The American journal of nursing
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Handoffs of patient care from one nurse to another are an integral part of nursing practice; but there is abundant evidence that poor communication and variable procedures result in inadequate handoffs. We sought to conduct a systematic review of articles that focused on nursing handoffs, conduct a qualitative review of barriers to and strategies for effective handoffs, and identify features of structured handoffs that have been effective. ⋯ Despite the well-known negative consequences of inadequate nursing handoffs, very little research has been done to identify best practices. There is remarkable consistency in the anecdotally suggested strategies; but there is a paucity of evidence to support them. We call for high-quality studies of handoff outcomes that focus on systems factors, human performance, and the effectiveness of structured protocols and interventions.
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Minority patients are at high risk for poor pain outcomes. When patients belong to a culture or speak a language that's different from that of their health care provider, the provider faces additional challenges in successfully assessing and managing the patients' pain. This article describes how and why culture affects both patients and nurses. It also discusses why members of cultural minority groups frequently receive suboptimal pain management and how nurses can improve patients' pain outcomes by using culturally sensitive assessments and providing culturally comfortable care.
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Patients and family members often aren't aware that the use of life-support interventions at the end of life-when the body's systems and organs are failing-can have unintended consequences. Nurses need to be knowledgeable and able to communicate what they know about those consequences to patients, family members, and others on the health care team, leading to better decision making at this difficult time.