Abraham2015

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Abraham2015
BibType ARTICLE
Key Abraham2015
Author(s) Joanna Abraham, Thomas Kannampallil, Corinne Brenner, Karen D. Lopez, Khalid F. Almoosa, Bela Patel, Vimla L. Parel
Title Characterizing the structure and content of nurse handoffs: A Sequential Conversational Analysis approach
Editor(s)
Tag(s) EMCA, Errors, Nurse, Transitions, Intensive Care
Publisher
Year 2015
Language
City
Month
Journal Journal of Biomedical Informatics
Volume 59
Number
Pages 76–88
URL Link
DOI 10.1016/j.jbi.2015.11.009
ISBN
Organization
Institution
School
Type
Edition
Series
Howpublished
Book title
Chapter

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Abstract

Effective communication during nurse handoffs is instrumental in ensuring safe and quality patient care. Much of the prior research on nurse handoffs has utilized retrospective methods such as interviews, surveys and questionnaires. While extremely useful, an in-depth understanding of the structure and content of conversations, and the inherent relationships within the content is paramount to designing effective nurse handoff interventions. In this paper, we present a methodological framework—Sequential Conversational Analysis (SCA)—a mixed-method approach that integrates qualitative conversational analysis with quantitative sequential pattern analysis. We describe the SCA approach and provide a detailed example as a proof of concept of its use for the analysis of nurse handoff communication in a medical intensive care unit. This novel approach allows us to characterize the conversational structure, clinical content, disruptions in the conversation, and the inherently phasic nature of nurse handoff communication. The characterization of communication patterns highlights the relationships underlying the verbal content of nurse handoffs with specific emphasis on: the interactive nature of conversation, relevance of role-based (incoming, outgoing) communication requirements, clinical content focus on critical patient-related events, and discussion of pending patient management tasks. We also discuss the applicability of the SCA approach as method for providing in-depth understanding of the dynamics of communication in other settings and domains.

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