Using cues from change-of-shift handoff information, a mental image of what the patient would look/be like was formed.
Study participants then received change-of-shift report after their usual procedures.
These three time frames (change-of-shift handoff, initial assessment, and end of the shift) were selected for several reasons.
Several participants verbalized a summary evaluation of vital signs in their think-aloud as "stable," "free," or "doing ok." This evaluation of vital signs was generally made because of the information presented to the participant in the change-of-shift report.
In summary, the answer to the research question (How is the nursing intervention known as surveillance expressed during nurses' think aloud in the course of nursing care?) is that nurses used the information gained first from the change-of-shift data to form a mental representation of what the patient would look like.
In a study of surveillance by nurses, Schmidt (2010) similarly found that one aspect of surveillance was "knowing what's going on." This knowing about the patient situation was influenced by the change-of-shift handoff, which included data contained in the medical record.
The change-of-shift report was identified by nurse participants as the means to develop the mental representation or schema for each patient.
Moving the change-of-shift handoff to the patient's bedside allows the oncoming nurse to visualize the patient as well as ask questions of the previous nurse and the patient.
Results also indicated nurses felt more prepared immediately after the change-of-shift handoff to discuss patient care issues with physicians.
Bedside nurse-to-nurse change-of-shift handoff increases nurses' awareness of the impact of communication on patient safety and satisfaction (Chaboyer et al., 2009).