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Clari M, Conti A, Chiarini D, Martin B, Dimonte V, Campagna S. Barriers to and Facilitators of Bedside Nursing Handover: A Systematic Review and Meta-synthesis. J Nurs Care Qual 2021; 36:E51-E58. [PMID: 33852530 DOI: 10.1097/ncq.0000000000000564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Bedside nursing handover (BNH) has been recognized as a contributor to patient-centered care. However, concerns about its effectiveness suggest that contextual factors should be considered before and after BNH implementation. PURPOSE This review aimed to identify, evaluate, and synthetize the qualitative literature on the barriers to and facilitators of BNH as experienced by nurses and patients. METHODS The Joanna Briggs Institute meta-aggregation method was applied. A systematic search was performed to identify qualitative studies published from inception to June 30, 2020. Two independent researchers assessed methodological quality and extracted data. RESULTS Twenty-four articles were included, comprising 161 findings, and 5 synthesized findings emerged with a moderate level of confidence. CONCLUSIONS BNH ensures patient safety and increases satisfaction and recognition among patients and nurses. This evidence on the barriers to and facilitators of BNH could help health care providers who have implemented or plan to implement this practice.
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Affiliation(s)
- Marco Clari
- Department of Public Health and Pediatrics, University of Torino, Torino, Italy (Drs Clari, Conti, and Campagna and Ms Martin and Mr Dimonte); and Department of Surgery, Città della Salute e della Scienza University Hospital, Torino, Italy (Ms Chiarini)
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Abstract
Healthcare providers in the hospital setting must discuss patient information to ensure continuity of care and patient safety. This study explores how patients perceive the information they hear discussed between healthcare providers and how the concept of "eavesdropping" can be addressed by healthcare providers and in the field of medical informatics. Using an inductive analysis of interviews with 14 adult inpatients, research findings indicate that patients value receiving information in the hospital setting, including information received through eavesdropping. Patient eavesdropping opportunities include "eavesdropping by design" events, such as during bedside shift changes and handoffs, as well as unintended "unintended eavesdropping" events, such as listening to healthcare provider conversations outside of the patient's room. Healthcare providers and medical informaticists have opportunities to address eavesdropping in the inpatient setting. Informatics systems that address "eavesdropping by design" and "unintended eavesdropping opportunities" can improve patient-provider communication and satisfy patient preferences for receiving medical information.
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McCloskey RM, Furlong KE, Hansen L. Patient, family and nurse experiences with patient presence during handovers in acute care hospital settings: a systematic review of qualitative evidence. ACTA ACUST UNITED AC 2020; 17:754-792. [PMID: 30889068 DOI: 10.11124/jbisrir-2017-003737] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The objective of this systematic review was to synthesize the best available evidence on patients', family members' and nurses' experiences with bedside handovers in acute care settings. INTRODUCTION The transfer of patient information between nurses represents a critical component of safety within health care. Conducting handover at the bedside allows patients and families to participate in information exchanges. Studies that address bedside handover highlight benefits and concerns with their implementation. Insight into patients', families' and nurses' experiences with bedside handovers can help to identify the most appropriate and safest approach to handovers. INCLUSION CRITERIA The current review considered patients, family members and nurses in the acute care hospital setting. Nurses included licensed nurses, registered nurses, practical nurses, nursing assistants, nurse researchers, and advanced practice nurses. METHODS A three-step search strategy was used to identify English language qualitative primary research studies. Two reviewers independently appraised the included studies using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. Qualitative studies that considered attitudes, beliefs and experiences of patients, families and nurses on patient presence during bedside handover were considered for this review. Papers included in the review were from 1998 to 2017. RESULTS The review included 12 qualitative publications. Key findings were extracted and classified as unequivocal (U) or credible (C). A total of 96 findings were extracted and aggregated into 14 categories. From the 14 categories, five synthesized findings were developed: i) becoming more informed; ii) upholding confidentiality and privacy; iii) varying desire and ability to participate; iv) individualizing patient care; and v) challenges in conducting bedside handovers can be overcome with adaptive practices. CONCLUSIONS This review captured the experiences of patients, families and nurses with patient presence during bedside handovers in a hospital setting. For the most part, patients and families describe bedside handover positively, reporting feeling more informed and engaged in care. This review highlights areas where patients' and nurses' views on bedside reporting may differ, particularly in the areas of desire to participate and the need for confidentiality. Although hospital environments can create challenges in sharing personal patient information at the bedside, these may be overcome through education and by the adoption of a flexible and individualized approach.
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Affiliation(s)
- Rose M McCloskey
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: a Joanna Briggs Institute Affiliated Group
| | - Karen E Furlong
- Department of Nursing and Health Sciences, University of New Brunswick, Saint John, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: a Joanna Briggs Institute Affiliated Group
| | - Linda Hansen
- Department of Information Services and Systems, University of New Brunswick, Saint John, Canada.,The University of New Brunswick (UNB) Saint John Collaboration for Evidence-Informed Healthcare: a Joanna Briggs Institute Affiliated Group
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Kullberg A, Sharp L, Johansson H, Brandberg Y, Bergenmar M. Improved patient satisfaction 2 years after introducing person-centred handover in an oncological inpatient care setting. J Clin Nurs 2019; 28:3262-3270. [PMID: 31066144 DOI: 10.1111/jocn.14903] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/18/2019] [Accepted: 05/02/2019] [Indexed: 11/26/2022]
Abstract
AIMS AND OBJECTIVES To investigate patients' satisfaction with care, 2 years after the introduction of person-centred handover (PCH) in an oncological inpatient setting, and to describe patients' perceptions of individualised care. BACKGROUND To obtain higher levels of patient satisfaction, bedside nursing handovers have been evaluated with positive results. One such model is PCH, which blends aspects of person-centred care with the bedside report and provides the opportunity for nursing staff and patients to perform the handover together. DESIGN A survey-based design was used with one data collection period. Patient satisfaction scores were compared with baseline data from a previous study that has been conducted in the same wards. METHOD Patient satisfaction was measured with the EORTC IN-PATSAT32 questionnaire, and individualised care was assessed with the Individualized Care Scale. A total of 120 adult patients with cancer were invited to participate from August 2017-March 2018. Of these, 90 chose to participate. The STROBE checklist for cross-sectional studies was used when preparing the paper. RESULTS Compared to the previous study, statistically significant improvements in patient satisfaction were observed in the subscales "Exchange of information between caregivers" and "Nurses' information provision" postimplementation of PCH. Regarding patients' perceptions of individualised care, the highest scores were in the ICS-A subscale "Clinical situation" and ICS-B "Decisional control," while "Personal life situation" scored the lowest overall. CONCLUSIONS Person-centred handover seems to have sustainable positive effects on important outcomes regarding patient satisfaction. A novel finding is the positive impact on nurses' information provision, indicating that PCH can facilitate effective information exchange between patients and nurses. RELEVANCE TO CLINICAL PRACTICE Person-centred handover seems to improve patients' satisfaction with nurses' provision and exchange of information. Nurses and managers should carefully consider the implementation process of PCH and evaluate its long-term effects. PCH can be recommended in the oncology inpatient setting.
