Implementation Of Handover Research Articles

Do Bedside Handovers Reduce Handover Duration? An Observational Study With Implications for Evidence-Based Practice.

Bedside handover is increasingly used and studied in nursing due to the method's acclaimed positive effects on patient safety, patient participation, communication, and efficiency. Still, reported results about its impact on handover duration are ambiguous. Revealing the root cause of these ambiguous effects is important, as increased duration could lead to overtime, lower job satisfaction, and failure in implementation. In contrast, decreased handover duration could lead to more efficient nursing care and facilitate implementation. To explore the effects of bedside handovers on the handover duration by comparing wards before and after the implementation of bedside handovers. As part of a multicentered longitudinal study, observations (N=638) with time measurement were performed. Approximately 22% of the observations were performed by two researchers to check reliability. These time measurements were compared to the handover duration before the implementation of bedside handover, determined through interviews (n=105), unstructured observations (n=40), and a review of time schedules (n=12). A descriptive, comparative research design was used. On average, a bedside handover takes 146s for one patient (83s-204s). Depending on the previously used handover model, the number of patients allocated to each nurse, and the use of a structured handover content, time gain or loss as a result of introducing the bedside handover can be expected. The effect on time depends on the organizational changes necessary for the implementation of bedside handovers, most importantly the use of a decentralized handover model and structured handover content. Implementing bedside handover will therefore not always lead to a decrease in time use. A matrix for estimating the effects of bedside handover on time use is presented. While using bedside handovers will not always lead to decreased handover time, it will increase direct patient contact, increasing the possibilities for patient participation and enhancing patient safety.

PENGETAHUAN PERAWAT TERHADAP PELAKSANAAN TIMBANG TERIMA PASIEN SESUAI SOP

<p><em>Nursing is one of a profession front for health workers in this effort to ensure the quality of health center in the community. Handover is good quality health services to offer a service nursing on a patient care, To optimize the role and function of nurse especially function to independence nurse. This research aims to know the the relations knowledge of a nurse with patient handover implementation as procedure. The kind of research used is descriptive analytic with the approach cross sectional. A population that used is nurse who were 101 people from 101 a person who uses technique total of sampling. The analysis in use is analysis univariat and bivariat. The results of the study was obtained 42,6 % nurse possess wisdom that low and 31.7 % nurse of these stations have the implementation of patient a less well , testing shows statistic been gained there are the kind of relationship is meaningless between knowledge a nurse with the implementation of these stations received patients ( p = 0,094 ). Based on the research done can be concluded that there was a correlation meaningful of the incentives a nurse with the implementation of the weigh received patients appropriate with the sop .Was recommended to researchers , the hospital to continue to motivate nurse in the implementation of the weigh received patients appropriate with the procedure. </em></p><p> </p><p><em><strong>Keywords: Knowledge, The Implementation of handover</strong></em></p><p><em><br /></em></p>

Implementation of Handover and Savings of Print and Record Works Policy at the Library of South Sumatra

It was known that there were lack of order mandatory submission in Local Library of South Sumatra. Implementation of handover and savings of print and record work policy was one of the steps of South Sumatera Provincial Government to preserve the work of the region. This implementation was very influential in determining the quality of local policies or regulations. The purpose of this study was to find out how many local works produced by South Sumatera Province. This research used qualitative research method with descriptive form. Data collected via interview to key informants, observation and literature study using Ripley and Franklin's theories of compliance, the smoothness of the function routines and the realization of the desired performance and its impact. The first dimension of compliance level had indicated the implementation of the handover and the saving of the work in the Library Board of South Sumatera Province, the second dimension of the smoothness of the function routine was the implementation of socialization and the data collection of published works, and the last dimension is the increasing of knowledge and the amount of work received at Delivery of Print Works and Record Works at the Library Board of South Sumatra Province. Indicators of this study can be concluded that the three dimensions used are quite ideal.

Description of Nursing Shift Handover Implementation in One of Provincial Public Hospitals in DKI Jakarta Province

Description of Nursing Shift Handover Implementation in One of Provincial Public Hospitals in DKI Jakarta Province

Implementation of fast handover for proxy mobile IPv6: Resolving out-of-order packets.

