidisciplinary rounds by minimizing the amount of time you spend reviewing patients. A qualitative approach was incorporated as methodology. This article backs up the findings by stating that SBAR can increase nurse and physician communication and performance.            According to the study conducted by Lisbeth Blom (2015), the quantitative, comparative study method was undertaken with pre and post-intervention questionnaires. The SBAR model was used to examine the experience of healthcare personnel in a hospital. The research concluded that professionals and patients benefited from SBAR’s expanded oral communication expertise. This is crucial to the study because it explains how SBAR may help practitioners and patients communicate better.                    The qualitative study conducted by Stewart (2016) aimed to examine how successful SBAR is in reducing communication errors during handoffs. The authors have concluded that the SBAR tool can help healthcare workers communicate more effectively. Hence, SBAR can make the healthcare environment and services safer for patients, reducing in-hospital fatalities. According to this study and thus it might be considered relevant to present research.                                                                                                                                                Comparison of articles             The similarity was observed in the methodology of most of the abovementioned articles except two articles by Achrekar et al. (2016) and Lisbeth Blom (2015), who used quantitative methods. All the papers were primarily based on the nursing perspective. However, a few included health professionals except nurses.             There were certain limitations in the articles, which were highlighted above. However, in the research conducted by Stewart (2016), secondary data was used to obtain the result, and thus bias in the development can be anticipated. Secondly, the limitation of the article by Haig, Sutton, and Whittington (2006) included its deviation from the subject. Although the researchers have followed a systematic approach throughout the research, they failed to comprehend the ways to spread the use of handover. Another major limitation of the articles was that none of the authors had indicated the usefulness of sign-out sheets taken as a comparative intervention for the present research.                                                                                                                                            Suggestions for future research            It will be beneficial to conduct more quantitative research on the same issue in the future. It would benefit healthcare professionals to compare the effectiveness of electronic SBAR handover tools and sign-out sheets. The point of the signoff sheet should also be investigated in the future to make a fair comparison. Since no studies or the minimal number of studies focussed on that tool, it remained unclear whether it was effective.                                                                                                                                                                 Conclusion            Most of the articles indicated the usefulness of using SBAR and displayed how improvement in clinical data was obtained through implementing this tool in clinical settings. Hence it can be summarized that SBAR is one of the valuable tools of handover in clinical practice. Therefore, this can be concluded that healthcare workers must facilitate the use of SBAR handover tools during their clinical practice to prevent in-hospital deaths (caused due to error in nursing handover) in a cohort of in-patients suffering from cardiovascular disease.                                                                                                                                                                    ReferencesAchrekar, M. S., Murthy, V., Kanan, S., Shetty, R., Nair, M., & Khattry, N. (2016). Introduction of situation, background, assessment, recommendation into nursing practice: a prospective study. Asia-Pacific journal of oncology nursing, 3(1), 45. https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5123547/Cornell, P., Townsend Gervis, M., Yates, L., & Vardaman, J. M. (2014). Impact of SBAR on Nurse Shift Reports and Staff Rounding. Medsurg Nursing, 23(5). http://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=10920811&AN=98979524&h=43zq83wKgT%2BcathGASLhBR3lGEMCO%2BVJra1n77x42QUGtFadLqfi2NhYswIL8XpYD7w9dX1xECV1ydLMbzZjRA%3D%3D&crl=cHaig, K. M., Sutton, S., & Whittington, J. (2006). SBAR: a shared mental model for improving communication between clinicians. The joint commission journal on quality and patient safety, 32(3), 167-175.https://medfam.umontreal.ca/wp-content/uploads/sites/16/9-article_communication_sbar.pdfKitney, P., Tam, R., Bramley, D., & Simons, K. (2020). Handover using ISBAR principles in two perioperative sites-A quality improvement project. Journal of Perioperative Nursing, 33(4), 7.https://www.journal.acorn.org.au/jpn/vol33/iss4/7/Lisbeth Blom MSc, R. (2015). The situation, background, assessment and recommendation (SBAR) model for communication between health care professionals: A clinical intervention pilot study. International Journal of Caring Sciences, 8(3), 530. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.1067.4089&rep=rep1&type=pdfShahid, S., & Thomas, S. (2018). The situation, background, assessment, recommendation (SBAR) communication tool for handoff in health care-a narrative review. Safety in Health, 4(1), 1-9.https://safetyinhealth.biomedcentral.com/articles/10.1186/s40886-018-0073-1Stewart, K. R. (2016). SBAR, communication, and patient safety: An integrated literature review. http://scholar.utc.edu/cgi/viewcontent.cgi?article=1070&context=honors-thesesStreeter, A. R., & Harrington, N. G. (2017). Nurse Handoff Communication. Seminars in oncology nursing, 33(5), 536-543. https://doi.org/10.1016/j.soncn.2017.10.002    Name______________Beena Shaji_______________________                                                                                                Complete your PICOT using your approved proposed nursing practice problem. If they were approved, you might use the population and intervention developed in your Topic 1 assignment. Include any necessary revisions in this submission. Refer to the “Example PICOT” below as needed for guidance on how to complete the PICOT.PICOT Question  PPopulationAmerican adults with heart diseaseIInterventionSBAR handover toolsCComparisonSign-out sheets for communicationOOutcomeAccurate and effective communication between nurse practitioners to ensure maximized safety for hospitalized heart disease patientsTTimeframeOne yearPICOTCreate a complete PICOT statement. In cohort patients suffering from cardiovascular/ heart diseases (P), can the use of SBAR handover tools (I) when compared to sign-out sheets (C ) reduce in-hospital deaths and improve communication between nurse practitioners and patients (O) over one year(T)?   Problem StatementCreate a problem statement for your PICOT. You will use this problem information throughout your final written paper.  In contemporary nursing practice, patient handover is an integral part. Complications in nurse handovers can lead to adverse outcomes. A lack of clarity in nursing handover leads to miscommunication, compromised patient safety, lengthened hospital stay, and increased rate of readmissions. SBAR handover tools have been widespread in care practice. They prevent miscommunication by creating a shared mental image of situations that require immediate attention or escalations and improving the exchange of critical information (Shahid & Thomas, 2018). SBAR tools get used in both primary and secondary healthcare settings. The SBAR tool provides a comprehensive, structured format through where medical information is provided in logical and concise sequence. Patients with cardiovascular diseases often require timely attention and escalation as several complications can develop throughout the hospital stay. Muller et al. (2018) outlined the adverse consequences of inappropriate nursing handovers during shift change, necessitating SBAR communication tools during shift change. Achrekar et al. (2016) revealed through a study that SBAR techniques in nursing practice could help nurses effectively communicate during the transition of care as it comprehensively includes all relevant information. Similarly, Haig and his colleagues conducted a quality improvement program through which he shared a standard mental model of handover communication among healthcare practitioners. The program resulted in the reconciliation in medication and reduction in the incidences of adverse health outcomes (Haig, Sutton & Whittington, 2006).The use of sign-outs is another approach to the transition of care from one healthcare practitioner to another. Sign-outs also provide a piece of structured information about the care needs of the patients and essential data about the patients that will inform appropriate care. However, the sign-outs might lack the salience of the SBAR tool used in communication. The information transfer can be incomplete or lead to misleading information being sent across the care setting. The handover should be frequently updated as the patient status can constantly change in the care situation. Therefore, it is essential to ensure smooth communication and reduce the chances of forgetting critical patient information, disrupting communication, and failing to be told. Handover tools used in practice should therefore be based on best practice evidence. This PICOT question will help healthcare professionals to explore the use of various types of handover tools and determine the best means through comparison.      ReferencesAchrekar, M. S., Murthy, V., Kanan, S., Shetty, R., Nair, M., & Khattry, N. (2016). Introduction of situation, background, assessment, recommendation into nursing practice: a prospective study. Asia-Pacific journal of oncology nursing, 3(1), 45. DOI: 10.4103/2347-5625.178171Haig, K. M., Sutton, S., & Whittington, J. (2006). SBAR: a shared mental model for improving communication between clinicians. The joint commission journal on quality and patient safety, 32(3), 167-175. https://medfam.umontreal.ca/wp-content/uploads/sites/16/9-article_communication_sbar.pdfMüller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ open, 8(8), e022202. https://doi.org/10.1136/bmjopen-2018-022202   Health Science Science NursingNURSING NUR 590

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