Patient Endorsement

Week 4

 What are the necessary information

needed for a patient record?
What is included in a patient history?

Look at the picture. What are they

most likely doing?
A) They are discussing
the latest issues in he
althcare.
B) The woman explains
to the man about the
new machine.
C) The man gives
reports at patients
bedside.
D) They are doing
patient endorsement.

Patient Endorsement
It is also called patient hand over;
handoff of care; clinical handover; ch
ange of shift report.
It is a form of communication; a realtime, interactive process of passing p
atient specific information form one c
aregiver or team to another for the pu
rpose of ensuring the continuity and s
afety of the patients care.

What is its significance?

To avoid adverse events caused by
poor communication:
Delay in diagnosis or treatment
Missed or duplicated tests
Wrong treatment
Medication error

What is the requirement for handoff

care?
Every hospital must implement a
standardized approach to handoff c
ommunication.
When endorsement must occur
What elements must be communicated
Endorsements must be verbal and
include the opportunity to ask and respo
nd to questions
Endorsements must be performed in a
consistent way

When must it occur?

Handoff of care occurs when
responsibility for patient care changes du
e to a change in patient location or chan
ge in provider. These are the four types of
handoff:
Change in the level of care

Inpatient admission from the ED, clinic or

procedure area
Transfer from ICU to acute care or from acute care
to ICU
Transfer from a clinic to the ED

 Temporary transfer of care

From inpatient, clinic, or ED to OR,

procedure area, diagnostic area

Discharge

Communication to next care provider (if

known) at inpatient discharge (via phone, let
ter or discharge summary)
Communication to home health provider
Communication to transfer facility (skilled
nursing facility, another hospital)

 Change in provider or change in service

RN/RT change of shift
Resident signout
Rotation change

Standard Elements that are

required in each endorsement
Identify patient name, medical
record number or date of birth, and
physician name
Diagnosis and current condition
Recent events / changes in condition
or treatment
Anticipated changes in condition or
treatment, what to watch for in next
phase of care, contingency plan

Kardex
Kardex is a communication tool used to
convey the clients current orders as well as up
coming tests or surgery, diet, etc quickly and b
riefly.
Nurses use it to organize the care and to
manage time and multiple priorities.
Kardexes may be in paper or electronic format.
The information they contain may be erasable.
Updating Kardex information regularly

11

Walking Rounds
A reporting method used when the
members of the care team walk to ea
ch clients room and discuss care and
progress with each other and with th
e client.

Vocabulary
shift - a persons scheduled period of work.
AM Shift (morning shift) [7am-3pm or 8am 4pm]
PM Shift (afternoon shift) [3pm 11pm or 4pm 12 mn]
NOC shift [(nocturnal) night shift or grave yard shift)]
[11 pm 7am or 12mn 8am]

frequency a number of times

duration length of time
diagnosis noun the identification of the
nature of an illness or other problem by ex
amination of the symptoms.

 treatment noun medical care given to a

patient with an injury or illness
progress noun onward or forward
movement
condition noun a persons state of health
interval noun a distinct period
contingency plan noun a plan designed
to take a possible future event or circumst
ance into account.

Listening

 Where do you usually hear this talk?

A. nurses station
B. faculty room
C. dietary department
Who is most likely talking?
A. Out going and on coming nurse
B. Nurse and doctor
C. Doctor and porter

 Which was not mentioned about the

patients symptom?
A. Vomiting
B. Loss of appetite
C. Chest pain
When is her tylenol due?
A. In two hours
B. Next day
C. In twelve hours

Speaking
From the example make your own
patient and endorse to the next nurs
e on duty

Writing
Summarize the endorsement you
have made.

Reading
Where can you usually read this
text?
What is a change of shift report?
Where does change of shift report
happen?
How are change of shift done?
Who are the other stewards of
patient safety?
What happens when the report is
brought to the bedside?

