Shift-to-shift nursing handover interventions associated with improved inpatient outcomes-Falls, pressure injuries and medication administration errors: An integrative review

Evaluation of the Handover Training Program Given to Nursing Students Using the Kirkpatrick Model: A Quasi-Experimental Observational Study

BACKGROUND

Patient handover training given to nursing students is important to ensure patient safety. There are a variety of evaluation models that can be used to evaluate the impact of education in nursing, one of which is the Kirkpatrick model.

OBJECTIVE

This study aims to evaluate the patient handover training given to nursing students according to the Kirkpatrick model.

METHODS

A pretest and posttest design was used with a convenience sample of 33 nursing students. The training provided was evaluated according to the reaction, learning, behavior, and result levels of the Kirkpatrick model. In the study, data were collected by researchers observing students through face-to-face interactions and bedside observations using Handoff Evaluation Scale (Handoff CEX).

RESULTS

It was found that 42.1% of the nursing students practiced verbal, 19.7% taped, and 36.8% bedside handovers before the training, while all the students practiced taped, verbal, and bedside handovers after the training. While the mean (SD) scores of patient handover (2.87 [0.95]) were at an insufficient level before the training, the scores after the training (7.12 [1.06]) increased to a high level. The difference between the mean patient handover scores before and after the training was statistically significant (P < .001).

CONCLUSIONS

After the training provided in the study, it was observed that nursing students improved their patient handover levels and styles, handover participation, and information transfer. Patient handover training given to undergraduate student nurses can be evaluated using the Kirkpatrick model.

Implementing a ward-level intervention to improve nursing handover communication with a focus on bedside handover-A qualitative study

AIM

To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention.

DESIGN

A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions.

METHODS

We implemented a tailored ward-based intervention to redesign nursing handover practice with co-constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre-implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio-recorded handover events (n = 233). Post-intervention we conducted interviews and focus groups (n = 79) and observed and/or audio-recorded handover events (n = 129) to qualitatively evaluate impact.

RESULTS

Our translational approach resulted in substantial changes post-intervention. Nurses conducted more shift-to-shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information.

CONCLUSION

Contextualised training combined with changes to ward-level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward-level leadership, collaboration and mentoring. The speed and degree of change post-intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists.

RELEVANCE TO CLINICAL PRACTICE

Nurses are more likely to conduct efficient group handovers and informative, patient-centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward-level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change.

REPORTING METHOD

We adhered to the COREQ guidelines.

PATIENT OR PUBLIC CONTRIBUTION

We interviewed patients on study wards pre and post intervention.

[Implementing bedside handover in neurological rehabilitation: An Action Research Approach in Practice Development]

Implementing bedside handover in neurological rehabilitation: An Action Research Approach in Practice Development Abstract. Background: Nursing handovers are considered high-risk tasks but are also an important resource for conveying pertinent insights in the patients' situation and engaging them in the care process. As part of a broader action research project, a participatory approach was used to implement bedside handovers. Aims: It seemed central to sustainable change to gain insights which underlying factors motivate nurses to change handover practices. Methods: A qualitative design was chosen, in which five exploratory interviews were conducted with nurses. Results: The biggest challenges are privacy concerns and dealing with cognitively impaired patients. The motivations for bedside handover are a less error-prone transfer of information and a more accurate impression of the patient, in addition to a patient contact which is experienced as valuable. Discussion: The change in handover structure is accompanied by changes in the ward culture. The challenges faced by the staff require high communication skills to bridge them. The main factor for the preference of the handover form is the effect on the patients. Limitations: Transferability is limited due to the high contextual relevance. Transfer: With the help of a structured implementation strategy, even rituals can be modified. The bedside handover has a beneficial influence on patient-centredness.

Shift handover quality in Saudi critical care units: determinants from nurses' perspectives

BACKGROUND

Nurses' effective handover communication is vital for patient safety and quality of care. Few studies have empirically tested how certain factors influence the quality of handover in the Saudi context.

METHODS

A descriptive correlational design was used with a convenience sample of all nurses (N = 201) working in Saudi hospital CCUs in 2022. Demographics and handover quality instruments were used to collect the necessary data in addition to two open-ended questions that asked about perceived barriers and facilitators to handover. The analysis was conducted using descriptive statistics and regression analysis.

RESULTS

The majority of nurses reported good-quality handover. The regression analysis showed that staffing, cognitive capacity, the focus of attention, relationships, and safety climate factors contributed positively to the variance of handover quality. In contrast, intrusions, distractions, anxiety, time stress, and acute and chronic fatigue factors negatively affected the prediction of handover quality (p < 0.05). Nurses added types of shifts and languages as barriers to handover while emphasizing training and the use of standardized tools for handover as facilitators.

CONCLUSION AND RECOMMENDATIONS

Nursing handover is a multidimensional phenomenon. By understanding the determinants that contribute to or hinder handover quality, it is possible to develop targeted interventions aimed at improving communication and the quality of shift handover in CCUs. The current study's findings highlight the need for nurses to work in a more supportive environment, receive better training, and follow a standardized handover protocol. Additionally, nurse managers should pay more attention to nurses' well-being to control or mitigate the effect of psychological precursors on the quality of nurses' handover. Future research should investigate handover practices and outcomes on units that have both good and bad practice environments.