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Affiliation(s)
- Anna Kullberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Lena Sharp
- Department of Learning, Informatics, Management and Ethics (LIME), Karolinska Institutet, Stockholm, Sweden.,Regional Cancer Centre Stockholm-Gotland, Stockholm, Sweden
| | - Hemming Johansson
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Yvonne Brandberg
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Sharp L, Dahlén C, Bergenmar M. Observations of nursing staff compliance to a checklist for person-centred handovers - a quality improvement project. Scand J Caring Sci 2019; 33:892-901. [PMID: 30963604 PMCID: PMC7432179 DOI: 10.1111/scs.12686] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 03/03/2019] [Indexed: 11/30/2022]
Abstract
Nursing shift‐to‐shift handovers are important as they impact the care quality indicators such as safety, patient satisfaction and continuity. However, nurses’ handovers have also been criticised and described as unstructured and ineffective. To improve the handovers and involve patients and their loved ones in the process, a person‐centred handover (PCH) model performed at bedside has been developed and tested at Karolinska University Hospital, Sweden. This study reports on the nursing staffs’ compliance to a checklist used for the newly introduced PCH model. A total of 43 PCH sessions were observed at two acute care wards, using a structured observation protocol. None of the observed handover sessions included all the 13 PCH checklist subcomponents. The checklist was used in 18 (44%) of the observed handover sessions. A statistically significant higher number of subcomponents were observed when the nurses used the PCH checklist (6.4 vs. 4.5 subcomponents, p < 0.05). The mean time spent on each PCH was 6 minutes. In 56% of the sessions, the patients were observed to actively participate in the handover. Overall, the nursing staffs’ compliance to the PCH checklist needs to be improved. The observations suggest that training on communication‐oriented tasks would be beneficial to establish a person‐centred handover process.
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Affiliation(s)
- Lena Sharp
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden.,Regional Cancer Centre, Stockholm-Gotland, Sweden
| | - Carina Dahlén
- Department of Oncology, Karolinska University Hospital, Stockholm, Sweden
| | - Mia Bergenmar
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden.,Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
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Bressan V, Cadorin L, Stevanin S, Palese A. Patients experiences of bedside handover: findings from a meta-synthesis. Scand J Caring Sci 2019; 33:556-568. [PMID: 30866081 DOI: 10.1111/scs.12673] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 02/03/2019] [Indexed: 12/21/2022]
Abstract
BACKGROUND Bedside shift reports have been recently recommended to ensure handovers. However, no evidence summarising studies designed to determine the qualitative approaches capable of better understanding patient experience have been published to date. AIM The aim of this study was to acquire a deeper understanding of the experiences of patients regarding bedside shift reports. DATA SOURCES AND REVIEW METHODS A systematic review of qualitative studies followed by a meta-synthesis method based upon Sandelowski's and Barroso's guidelines was performed. Four databases were systematically explored (PubMed, CINAHL, Scopus and PsycINFO) without any limitation in time and up to the 31 August 2018. A total of 10 studies were included and evaluated in their methodological quality; then, a thematic synthesis was developed to synthetize the findings. RESULTS Three major themes reflect patients' experience regarding the bedside shift reports: (i) 'Being involved'; (ii) 'Being the centre of nursing care processes'; and (iii) 'Experiencing critical issues'. Patients are supportive of bedside shift reports as a right, as an opportunity to be involved, and of being in the centre of the nursing care process. By designing and implementing bedside shift reports, nurses also have an opportunity to increase patient safety and to provide concrete proof of the advancements achieved by the nursing profession in recent years. CONCLUSIONS The bedside shift reports experience has been little studied to date from the perspective of patients. According to the findings, implementation of the bedside shift reports should include providing education to nurses with regard to the preferences and expectations of patients, as well as the critical issues that they can experience during the bedside shift reports. Presenting the bedside shift reports method, asking patient consent, discussing potential critical issues and the degree of involvement preferred at hospital admission, is strongly recommended.