Mobile IP allows for location-independent routing of IP datagrams on the Internet. Mobile IP specifies how a mobile node (MN) registers with its home agent and how the home agent routes datagrams to the MN through the tunnel. Current Mobile IP protocols have difficulties meeting the stringent handover delay requirements of future wireless networks. Fast handover for Proxy Mobile IPv6 (FPMIPv6) is used to resolve handover latency and packet loss problems that occur in the Proxy Mobile IPv6 (PMIPv6) protocol. However, while implementing the FPMIPv6 scheme in a testbed, we encounter the out-of-order packet (OoOP) problem. The cause of this problem is the existence of two paths for data transmitted from a correspondent node (CN) to an MN. Since the problem affects the quality of service (QoS) of the network and the performance of the MN, we propose a new scheme using the last packet marker and packet buffering to solve this problem in FPMIPv6. The new Mobile Access Gateway (MAG) can control and deliver the data transmitted via the old path or the new path to an MN in order, using the last packet marker to notify the end of the data delivery in the old path and the packet buffering for holding the data delivered in the new path. We implement both the proposed scheme and FPMIPv6 in a testbed as a real network environment to demonstrate the correctness, cost effectiveness, and performance of the proposed scheme. A performance evaluation reveals that the proposed scheme can handle the OoOP problem efficiently.

Patient satisfaction after implementation of person-centred handover in oncological inpatient care - A cross-sectional study.

Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction. A cross-sectional design featuring two points of measurement at one intervention ward and two control wards was applied. The EORTC IN-PATSAT32 questionnaire was used for measuring patient satisfaction. Baseline measurements were taken during the spring of 2014, when all three wards used a non-verbal handover model, and included responses from 116 patients. Follow-up measurements (comparing PCH and non-verbal handover) involved 209 patients and were on-going from September 2014 to May 2015. After the introduction of PCH, one change in patient satisfaction was detected regarding the subscale measuring exchange of information between caregivers. Patients from the intervention ward scored statistically higher after the implementation of PCH when compared to the control wards (p = .0058). The difference remained after a multivariate regression analysis controlling for clinical variables. In conclusion, PCH is feasible in oncological inpatient care but does not seem to affect patient satisfaction.

From LTE to 5G for Connected Mobility

Long Term Evolution, the fourth generation of mobile communication technology, has been commercially deployed for about five years. Even though it is continuously updated through new releases, and with LTE Advanced Pro Release 13 being the latest one, the development of the fifth generation has been initiated. In this article, we measure how current LTE network implementations perform in comparison with the initial LTE requirements. The target is to identify certain key performance indicators that have suboptimal implementations and therefore lend themselves to careful consideration when designing and standardizing next generation wireless technology. Specifically, we analyze user and control plane latency, handover execution time, and coverage, which are critical parameters for connected mobility use cases such as road vehicle safety and efficiency. We study the latency, handover execution time, and coverage of four operational LTE networks based on 19,000 km of drive tests covering a mixture of rural, suburban, and urban environments. The measurements have been collected using commercial radio network scanners and measurement smartphones. Even though LTE has low air interface delays, the measurements reveal that core network delays compromise the overall round-trip time design requirement. LTE's breakbefore- make handover implementation causes a data interruption at each handover of 40 ms at the median level. While this is in compliance with the LTE requirements, and lower values are certainly possible, it is also clear that break-before-make will not be sufficient for connected mobility use cases such as road vehicle safety. Furthermore, the measurements reveal that LTE can provide coverage for 99 percent of the outdoor and road users, but the LTE-M or NarrowBand-IoT upgrades, as of LTE Release 13, are required in combination with other measures to allow for additional penetration losses, such as those experienced in underground parking lots. Based on the observed discrepancies between measured and standardized LTE performance, in terms of latency, handover execution time, and coverage, we conclude the article with a discussion of techniques that need careful consideration for connected mobility in fifth generation mobile communication technology.

Centralized Light Access Network (C-LiAN): A Novel Paradigm for Next Generation Indoor VLC Networks

Visible light communication (VLC) builds upon the idea of using existing lighting infrastructure for wireless data transmission. In a conventional VLC network, each light fixture acts as an access point (AP) which are connected to each other through electrical grid as well as data backbone. These VLC-enabled fixtures consist baseband unit (BBU) followed by the optical front-end (OFE). In this paper, we propose the so-called centralized light access network (C-LiAN) which aggregates all AP computational resources into a central pool that is managed by a centralized controller. Unlike the distributed architecture where each light fixture performs both baseband processing and optical transmission/reception, the centralized architecture employs “dummy” fixtures with a VLC OFE. Moving the baseband processing to a central pool reduces the associated cost and complexity of each VLC-enabled LED luminary. It further enables joint processing of signals from different APs making possible an efficient implementation of joint processing, offloading, handover, interference management, scheduling, and resource management algorithms. As an example to demonstrate the virtues of C-LiAN, we further present the performance of coordinated multi-point transmission and enhanced inter-cell interference coordination with almost blank subframe techniques originally proposed for Long Term Evolution-Advanced in the context of indoor VLC networks.

