46 Abstracts / Australian Critical Care 27 (2014) 43–63

An evidence based ICU specific minimumdataset for bedside nursing handover improvescommunication

A. Spooner 1,∗, W. Chaboyer 2, A. Corley 1, N.Hammond 3, J. Fraser 1

1 Critical Care Research Group, Adult Intensive CareServices, The Prince Charles Hospital, Brisbane,Australia2 NHMRC Centre of Research Excellence in NursingInterventions for Hospitalised Patients, ResearchCentre for Clinical and Community PracticeInnovation, Griffith University, Gold Coast, Australia3 Intensive Care Unit, Royal North Shore Hospital,Sydney, Australia

Miscommunication during handover is associated with adverseevents. Based on our previous research and the national standard,an evidence based electronic minimum dataset (MDS) wasintroduced at The Prince Charles Hospital, intensive care unit (ICU).

This study assessed whether communication during bedsidenursing handover improved after introducing an ICU-specific elec-tronic MDS.

During January and June 2013, 30 pre and 30 post-implementation audits were undertaken in a 21-bed ICU. Datacollection days were randomly selected and 60 bedside nursinghandovers were observed. The audit tool incorporated the ISBAR(Identify-Situation-Background-Assessment-Request) mnemonicto categorise handover information and assess handover quality.Descriptive summaries (frequencies) of adherence to each crite-ria was calculated. Ethics approval was obtained and all nursesconsented to participate.

Observational audits predominantly occurred from night shift today shift (83% pre, 90% post). A reduction in average handover time(16.6–15.8 min) and interruptions (1.4 interruptions/handover to0.5 interruptions/handover) was seen post-implementation. Over-all, handover communication improved following implementationof the MDS. Patient identification bands were checked (3% pre,37% post), and pressure area and wound management (30% pre,63% post) was discussed more frequently post-implementation.However, information regarding alerts (54% pre, 38% post), patientinvolvement in handover (30% pre, 25% post), and safety-checks(2.3 out of 3 pre, 2 out of 3 post) decreased post-intervention. Theuse of the new MDS was embraced by 90% of nurses.

Despite improvements in handover information, these findingshighlight gaps in communication during handover. Regular evalua-tion, modifications and education is required to improve handovercommunication.

http://dx.doi.org/10.1016/j.aucc.2013.10.011

Exploring compassion fatigue: How doescompassion fatigue affect the intensive carenurse?

A. Vann ∗, F. Coyer

Royal Brisbane and Women’s Hospital, Australia

Background: Intensive care is recognised as a highly stressfulwork area. Compassion fatigue is associated with exposure to trau-matic events evidenced as a state of stress, tension or preoccupationwith one’s work.

Aim: The aim was to determine the extent of compassion fatiguein registered nurses working in an adult intensive care unit (ICU).

Methods: The study used a descriptive survey design to survey174 registered nurses. The study was conducted in a 36 bed Level

III ICU in a Queensland tertiary referral hospital. Demographic datawere collected. The instrument was the ProQOL v4, comprising of30 items addressing compassion satisfaction (CS) and compassionfatigue and burn out (BO), rated on a 5 point Likert scale. Scoresrange from 20 to 50, higher scores for compassion satisfactionindicating high work satisfaction and high scores for compassionfatigue indicating burnout or work ineffectiveness.

Results: Of the 174 questionnaires given out, 104 were returned,a response rate of 60%.

The overall CS score mean was 36.13.The mean for BO was 32.2and 23.44 for secondary traumatic stress (STS). Thus STS and BOwere not prevalent among participants. The survey also demon-strated that if you scored a high mark (above 42) in compassionsatisfaction, you were more likely to score lower marks (below 22)in BO and the STS scale.

Conclusion: Self-care and awareness play an important role forindividuals to manage compassion fatigue. Further study in thisarea will allow for strategies to be put in place to manage andsupport compassion fatigue.

http://dx.doi.org/10.1016/j.aucc.2013.10.012

Adult Critical Care Free Papers

The lived experiences of graduate nursesworking in an intensive care unit as firstplacement after graduation: Aphenomenological study

A. Salkaya 1,2,∗, R. Wiechula 2, J. Kernick 3

1 Ashford Hospital, Australia2 School of Nursing, University of Adelaide, Australia3 Royal Adelaide Hospital, Australia

Winner: Best Nursing Presentation sponsored by

Introduction: Retention and support of graduate nurses is astrategy to addressing the intensive care nursing shortage. Theintensive care environment poses extra challenges for new gra-duates due to the complexity and high level of clinical competencerequired. Although studies have investigated the graduate nurses’experiences generally, little is known their experiences in ICU astheir first placement.

Objectives: To gain insight into the experiences of graduatenurses, to understand the meaning of these experiences and theeffects these experiences may have on their subsequent careers. Italso sought graduate nurses’ perceptions of the graduate trainingprogram and the support they received during their time in the ICU.

Methods: A qualitative study was undertaken using Heideg-ger’s hermeneutic phenomenology, involving 5 graduate nursesemployed in a level-3 private hospital ICU. Data was collectedthrough semi-structured interviews. All interviews were taperecorded, transcribed, and analysed for emerging themes.

Results: Participants described a variety of experiences, relat-ing to seven main themes: challenges, needing education, support,hyper-feelings, time, confidence, and wanting to stay in ICU. Keyfactors influencing these experiences included the graduate nurses’prior undergraduate education, the Graduate Nurse Program struc-ture and having an ICU educator.