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Affiliation(s)
- Valentina Bressan
- School of Nursing, Department of Medical Sciences, University of Udine, Udine, Italy
| | - Lucia Cadorin
- Continuing Education Centre, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano - Pordenone, Italy
| | | | - Alvisa Palese
- School of Nursing, Department of Medical Sciences, University of Udine, Udine, Italy
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Khuan L, Juni MH. Nurses' Opinions of Patient Involvement in Relation to Patient-centered Care During Bedside Handovers. Asian Nurs Res (Korean Soc Nurs Sci) 2017; 11:216-222. [DOI: 10.1016/j.anr.2017.08.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2016] [Revised: 08/03/2017] [Accepted: 08/05/2017] [Indexed: 10/19/2022] Open
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Koivula-Tynnilä H, Axelin A, Leino-Kilpi H. Informational Privacy in the Recovery Room-Patients' Perspective. J Perianesth Nurs 2017; 33:479-489. [PMID: 30077292 DOI: 10.1016/j.jopan.2016.12.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Revised: 12/06/2016] [Accepted: 12/11/2016] [Indexed: 10/19/2022]
Abstract
PURPOSE To describe patients' perceptions of informational privacy and factors promoting it in the recovery room. DESIGN A descriptive semistructured qualitative interview study. METHODS The study was conducted in 2013, and the data were analyzed with inductive content analysis. Adult surgical recovery room patients (n = 17) were recruited with purposive sampling at the Department of Ear, Nose and Throat diseases in a university hospital in Finland. FINDINGS Informational privacy was described as control of patients' health information maintained by the health care professionals and the patients. Informational privacy was especially important in relation to other patients. Health care professionals and patients' attitude, behavior, and knowledge of informational privacy, barriers of hearing and seeing, societal rules, and the electronic patient data system promoted informational privacy. CONCLUSIONS Informational privacy in relation to other patients could be improved in the recovery room, for example, by developing patient health information transmission and architectural solutions.
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Roslan SB, Lim ML. Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study. PROCEEDINGS OF SINGAPORE HEALTHCARE 2016. [DOI: 10.1177/2010105816678423] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Background: Clinical handover is the transfer of relevant and important information and responsibility for patient care from one healthcare provider to another. An effective clinical handover is determined by the transition of critical information and the continuity of quality care for the patient. In the inpatient settings, bedside clinical handover mainly occurs during shift changes (morning to afternoon shift, afternoon to night shift and night to morning shift). Bedside clinical handover can take place in a cohort room of up to six patients or a single-bedded room with only one patient. Various nurses in the nursing hierarchy are involved in the handover, each contributing to ensure patients’ safety and continuity of quality care. Aim: To explore nurses’ perceptions of bedside clinical handover in an inpatient acute-care ward in Singapore. Methodology: An interpretive, descriptive, qualitative study was conducted using focus group interviews with semi-structured questions. The interviews were conducted with 20 nurses from an acute-care hospital in Singapore. The interviews were audiotaped and transcribed verbatim. Data collected were analyzed using thematic analysis. Results: Nurses described that bedside clinical handover could potentially compromise patient’s confidentiality and that the patient and/or their family members and the environment were sources of constant interruptions and distractions. Bedside clinical handover also acted as a platform for communication amongst nurses and between nurses and patients. Conclusion: This study provided an insight into nurses’ perceptions of bedside clinical handover and offered a foundation for nurses to improve the handover process.
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Affiliation(s)
| | - Mei Ling Lim
- Division of Nursing, Singapore General Hospital, Singapore
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10
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Bruton J, Norton C, Smyth N, Ward H, Day S. Nurse handover: patient and staff experiences. ACTA ACUST UNITED AC 2016; 25:386-90, 392-3. [DOI: 10.12968/bjon.2016.25.7.386] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jane Bruton
- Clinical Research Manager, Patient Experience Research Centre, Imperial College London
| | - Christine Norton
- Professor of Clinical Nursing Research, King's College London and Imperial College Healthcare NHS Trust
| | - Natasha Smyth
- Research Assistant, Wellcome Trust Centre for Neuroimaging, Institute of Neurology, University College London
| | - Helen Ward
- Professor of Public Health, Imperial College London
| | - Sophie Day
- Visiting Professor of Anthropology, Patient Experience Research Centre, Imperial College London
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Abstract
Current literature on patients' perceptions of bedside handoff describes studies using qualitative, anecdotal, and/or indirect measurement. This study identifies patients' perceptions of the bedside handoff through direct and quantitative measurement. The statistically significant findings from a survey of 103 medical surgical adult patients demonstrate that registered nurse bedside handoff has a positive effect on patient perceptions of safety, understanding, and satisfaction. Bedside end-of-shift handoff is most effective when it is performed consistently.
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Kumar P, Jithesh V, Vij A, Gupta SK. Need for a hands-on approach to hand-offs: A study of nursing handovers in an Indian Neurosciences Center. Asian J Neurosurg 2016; 11:54-9. [PMID: 26889281 PMCID: PMC4732244 DOI: 10.4103/1793-5482.165776] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Context: Standardized nursing handovers have been known to improve outcome, reduce error, and enhance communication. Few, if any, studies on nursing handovers have been conducted in the India. Aim: The aim was to study nursing handover practices in a Neurosciences Center in India. Subjects and Methods: This study was conducted in a 200 bedded public sector Neurosciences Center in New Delhi, to assess nursing handover practices across five wards, all shifts, weekdays, and weekends using a pretested checklist. Ten elements were observed under the categories of time, duration, process, nurse interaction, and patient communication. Statistical Analysis: Analysis of variance, Z-test, and Spearman's correlation coefficient. Results: Totally, 525 nursing handovers revealed varying compliance levels among (63%) time, place (76%), process (82%), staff interaction (53%), and patient communication (44%) related elements. Poorer compliance was seen in morning shifts and weekends; the difference being statistically significant. Bedside handovers were more frequent during weekends and night shifts and were positively correlated with increased staff interaction and patient communication and negatively related to handover duration. Though nurses showed better adherence to process related elements, background patient information, and assessment was explained less frequently. Differences between wards were insignificant except in categories of nurse interaction and patient communication which was better in the neurosurgery than neurology wards. Conclusion: Study revealed a need for a system change and standardization of handovers. Greater administrative commitment, use of technology, training, and leadership development will aid in continuity of care, promote patient safety, and ensure better outcomes.
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Affiliation(s)
- Parmeshwar Kumar
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | | | - Aarti Vij
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
| | - Shakti Kumar Gupta
- Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India
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Abstract
The study purpose was to describe how bedside nurses can use nursing bedside shift report (NBSR) to keep patients safe. NBSR has been recommended as a means of increasing patient safety, but little is known about how or whether it does so. Grounded theory methods were used. Data were collected from 2014 to 2015 with bedside nurses in a pediatric unit with an established NBSR process. The primary process by which bedside nurses use NBSR to keep patients safe is reducing risk of harm through conveying the patient story from shift to shift. Having a perspective from the bedside is a key antecedent to reducing risk of harm, as it supports the nurses' ability to subsequently identify and address risks. Although often seen as a routine exchange of information, how nursing shift report is conducted can impact patient safety. The study reinforces the value of targeting nursing communication to improve patient safety.