Roadmap and Challenges to the Deployment of 4g Lte Network: The Nigerian Experience

Nokia, a leading equipment vendor, named Nigeria as a "priority country" in March 2014, when it announced it was expanding its presence with the opening of a new office in the country's largest city Lagos, and an overhaul of its existing office in capital city Abuja. [1]. Nigeria, therefore, present a huge market potential in the telecoms world. However, this potential has not been fully tapped as broadband penetration is abysmally low. Also, next generation technology is needed to drive the Internet of Things (IoT), Artificial Intelligence, Smart Cities and various smart innovations technology can avail. [2]. This research looked at how these problems could be tackled through the deployment of 4G LTE. It was found that for the 4G LTE network to be successfully deployed across the whole of Nigeria, certain factors had to be addressed. Some of these factors include, spectrum challenge, challenges in the implementation of hard handover, inability to acquire 4G LTE enabled devices due to low-income base of users, inadequate number of base stations and problem integrating 4G equipment with existing legacy networks.

A review of enhanced paramedic roles during and after hospital handover of stroke, myocardial infarction and trauma patients.

BackgroundAmbulance paramedics play a critical role expediting patient access to emergency treatments. Standardised handover communication frameworks have led to improvements in accuracy and speed of information transfer but their impact upon time-critical scenarios is unclear. Patient outcomes might be improved by paramedics staying for a limited time after handover to assist with shared patient care. We aimed to categorize and synthesise data from studies describing development/extension of the ambulance-based paramedic role during and after handover for time-critical conditions (trauma, stroke and myocardial infarction).MethodsWe conducted an electronic search of published literature (Jan 1990 to Sep 2016) by applying a structured strategy to eight bibliographic databases. Two reviewers independently assessed eligible studies of paramedics, emergency medical (or ambulance) technicians that reported on the development, evaluation or implementation of (i) generic or specific structured handovers applied to trauma, stroke or myocardial infarction (MI) patients; or (ii) paramedic-initiated care processes at handover or post-handover clinical activity directly related to patient care in secondary care for trauma, stroke and MI. Eligible studies had to report changes in health outcomes.ResultsWe did not identify any studies that evaluated the health impact of an emergency ambulance paramedic intervention following arrival at hospital. A narrative review was undertaken of 36 studies shortlisted at the full text stage which reported data relevant to time-critical clinical scenarios on structured handover tools/protocols; protocols/enhanced paramedic skills to improve handover; or protocols/enhanced paramedic skills leading to a change in in-hospital transfer location. These studies reported that (i) enhanced paramedic skills (diagnosis, clinical decision making and administration of treatment) might supplement handover information; (ii) structured handover tools and feedback on handover performance can impact positively on paramedic behaviour during clinical communication; and (iii) additional roles of paramedics after arrival at hospital was limited to ‘direct transportation’ of patients to imaging/specialist care facilities.ConclusionsThere is insufficient published evidence to make a recommendation regarding condition-specific handovers or extending the ambulance paramedic role across the secondary/tertiary care threshold to improve health outcomes. However, previous studies have reported non-clinical outcomes which suggest that structured handovers and enhanced paramedic actions after hospital arrival might be beneficial for time-critical conditions and further investigation is required.

Patient and nurse preferences for implementation of bedside handover: Do they agree? Findings from a discrete choice experiment.