Grammar: Simple Past

Past tense describe past events in
the past
Structure
Positive sentence
Subject + main verb (ed)
Negative and question sentence
Subject + auxiliary do + main verb
did
base

 With main verb be

subject + main verb be
was, were

 Use the Simple Past to express the

idea that an action started and finish
ed at a specific time in the past. Som
etimes, the speaker may not actually
mention the specific time, but they d
o have one specific time in mind.
I saw a movie yesterday.
I didn't see a play yesterday.
She washed her car.

 We use the Simple Past to list a

series of completed actions in the pa
st. These actions happen 1st, 2nd, 3r
d, 4th, and so on.
I finished work, walked to the beach,
and found a nice place to swim.
He arrived from the airport at 8:00,
checked into the hotel at 9:00, and me
t the others at 10:00.

 The Simple Past can be used with a

duration which starts and stops in th
e past. A duration is a longer action o
ften indicated by expressions such as
: for two years, for five minutes, all d
ay, all year, etc.
We talked on the phone for thirty
minutes.
A: How long did you wait for them?
B: We waited for one hour.

 The Simple Past can also be used to

describe a habit which stopped in the past.
It can have the same meaning as "used to."
To make it clear that we are talking about a
habit, we often add expressions such as: al
ways, often, usually, never, when I was a c
hild, when I was younger, etc.
He played the violin.
They never went to school, they always
skipped class.

 The Simple Past can also be used to

describe past facts or generalizations
which are no longer true. As in USE 4
above, this use of the Simple Past is
quite similar to the expression "
used to.
He didn't like tomatoes before.
People paid much more to make cell
phone calls in the past.

Past Continuous
The past continuous tense is an
important tense in English. We use it
to say what we were in the middle of
doing at a particular moment in the p
ast.
I was singing

 The structure of the past continuous

tense is:
Subject + auxiliary verb BE +
main verb
was
were

base + ing

 USE 1 Interrupted Action in the

Past
Use the Past Continuous to indicate
that a longer action in the past was i
nterrupted. The interruption is usuall
y a shorter action in the Simple Past.
Remember this can be a real interrup
tion or just an interruption in time.

Examples:
I was watching TV when she called.
When the phone rang, she was writing a letter.
While we were having the picnic, it started to
rain.
What were you doing when the earthquake
started?
I was listening to my iPod, so I didn't hear the
fire alarm.
You were not listening to me when I told you
to turn the oven off.
While John was sleeping last night, someone
stole his car.

 USE 2 Specific Time as an

Interruption
In USE 1the Past Continuous is
interrupted by a shorter action in the
Simple Past. However, you can also u
se a specific time as an interruption.

 Examples:
Last night at 6 PM, I was eating
dinner.
At midnight, we were still driving
through the desert.
Yesterday at this time, I was sitting
at my desk at work.

 USE 3 Parallel Actions

When you use the Past Continuous
with two actions in the same sentenc
e, it expresses the idea that both acti
ons were happening at the same tim
e. The actions are parallel.

 Examples:
I was studying while he was
making dinner.
While Ellen was reading, Tim was
watching television.
Were you listening while he was
talking?
I wasn't paying attention while I
was writing the letter, so I made se

 USE 4 Atmosphere
In English, we often use a series of
parallel actions to describe the atmos
phere at a particular time in the past.

 Example:
When I walked into the office, several
people were busily typing, some
were talking on the phones, the bos
s was yelling directions, and custom
ers were waiting to be helped. One
customer was yelling at a secretary
and waving his hands. Others were
complaining to each other about th
e bad service.

 USE 5 Repetition and Irritation with

"Always"
The Past Continuous with words such as
"always" or "constantly" expresses the ide
a that something irritating or shocking oft
en happened in the past. The concept is v
ery similar to the expression "used to" but
with negative emotion. Remember to put t
he words "always" or "constantly" betwee
n "be" and "verb+ing."

 Examples:
She was always coming to class
late.
He was constantly talking. He
annoyed everyone.
I didn't like them because they were
always complaining.

 Assignment
Write 5 sentences about your first
year in the university using simple pa
st.
Write 5 sentences about your
practicum using past continuous.