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Affiliation(s)
| | - Kirstin A Manges
- The University of Iowa, Iowa City, USA Iowa City VA Healthcare System, IA, USA
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Abraham J, Kannampallil T, Brenner C, Lopez KD, Almoosa KF, Patel B, Patel VL. Characterizing the structure and content of nurse handoffs: A Sequential Conversational Analysis approach. J Biomed Inform 2016; 59:76-88. [DOI: 10.1016/j.jbi.2015.11.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Revised: 11/19/2015] [Accepted: 11/20/2015] [Indexed: 12/01/2022]
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Spinks J, Chaboyer W, Bucknall T, Tobiano G, Whitty JA. Patient and nurse preferences for nurse handover-using preferences to inform policy: a discrete choice experiment protocol. BMJ Open 2015; 5:e008941. [PMID: 26560060 PMCID: PMC4654394 DOI: 10.1136/bmjopen-2015-008941] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
INTRODUCTION Nursing 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 when implementing bedside handover to maximise the successful uptake of this policy. We outline a study which aims to (1) identify, compare and contrast the preferences for various aspects of handover common to nurses and patients while accounting for other factors, such as the time constraints of nurses that may influence these preferences.; (2) identify opportunities for nurses to better involve patients in bedside handover and (3) identify patient and nurse preferences that may challenge the full implementation of bedside handover in the acute medical setting. METHODS AND ANALYSIS We outline the protocol for a discrete choice experiment (DCE) which uses a survey design common to both patients and nurses. We describe the qualitative and pilot work undertaken to design the DCE. We use a D-efficient design which is informed by prior coefficients collected during the pilot phase. We also discuss the face-to-face administration of this survey in a population of acutely unwell, hospitalised patients and describe how data collection challenges have been informed by our pilot phase. Mixed multinomial logit regression analysis will be used to estimate the final results. ETHICS AND DISSEMINATION This study has been approved by a university ethics committee as well as two participating hospital ethics committees. Results will be used within a knowledge translation framework to inform any strategies that can be used by nursing staff to improve the uptake of bedside handover. Results will also be disseminated via peer-reviewed journal articles and will be presented at national and international conferences.
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Affiliation(s)
- Jean Spinks
- Centre for Applied Health Economics, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Wendy Chaboyer
- National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Tracey Bucknall
- Faculty of Health, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Deakin University and Alfred Health, Melbourne, Victoria, Australia
| | - Georgia Tobiano
- Centre for Health Practice Innovation, Menzies Health Institute Queensland, Griffith University, Brisbane, Queensland, Australia
| | - Jennifer A Whitty
- Faculty of Health and Behavioural Sciences, School of Pharmacy, The University of Queensland, Brisbane, Queensland, Australia
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Abstract
A study was undertaken to explore patients' experiences and perceptions associated with implementation of bedside nursing handover. Interviews were conducted with patients and analyzed using a directed content analysis. Three themes emerged through which patients described their experience with bedside nursing handover as follows: (1) creating a space for personal connection; (2) "bumping up to speed"; and (3) varying preferences. Health care leaders and nurses can use study findings to tailor strategies to engage patients, taking into account their preferences, in bedside nursing handover.
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17
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Abstract
Bedside shift reports are viewed as an opportunity to reduce errors and important to ensure communication between nurses and communication. Models of bedside report incorporating the patient into the triad have been shown to increase patient engagement and enhance caregiver support and education. Nurse shift reports and nurse handovers are 2 of the most critical processes in patient care that can support patient safety and reduce medical errors in the United States. Nurses continue to not recognize the evidence supporting this practice and adopt bedside report into practice.
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Kerr D, Klim S, Kelly AM, McCann T. Impact of a modified nursing handover model for improving nursing care and documentation in the emergency department: A pre- and post-implementation study. Int J Nurs Pract 2014; 22:89-97. [DOI: 10.1111/ijn.12365] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Debra Kerr
- College of Health and Biomedicine; Victoria University; St Albans Victoria Australia
| | - Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research; Western Health; St Albans Victoria Australia
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research; Western Health; St Albans Victoria Australia
| | - Terence McCann
- College of Health and Biomedicine; Victoria University; St Albans Victoria Australia
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Sand-Jecklin K, Sherman J. A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. J Clin Nurs 2014; 23:2854-63. [PMID: 24606553 DOI: 10.1111/jocn.12575] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/25/2014] [Indexed: 11/29/2022]
Affiliation(s)
| | - Jay Sherman
- West Virginia University Healthcare; Morgantown WV USA
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Developing a patient-centered ISHAPED handoff with patient/family and parent advisory councils. J Nurs Care Qual 2014; 28:208-16. [PMID: 23528749 DOI: 10.1097/ncq.0b013e31828b8c9c] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Our hospital system used Lean strategies to develop a new process for the change-of-shift bedside handoff titled ISHAPED (I = Introduce, S = Story, H = History, A = Assessment, P = Plan, E = Error Prevention, and D = Dialogue). Several teams collaborated with a Parent Advisory Council and a Patient/Family Advisory Council to design a study to explore patient perceptions of the handoff. The findings from the study along with recommendations from the councils were used to develop education modules on implementing patient-centered handoffs.
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Abstract
Nursing shift report on the medical-surgical units of a large teaching hospital was modified from a recorded report to a blend of both recorded and bedside components. Comparisons between baseline and postimplementation data indicated increased patient satisfaction and nurse perception of accountability and patient involvement but reduced nurse perceptions of efficiency and effectiveness of report. Patient falls at shift change and medication errors were reduced, whereas nurse overtime remained unchanged.