ObjectiveTo describe and compare patients' and nurses' preferences for the implementation of bedside handover.DesignDiscrete choice experiment describing handover choices using six characteristics: whether the patient is invited to participate; whether a family member/carer/friend is invited; the number of nurses present; the level of patient involvement; the information content; and privacy.SettingTwo Australian hospitals.ParticipantsAdult patients (n=401) and nurses (n=200) recruited from medical wards.Main outcome measuresMean importance scores for handover characteristics estimated using mixed multinomial logit regression of the choice data.ResultsBoth patient and nurse participants preferred handover at the bedside rather than elsewhere (P<.05). Being invited to participate, supporting strong two‐way communication, having a family member/carer/friend present and having two nurses rather than the nursing team present were most important for patients. Patients being invited to participate and supporting strong two‐way communication were most important for nurses. However, contrary to patient preferences, having a family member/carer/friend present was not considered important by nurses. Further, while patients expressed a weak preference to have sensitive information handed over quietly at the bedside, nurses expressed a relatively strong preference for handover of sensitive information verbally away from the bedside.ConclusionsAll participants strongly support handover at the bedside and want patients to participate although patient and nurse preferences for various aspects of bedside handover differ. An understanding of these preferences is expected to support recommendations for improving the patient hospital experience and the consistent implementation of bedside handover as a safety initiative.

Implementation of Server Handover for Live Streaming Application during High Traffic with Bitrate Adaptation

As the rate of internet users is increasing on a daily basis, a tremendous amount of these users are accessing online streaming websites and applications. This paper proposes a live streaming architecture that supports traffic balancing during peak times and bitrate adaptation. Rather than replicating content on multiple servers, we implemented traffic balancing by assigning a temporary regional server to manage the traffic at regional area. Bitrate adaptation at server side was also proposed and implemented to provide a fair video quality to all users. Through a few tests that has been run on the testbed, we can see the live video streaming was move seamlessly from one server to another server with an acceptable video quality among the users.

Patient and nurse preferences for nurse handover—using preferences to inform policy: a discrete choice experiment protocol

IntroductionNursing bedside handover in hospital has been identified as an opportunity to involve patients and promote patient-centred care. It is important to consider the preferences of both patients and nurses...

A survey of handover management in LTE-based multi-tier femtocell networks: Requirements, challenges and solutions

Ubiquitous mobile communication requires increased capacity and appropriate quality guarantee for services. To meet these demands next-generation mobile network operators will deploy small cells next to conventional base station structure intensively to enhance capacity and service coverage for customers. Implementation of seamless handover between first tier (macrocell layer) and second tier (small cells) is one of the key challenges to fulfill the QoS requirements. In this paper we introduce the reader to the details of the handover procedure: information gathering, decision strategies and the base station exchange process. All these three phases face difficulties in multi-tier networks. High dense femtocell deployment makes handover related information gathering very hard, efficient handover decision mechanisms are vital to reduce the number of unnecessary handovers and avoid ping-pong effect. Last but not least base station exchange has to be accelerated to achieve appropriate system performance. Next a comprehensive survey of state of the art handover optimization solutions in 3GPP LTE/LTE-A Home eNodeB handover management is presented which includes the actual version of 3GPP LTE/LTE-A HeNB handover procedure.

Adopting a patient‐centred approach: an investigation into the introduction of bedside handover to three rural hospitals

To study empirically the process and outcomes of the implementation of nurse-to-nurse bedside handover in three rural South Australian hospitals. While the importance of handover is identified in literature, little is written about its implementation. It is, however, suggested that bedside handover is a more patient-focussed approach than others available. A mixed-method, pretest post-test evaluative approach involving quasi-experimental and ethnographic elements was used. The self-selected sample comprised nine inpatients (five women, four men) and forty-eight self-selected enrolled/registered nursing staff (forty-seven women, one man) from three acute hospital wards in rural South Australia. Lewin's (Human Relations, 1, 1947a, 2; Readings in Social Psychology. Henry Holt, New York, 1947b, 197) 3-stage model of change provided a theoretical basis and structure for the study. Patient perceptions were obtained using ethnographic interviewing. Staff perceptions of patient involvement were obtained through questions rated on a 7-point Likert scale and ethnographic interviewing. Results indicated that patients preferred the bedside handover method over the traditional closed-door office handover approach. The key differences (as defined by patients) are that the bedside handover process incorporates social aspects for the patient, patients have the opportunity to know who is looking after them and patients are included in discussion related to their care. Furthermore, results suggest that staff believed the level of patient involvement in their care had increased under the bedside handover process. The results demonstrate that both patients and staff perceive patients to be more involved in their care under the bedside handover approach. The literature notes a recent move towards adopting patient-centred care approaches in clinical settings and the many benefits associated with this style of care. This study has proven that implementing bedside handover has resulted in a patient-centred approach. This study generates further knowledge about rural nursing and contributes insight into the importance of handover implementation method--areas that are not widely documented in existing literature.