Braided identities in acute care nurses' practices of work: professional, clinician, employee

Purpose

This paper aims to explore how dispositions of nursing habitus carry shift handover into practice in acute care.

Design/methodology/approach

Handover (the exchange of information by nurses between shifts) is more recently purported to be a procedure that transfers the responsibility of and accountability for care to maintain patient safety. Using Bourdieu's theory of practice as lens, this paper examines data from an ethnographic study of nurses' work in acute care to reveal what happens in and around nurses' practices of handover.

Findings

Exploring handover as a practice enables identification of nurses' responsibilities of work as professional, clinician and employee. These responsibilities are not practised separately, rather, as braided identities they are embodied into nurses' practices of work. Nurses' clinician and employee identities address the clinical and organisationally relevant material contained in handover, but it is in the ways that nurses embody their responses that their professional identity becomes evident.

Research limitations/implications

Viewing handover as a procedure suggests that nurses are rule followers and/or sole players and conceptualises nurses as individualised professionals only. This received knowledge as doxa misrecognises the centrality of connectedness between nurses in their work in the acute care setting.

Originality/value

Recognising nurses' braided workplace identities as being professional, clinician and employee upends the doxa of nurses work as tasks and roles in the delivery of healthcare in the acute care setting.

World guidelines for falls prevention and management for older adults: a global initiative

BACKGROUND

falls and fall-related injuries are common in older adults, have negative effects on functional independence and quality of life and are associated with increased morbidity, mortality and health related costs. Current guidelines are inconsistent, with no up-to-date, globally applicable ones present.

OBJECTIVES

to create a set of evidence- and expert consensus-based falls prevention and management recommendations applicable to older adults for use by healthcare and other professionals that consider: (i) a person-centred approach that includes the perspectives of older adults with lived experience, caregivers and other stakeholders; (ii) gaps in previous guidelines; (iii) recent developments in e-health and (iv) implementation across locations with limited access to resources such as low- and middle-income countries.

METHODS

a steering committee and a worldwide multidisciplinary group of experts and stakeholders, including older adults, were assembled. Geriatrics and gerontological societies were represented. Using a modified Delphi process, recommendations from 11 topic-specific working groups (WGs), 10 ad-hoc WGs and a WG dealing with the perspectives of older adults were reviewed and refined. The final recommendations were determined by voting.

RECOMMENDATIONS

all older adults should be advised on falls prevention and physical activity. Opportunistic case finding for falls risk is recommended for community-dwelling older adults. Those considered at high risk should be offered a comprehensive multifactorial falls risk assessment with a view to co-design and implement personalised multidomain interventions. Other recommendations cover details of assessment and intervention components and combinations, and recommendations for specific settings and populations.

CONCLUSIONS

the core set of recommendations provided will require flexible implementation strategies that consider both local context and resources.

Effect of SWOT Analysis Combined with the Medical and Nursing Integration Emergency Nursing Process on Emergency Treatment Efficiency and Prognosis of Patients with Acute Myocardial Infarction

Acute myocardial infarction (AMI) is a common clinical emergency. Effective emergency treatment at the early stage of onset can effectively reduce the mortality rate. Time is the key of emergency treatment, which is directly related to the treatment effect and the prognosis of patients, and clinical intensive nursing intervention for emergency treatment is of great significance in improving the efficiency of emergency treatment and prognosis. In this study, the effects of routine emergency care flow and SWOT analysis combined with medical and nursing integration on emergency treatment efficiency and prognosis of patients with acute myocardial infarction were compared. The results showed that the combined scheme could improve the rescue effect and success rate of patients with acute myocardial infarction, shorten the rescue time, and reduce the mortality and complication rate of myocardial infarction, which provided a new direction for clinical emergency treatment of acute myocardial infarction.

Patient and carer experience of living with a pressure injury: A meta-synthesis of qualitative studies

INTRODUCTION

Pressure injuries are a significant cause of harm, contributing to increased mortality and financial burden on the healthcare system. Significant research on pressure injury risk assessment, prevention and treatment exists, but limited research exploring the patient and carer experience of living with pressure injury.

AIMS

The aim of this meta-synthesis was to describe the patient and carer experience of living with a pressure injury.

DESIGN

Meta-synthesis.

METHODS

A prospective review protocol was registered, and systematic search conducted across five electronic databases. The PRISMA 2020 checklist for reporting systematic reviews was used. Two reviewers independently undertook screening and review of articles, using the CASP checklist for evaluating qualitative research. A meta-synthesis using thematic content analysis was undertaken.

RESULTS

Twelve studies met the inclusion criteria. Meta-synthesis led to the construction of three primary themes: loss of autonomy and independence, psychological effects, and adjustment. Within these primary themes, sub-themes of dependence, social isolation and social avoidance behaviours, feelings and emotions, loss, managing, physical consequences, service provision, and functional challenges, were identified.

CONCLUSION

The psychology and mindset of those involved, and support to navigate the challenges that arise are two unique and clinically relevant categorisations to guide provision of pressure injury care. Adaptation to a pressure injury is multi-faceted and contextual, challenges to adaptation create additional psychological burden. Interventions encompassing all facets of the experience are necessary. Current research into experiences is limited, and further research to support interventions is necessary.