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Kitson AL, Muntlin Athlin Å, Elliott J, Cant ML. What's my line? A narrative review and synthesis of the literature on Registered Nurses' communication behaviours between shifts. J Adv Nurs 2013; 70:1228-42. [DOI: 10.1111/jan.12321] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/02/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Alison L. Kitson
- The University of Adelaide - School of Nursing; South Australia Australia
| | - Åsa Muntlin Athlin
- The University of Adelaide - School of Nursing; South Australia Australia
- Department of Medical Sciences; Uppsala University; Uppsala University Hospital; Sweden
| | - Janice Elliott
- The University of Adelaide - School of Nursing; South Australia Australia
| | - Megan L. Cant
- The University of Adelaide - School of Nursing; South Australia Australia
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Younan LA, Fralic MF. Using “Best-Fit” Interventions to Improve the Nursing Intershift Handoff Process at a Medical Center in Lebanon. Jt Comm J Qual Patient Saf 2013; 39:460-7. [DOI: 10.1016/s1553-7250(13)39059-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
Within the context of contemporary nursing practice, bedside handover has been advocated as a potentially more suitable mode for achieving patient-centred care. Given that patients can play an important role in the process, better understanding of patients' perspectives of bedside handover could be a critical determinate for successful implementation of the practice. Using a phenomenological approach, this study attempted to explore patients' perceptions of bedside nursing handover. Four key themes emerged from the patient interviews: 'a more effective and personalised approach', 'being empowered and contributing to error minimization', 'privacy, confidentiality and sensitive topics', and 'training need and avoidance of using technical jargon'. Patients welcome bedside handover as they can be empowered through participation in the process. Nevertheless, attention is needed to ensure that adequate training is provided to nurses and to minimize the use of technical jargon so that handover is delivered with a professional and consistent approach.
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Affiliation(s)
- Sai Lu
- Victoria University, St. Albans, Victoria, Australia
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Kerr D, Lu S, McKinlay L. Towards patient-centred care: Perspectives of nurses and midwives regarding shift-to-shift bedside handover. Int J Nurs Pract 2013; 20:250-7. [DOI: 10.1111/ijn.12138] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Debra Kerr
- Victoria University; St Albans Victoria Australia
| | - Sai Lu
- Victoria University; St Albans Victoria Australia
| | - Louise McKinlay
- Centre of Education; Western Health; Footscray Victoria Australia
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Klim S, Kelly AM, Kerr D, Wood S, McCann T. Developing a framework for nursing handover in the emergency department: an individualised and systematic approach. J Clin Nurs 2013; 22:2233-43. [DOI: 10.1111/jocn.12274] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Sharon Klim
- Joseph Epstein Centre for Emergency Medicine Research; Western Health; Footscray VIC Australia
| | - Anne-Maree Kelly
- Joseph Epstein Centre for Emergency Medicine Research; Western Health; Footscray VIC Australia
| | - Debra Kerr
- School of Nursing and Midwifery; Victoria University; St Albans VIC Australia
| | - Sallie Wood
- Department of Emergency Medicine; Sunshine Hospital; Western Health; Footscray VIC Australia
| | - Terence McCann
- School of Nursing and Midwifery; Victoria University; St Albans VIC Australia
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Kerr D, McKay K, Klim S, Kelly AM, McCann T. Attitudes of emergency department patients about handover at the bedside. J Clin Nurs 2013; 23:1685-93. [PMID: 23808711 DOI: 10.1111/jocn.12308] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/05/2013] [Indexed: 11/28/2022]
Abstract
AIMS AND OBJECTIVES To explore patients' perspectives of bedside handover by nurses in the emergency department (ED). BACKGROUND International guidelines promote standardisation in clinical handover. Poor handover can lead to adverse incidents and expose patients to harm. Studies have shown that nurses and patients have favourable opinions about handover that is conducted at the bedside in hospital wards; however, there is a lack of evidence for patients' perspective of nursing handover in the ED environment. DESIGN Qualitative descriptive study. METHODS Semi-structured interviews with 30 ED patients occurred within one hour of bedside handover. Data were analysed using thematic content analysis. RESULTS Two main themes were identified in the data. First, patients perceive that participating in bedside handover enhances individual care. It provides the opportunity for patients to clarify discrepancies and to contribute further information during the handover process, and is valued by patients. Patients are reassured about the competence of nurses and continuum of care after hearing handover conversations. Second, maintaining privacy and confidentiality during bedside handover is important for patients. Preference was expressed for handover to be conducted in the ED cubicle area to protect privacy of patient information and for discretion to be used with sensitive or new information. CONCLUSIONS Bedside handover is an acceptable method of performing handover for patients in the ED who value the opportunity to contribute and clarify information, and are reassured that their information is communicated in a private location. RELEVANCE TO CLINICAL PRACTICE From the patients' perspective, nursing handover that is performed at the bedside enhances the quality and continuum of care and maintains privacy and confidentiality of information. Nurses should use discretion when dealing with sensitive or new patient information.
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Affiliation(s)
- Debra Kerr
- School of Nursing and Midwifery, Victoria University, St Albans, Victoria, Australia
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Tobiano G, Chaboyer W, McMurray A. Family members’ perceptions of the nursing bedside handover. J Clin Nurs 2012; 22:192-200. [DOI: 10.1111/j.1365-2702.2012.04212.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Klee K, Latta L, Davis-Kirsch S, Pecchia M. Using continuous process improvement methodology to standardize nursing handoff communication. J Pediatr Nurs 2012; 27:168-73. [PMID: 21964442 DOI: 10.1016/j.pedn.2011.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 08/19/2011] [Accepted: 08/30/2011] [Indexed: 11/28/2022]
Abstract
The purpose of this article was to describe the use of continuous performance improvement (CPI) methodology to standardize nurse shift-to-shift handoff communication. The goals of the process were to standardize the content and process of shift handoff, improve patient safety, increase patient and family involvement in the handoff process, and decrease end-of-shift overtime. This article will describe process changes made over a 4-year period as result of application of the plan-do-check-act procedure, which is an integral part of the CPI methodology, and discuss further work needed to continue to refine this critical nursing care process.