Bedside Handover Enhances Completion of Nursing Care and Documentation

Bedside handover has been proposed as a patient-focused nursing practice model with the potential to reduce adverse events and improve standards of care. This pre-/postintervention study examined changes in completion of nursing care tasks and documentation after the implementation of bedside handover. Analysis of 754 cases revealed significant improvements in several nursing care tasks and documentation, whereas there was no variation in handover duration. Implementing bedside handover may enhance nursing care for hospitalized patients.

Transferring information to an out-of-hours primary care service for patients with palliative care needs: an action research study to improve the use of handover forms

To work with service users and providers to optimise the design and implementation of handover forms to support the transfer of information between daytime and out-of-hours primary care services for patients with palliative care needs. There is a need for improved informational continuity between daytime and out-of-hours primary care services for patients with palliative care needs. Research suggests that while handover forms are vital to ensure continuity of care, they remain underused for such patients. Audit work in an out-of-hours primary care service in South West England identified that their current system of handover forms was underused. An action research study consisting of two phases was undertaken. In phase one, the views of general practitioners and nurses working in the out-of-hours and daytime primary care services (29 health professionals) in Devon (population c.1.4 million) and patients with palliative care needs and their carers (8 participants) were investigated using qualitative interviews and focus group methods. Participants' views on the content and use of handover forms, and of the systems supporting their generation were sought. In phase two, additional feedback from the health professional stakeholder groups was collected and collaborative work undertaken with the out-of-hours service to implement recommendations emerging from the qualitative research. Findings Respondents identified variable use of handover forms and inconsistent practice in terms of: who was responsible for generating and updating forms; when and where they were discussed in primary care; the criteria used to define which patient needed a form; and the information forms should contain. There was uncertainty about how handover forms were used by the out-of-hours service and concerns about incomplete access to forms for certain groups of staff. An action plan to improve the existing system was developed. This included distribution of educational materials (desktop guide, newsletter) to key stakeholders, and the modification of information systems to facilitate the updating of messages and the accessibility of electronic records for previously under-served staff.

Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover

Street M, Eustace P, Livingston PM, Craike MJ, Kent B, Patterson D. International Journal of Nursing Practice 2011; 17: 133–140 Communication at the bedside to enhance patient care: A survey of nurses' experience and perspective of handover Strategies to support continuity of care and improve patient safety during clinical handover have been developed. The aims of this study were to identify the strengths and limitations in current practice of nursing clinical handover and implement a new bedside handover process. A total of 259 nurses completed a cross‐sectional survey at change of shift on 1 day, which was followed by an audit of the pilot implementation of bedside handover. The survey results showed great variation in the duration, location and method of handover with significant differences in the experience of nurses employed part‐time compared with full‐time. Following implementation of standardized bedside handover on two wards, the audit revealed significant improvement in the involvement of patients, use of Situation‐Background‐Assessment‐Recommendation, active patient checks and checking of documentation. These findings suggest the use of standardized protocols and communication tools for bedside handover improve continuity of patient care.

A mobility framework to improve heterogeneous wireless network services

We propose and investigate the Internet Protocol version 6 (IPv6) enabled mobility framework to improve the user mobility experience in heterogenous wireless networks. The framework considers the traditional IP network infrastructure, IPv6 based mobility support, multihoming, traffic flow transparent handovers and flat/dynamic mobility policy enforcement to guarantee the Quality of Service (QoS) and Quality of Experience (QoE) with ubiquitous connectivity. Using Network Mobility (NEMO) we can provide a flexible network integration mechanism across WiFi, WiMax and UMTS systems vertically. The flexible approach overcomes the limitation of different networks access denial when nodes move using two operations: Policy enforced handover management and Dynamic handover implementation. The paper describes the design rationale behind the solution, introduces an experimental testbed and simulation models, validates mobility related services performance, and discusses our research findings.

SIP-based mobility management in next generation networks

The ITU-T definition of next generation networks includes the ability to make use of multiple broadband transport technologies and to support generalized mobility. Next generation networks must integrate several IP-based access technologies in a seamless way. In this article, we first describe the requirements of a mobility management scheme for multimedia real-time communication services; then, we report a survey of the mobility management schemes proposed in the recent literature to perform vertical handovers between heterogeneous networks. Based on this analysis, we propose an application-layer solution for mobility management that is based on the SIP protocol and satisfies the most important requirements for a proper implementation of vertical handovers. We also implemented our proposed solution, testing it in the field, and proving its overall feasibility and its interoperability with different terminals and SIP servers.