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Affiliation(s)
- Kristi Klee
- Seattle Children's Hospital, Seattle, WA, USA.
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McCloskey R, Furlong K, Hansen L. Patient, family and nurse experiences with patient presence during hand-off reports within hospitals: A systematic review. ACTA ACUST UNITED AC 2012; 10:1-15. [DOI: 10.11124/jbisrir-2012-300] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Kerr D, Lu S, McKinlay L, Fuller C. Examination of current handover practice: Evidence to support changing the ritual. Int J Nurs Pract 2011; 17:342-50. [DOI: 10.1111/j.1440-172x.2011.01947.x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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McMurray A, Chaboyer W, Wallis M, Johnson J, Gehrke T. Patients' perspectives of bedside nursing handover. Collegian 2011; 18:19-26. [PMID: 21469417 DOI: 10.1016/j.colegn.2010.04.004] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Patient participation in handover is one aspect of patient-centred care, where patients are considered partners in care. Understanding the patient perspective provides a foundation for nurses to tailor their bedside handovers to reflect patients' thoughts and beliefs and encourage their active involvement in decision-making. AIM This study examined patients' perspectives of participation in shift-to-shift bedside nursing handover. METHODS A descriptive case study was conducted with 10 patients in one Queensland hospital who had experienced bedside handover during their hospitalisation in 2009. Participants were asked their views about bedside handover including its benefits and limitations, their existing and potential role in handover, the role of family members, and issues related to confidentiality. Data were analysed using thematic content analysis. FINDINGS Four themes emerged from the analysis. First, patients appreciated being acknowledged as partners in their care. Second, they viewed bedside handover as an opportunity to amend any inaccuracies in the information being communicated. Third, some preferred passive engagement rather than being fully engaged in the handover. Fourth, most patients appreciated the inclusive approach of handover as nurse-patient interaction. CONCLUSIONS Bedside handover provides an opportunity for patients to be involved as active participants in their care. They value having access to information on an ongoing basis, and although not all choose the same level of interaction, they see their role as important in maintaining accuracy, which promotes safe, high quality care.
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Bringing change-of-shift report to the bedside: a patient- and family-centered approach. J Perinat Neonatal Nurs 2010; 24:348-53; quiz 354-5. [PMID: 21045614 DOI: 10.1097/jpn.0b013e3181f8a6c8] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Change-of-shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The communication that ensues during this process is linked to both patient safety and continuity of care giving. While many nurses already recognize the value of bringing report to the patient's bedside and have practiced in this manner, this remains relatively uncommon. Typically, nurse change-of-shift report has occurred at a nurses' station, conference room, or hallway and may be face to face, audio-taped, recorded on a telephone service, or in a written format. When report is given away from the bedside, the opportunity to visualize the patient and include the patient and family in an exchange of information and care planning is lost. Yet, patients and families, also stewards of patient safety, are given an opportunity to hear and participate in the exchange of information when report is brought to the bedside. Welcoming patients and families into the report process may be a new and challenging process for nursing staff.
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Dufault M, Duquette CE, Ehmann J, Hehl R, Lavin M, Martin V, Moore MA, Sargent S, Stout P, Willey C. Translating an Evidence-Based Protocol for Nurse-to-Nurse Shift Handoffs. Worldviews Evid Based Nurs 2010; 7:59-75. [DOI: 10.1111/j.1741-6787.2010.00189.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bost N, Crilly J, Wallis M, Patterson E, Chaboyer W. Clinical handover of patients arriving by ambulance to the emergency department - a literature review. Int Emerg Nurs 2010; 18:210-20. [PMID: 20869662 DOI: 10.1016/j.ienj.2009.11.006] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2009] [Accepted: 11/15/2009] [Indexed: 11/17/2022]
Abstract
AIM To provide a critical review of research on clinical handover between the ambulance service and emergency department (ED) in hospitals. METHOD Data base and hand searches were conducted using the keywords ambulance, handover, handoff, emergency department, emergency room, ER, communication, and clinical handover. Data were extracted, summarised and critically assessed to provide evidence of current clinical handover processes. RESULTS From 252 documents, eight studies fitted the inclusion criteria of clinical handover and the ambulance to ED patient transfer. Three themes were identified in the review: (1) important information may be missed during clinical handover; (2) structured handovers that include both written and verbal components may improve information exchange; (3) multidisciplinary education about the clinical handover process may encourage teamwork, a shared common language and a framework for minimum patient information to be transferred from the ambulance service to the hospital ED. CONCLUSION Knowledge gaps exist concerning handover information, consequences of poor handover, transfer of responsibility, staff perception of handovers, staff training and evaluation of recommended strategies to improve clinical handover. Evidence of strategies being implemented and further research is required to examine the ongoing effects of implementing the strategies.
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Affiliation(s)
- Nerolie Bost
- Gold Coast Hospital & Griffith University, Emergency Department, Southport 4215 QLD, Australia.
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Peat M, Entwistle V, Hall J, Birks Y, Golder S. Scoping Review and Approach to Appraisal of Interventions Intended to Involve Patients in Patient Safety. J Health Serv Res Policy 2010; 15 Suppl 1:17-25. [DOI: 10.1258/jhsrp.2009.009040] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Objective To review the literature on the involvement of patients in efforts to promote their own or others’ safety while using health care services. Method A total of 1933 reports were identified as potentially relevant and 745 of these were included in the review (437 descriptions of interventions, 299 comment or opinion pieces and 42 discussions or studies of patients’ willingness and ability to adopt safety-promoting behaviours). Results The rate of publication on these topics has increased, especially in the USA and UK. However, there is scant evidence of the impact of patient involvement initiatives on safety outcomes and there has been little exploration of patients’ willingness and ability to adopt particular safety-oriented behaviours. We identified three broad routes by which patients’ actions might contribute to their safety by helping to make sure that: their treatment is appropriate for them (informing the management plan); treatment is given as planned and according to appropriate protocols (monitoring and ensuring safe delivery of treatment); and problems and risks within health care systems are identified and reduced (informing systems improvements). Conclusions An approach for appraising interventions intended to promote patient involvement in patient safety should involve: identification of the routes by which interventions assume patients’ actions might contribute to their safety; identification of the conditions that would need to be met for patients to behave and contribute as the interventions (implicitly) assume; examination of the extent to which the intervention supports fulfilment of those conditions; and consideration of the potential negative effects of the intervention.
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Affiliation(s)
- Maggie Peat
- Department of Health Sciences, University of York, York
| | | | - Jill Hall
- Department of Health Sciences, University of York, York
| | - Yvonne Birks
- Department of Health Sciences, University of York, York
| | - Su Golder
- Department of Health Sciences, University of York, York
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Messam K, Pettifer A. Understanding best practice within nurse intershift handover: what suits palliative care? Int J Palliat Nurs 2009; 15:190-6. [DOI: 10.12968/ijpn.2009.15.4.41968] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kerry Messam
- Northampton General Hospital NHS Trust, Northampton Centre for Oncology, Northampton
| | - Annie Pettifer
- Coventry University, Department of Nursing, Midwifery and Health Care, Coventry, England, United Kingdom
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Abstract
The author conducted an ethnographic study of an adolescent residential psychiatric unit which revealed a category of behaviour--the shift report. A questionnaire was administered to staff to reveal further meanings. Reporting was found to schematize knowledge according to common referents, promote and validate insider roles through language, offer a means of personal reintegration and catharsis, and provide a forum for the symbolic enactment of democratic values which permeated every aspect of culture on the unit. Staff members were categorically in favour of their verbal and private shift report. There was little partitioning of informal and formal aspects of report in the interest of saving time. Instead, socializing and 'catching up' were important aspects of shift report and constituted a large part of team building. The informal nature of report, particularly in the use of language allowed staff to come to terms with frustrations rather than constituting patient stereotyping. As a ritual, the shift report fostered behavioural synchrony, individual empowerment and a democratic 'all-channel network' of communication. It is hoped that this account will encourage more practising nurses and managers to view their shift report as something more than a simple 'handover'; that is, a ritual play of core values, roles and relationships.
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Affiliation(s)
- O Yonge
- University of Alberta, Edmonton, Canada.
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43
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Abstract
Shift report is a multifaceted process that serves to provide nurses with vital patient information to facilitate clinical decisions and patient care planning. A shift report also provides nurses with a forum for functions, such as patient problem solving and collaboration. The authors conducted a literature review, which indicates that current methodologies used to collect and convey patient information are ineffective and may contribute to negative patient outcomes. Data incongruence, legal implications, time constraints augmented by the nursing shortage, and the financial impact of shift report are also addressed. The literature reveals significant rationale for pioneering new and innovative methods of shift-to-shift communication. In the report To Err is Human: Building a Safe Health System, the Institute of Medicine attributes the deaths of up to 98,000 hospitalized Americans to medical errors, including communication failures [Institute of Medicine. (1999). To err is human: Building a safe health system. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. As a result, government policy makers and health care agencies have focused their attention on determining the root cause of errors to identify preventative measures, including the use of information technology [Institute of Medicine. (2004). Keeping patients safe: Transforming the work environment of nurses. Report by the Committee on Quality of Health Care in America. Washington, DC: National Academy Press]. Under these premises, the authors examined the process of nursing shift report and how it impacts patient outcomes. The use of computer technology and wireless modes of communication is explored as a means of improving the shift report process and, subsequently, health care outcomes and patient safety.
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Manias E, Aitken R, Dunning T. Graduate nurses’ communication with health professionals when managing patients’ medications. J Clin Nurs 2005; 14:354-62. [PMID: 15707446 DOI: 10.1111/j.1365-2702.2004.01084.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AIM AND OBJECTIVES The aim was to examine how graduate nurses communicated with other health professionals about their medication management activities in the acute care context. The objectives were to determine the types of information communicated about patients' medications and the communication processes used during interactions with other nurses, doctors and pharmacists. BACKGROUND Graduate nurses are challenged with enormous responsibilities and their competence is constantly tested in an ever-changing arena. One of their responsibilities involves communicating with other health professionals about patients' medications. DESIGN A qualitative exploratory research design was used for this study. METHODS Participant observation and semi-structured interviews were conducted to elicit information from 12 graduate nurses with university degrees employed in a metropolitan public hospital, in Melbourne, Australia. Graduate nurses were observed once for two hours and interviewed on the same day of the observation at a mutually convenient time. The purpose of these interviews was to clarify activities observed and to obtain further information. RESULTS The results highlighted how work dynamics of the clinical setting had an impact on the ability of graduate nurses to communicate effectively with other nurses, doctors and pharmacists. These work dynamics included the availability of doctors and the structure of ward rounds. The results also demonstrated the value graduate nurses placed on communicating particular information such as evaluating the effect of medication changes and organizing discharge medication. CONCLUSIONS Graduate nurses were effective in communicating about medication management activities when they initiated or were prepared for such interactions. When graduate nurses were not prepared, such as during impromptu ward rounds, they did not participate effectively and important information was not communicated. RELEVANCE TO CLINICAL PRACTICE It is important to understand how collegial communication facilitates accurate exchange of information and effective decision-making to achieve optimal health care outcomes for patients.
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Affiliation(s)
- Elizabeth Manias
- Faculty of Medicine, Dentistry and Health Sciences, School of Nursing, The University of Melbourne, 723 Swanston Street Level 1, Carlton, Victoria 3053, Australia.
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45
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Hopkinson JB. The hidden benefit: the supportive function of the nursing handover for qualified nurses caring for dying people in hospital. J Clin Nurs 2002; 11:168-75. [PMID: 11903716 DOI: 10.1046/j.1365-2702.2002.00576.x] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
1. The nursing handover is a key activity for nurses working in acute hospital wards in the NHS. Little scholarly attention has been paid to the use nurses make of the information exchanged during nursing handover or how certain features of the nursing handover might impact positively or negatively on patient outcomes. 2. This paper draws on data from a phenomenological study of 28 qualified diplomate nurses. 3. During the course of non-directive semi-structured interviews, some of the participants in this study expressed the opinion that nursing handover was helpful in enabling them to work with dying people in the acute hospital medical wards in which they worked. 4. The nurses identified two important functions of the nursing handover. The first was as a forum for discussing opinions and expressing feelings. The second was as a source of information on which to base their nursing decisions and actions. 5. It is proposed that some qualified nurses need help with the emotional labour of caring for dying people and that the nursing handover can assist in emotional adaptation, so enabling the management of troubling thoughts or feelings experienced in the course of caring for someone who is dying. 6. The role of the nursing handover in providing emotional support for nurses has been little studied and is a potentially useful area of future research, especially if it can be related to patient experiences and outcomes.
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Abstract
BACKGROUND A qualitative study of shift handover practice and function from a socio-technical perspective Background. Shift handover plays a pivotal role in the continuity of patient care in 24-hour nursing contexts. The critical nature of this communication system is recognized within the literature and by the nursing profession; however, there are few in-depth studies. The rationale for this study is to gain a better understanding of handover practices and functions and their implications for effectiveness. METHOD Handover systems on two very different paediatric wards were selected as case studies. In each case, 20 handovers were observed and audio-taped and 12 individual and two-group interviews with nursing staff about handover were also conducted. Analysis involved categorizing the data and characterizing handover practices and functions using an inductive approach to generate qualitative themes. The ethics committees of the hospital and the university approved the research. All involved were fully informed about the study, with confidentiality maintained throughout. RESULTS Handover practices are distributed over time, socially among the staff and technologically through a range of artifacts, while the system also accomplishes informational, social and educational functions. Handover effectiveness is characterized by flexibility in managing competing demands and tensions, such as maintaining confidentiality while practising family centred care. There are limitations in how far the findings can be generalized to other nursing contexts, and the possible effects of the researcher's presence are also recognized. CONCLUSIONS Handover is a complex system based on several sound socio-technical principles and the value of this nurse-to-nurse communication should be acknowledged. The multiple functions highlight the knowledge and expertise currently hidden within handover, which could be promoted in terms of nursing professionalism.
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Affiliation(s)
- Micky P Kerr
- Research Associate, Institute of Work Psychology, University of Sheffield, Sheffield, UK.
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Dowding D. Examining the effects that manipulating information given in the change of shift report has on nurses' care planning ability. J Adv Nurs 2001; 33:836-46. [PMID: 11298222 DOI: 10.1046/j.1365-2648.2001.01723.x] [Citation(s) in RCA: 70] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
AIM OF THE STUDY To investigate the effect that manipulating the style and content of the nurse change of shift report had on an individual's ability to plan patient care. BACKGROUND The nurse change of shift report occurs on most hospital wards at least two if not three times a day. However, little research exists examining how changing the style and information content of the shift report may affect an individual's ability to process the information they hear. It is suggested that how individuals structure their knowledge, in the form of schema, is an important consideration when examining how they process information. DESIGN This was an experimental study where two independent variables, report style (retrospective vs. prospective) and schema information (schema consistent vs. schema inconsistent) were compared in a factorial design. A convenience sample of 48 registered nurses from acute medical and acute surgical wards were randomly allocated to one of the four experimental conditions. Outcome measures included the amount of information that subjects accurately recorded and recalled from the shift report, together with their ability to plan patient care. RESULTS Results indicated that the type of report had a significant effect on an individual's ability to plan patient care, and type of information content on their ability to accurately record and recall the information they heard. CONCLUSIONS The implications of the results, both for schema theory as an explanation of nursing knowledge, and for the type of report which should be used in acute medical and acute surgical wards are discussed, together with the implications of the study for further research.
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Affiliation(s)
- D Dowding
- Nursing Research Initiative for Scotland, Nursing and Midwifery Building, University of Stirling, Stirling, UK.
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Abstract
Communicating nursing care during the patient's total hospital stay is a difficult task to achieve within the context of high patient turnover, a lack of overlap time between shifts, and time constraints. Clear and accurate communication is pivotal to delivering high quality care and should be the gold standard in any clinical setting. Handover is a commonly used communication medium that requires review and critique. This study was conducted in five acute care settings at a major teaching hospital. Using a grounded theory approach, it explored the use of three types of handover techniques (verbal in the office, tape-recorded, and bedside handovers). Data were obtained from semistructured interviews with nurses and participant field observations. Textual data were managed using NUD*IST. Transcripts were critically reviewed and major themes identified from the three types of handovers that illustrated their strengths and weaknesses. The findings of this study revealed that handover is more than just a forum for communicating patient care. It is also used as a place where nurses can debrief, clarify information and update knowledge. Overall, each type of handover had particular strengths and limitations; however, no one type of handover was appraised as being more effective. Achieving the multiple goals of handover presents researchers and clinicians with a challenging task. It is necessary to explore more creative ways of conducting the handover of patient care, so that an important aspect of nursing practice does not get classified as just another ritual.
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Abstract
This paper considers the ways in which the nursing handover involves a complex network of communication that impacts on nursing interactions. The critical ethnographic study upon which this paper is based involved a research group of six nurses who worked in one critical care unit. Data-collection methods involved professional journalling, participant observation, and individual and focus group interviews. The nursing handover took on many forms and served different purposes. At the start of a shift, the nurse coordinator of the previous shift presented a 'global' handover of all patients to oncoming nurses. Nurses proceeded then to the bedside handover, where the intention changed from one that involved a broad overview of patients, to one that concentrated on a patient's individual needs. Data analysis identified five practices for consideration: the global handover serving the needs of nurse coordinators; the examination; the tyranny of tidiness; the tyranny of busyness; and the need to create a sense of finality. In challenging nurses' understanding of these practices, they can become more sensitive to other nurses' needs, thus promoting the handover process as a site for collaborative and supportive communication.
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Affiliation(s)
- E Manias
- School of Postgraduate Nursing, The University of Melbourne, Victoria, Australia.
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