Handover in Nursing: A Concept Analysis

The Nursing Inter Shift Handover: A Moment of Care for Patients and Their Family Caregivers

Precedents: The transfer between nursing shifts must guarantee the quality of care for patients and their families in the hospital. This study aimed to transform the handover between nursing shifts to strengthen the care capacity of patients and their family caregivers, and improve the care capacity of nursing staff, in a Latin American university hospital. Methods: This is a Nursing Methodology Research developed in the following phases: (a) identification of the best handover practices between nursing shifts to apply them within the institutional culture; (2) diagnosis of the transfer between shifts in the hospital; (3) design and validation of the transformation proposal; (4) measurement of transfer indicators; and (5) definition of a path to improve this transfer. Results: The proposal developed focuses on the patient and their family caregiver. The proposed protocol considered the perspective of the care recipients, the nursing staff, and the best available evidence. The overall transfer rating over 10 months went from 65% to 84%. Conclusions: The adjustment to the transfer process made it possible to strengthen the care capacity of patients and their family caregivers and improve the care capacity of the nursing staff.

Educational interventions for improving nursing shift handovers: A systematic review

AIM

This study analyzed the components of educational interventions for handovers among nursing students and nurses.

BACKGROUND

A handover is a communication process that occurs when patient care responsibilities and rights are transferred from one nurse to another. This process is important in nursing to ensure the continuity of nursing care and patient safety.

DESIGN

A systematic literature review of Korean and international studies was conducted to identify the components of handover educational programs for nursing students and nurses and analyze their effects, thereby providing a basis for the further development of these programs.

METHODS

Studies published in English or Korean no later than June 30, 2022, were found via an electronic database search using the MEDLINE, Embase, and CINAHL databases. Three reviewers independently evaluated all the studies. These studies focused on educational interventions for nursing students and nurses regarding covering shift-to-shift nursing handovers. After reviewing 1971 extracted articles, 18 satisfied the inclusion criteria.

RESULTS

Nine articles involved nursing students and nine involved nurses. Four articles covered bedside handovers as educational topics. Educational methods included lectures and active practice. Active practice comprised demonstrations, role-play, and feedback. The main content areas of the educational programs were an introduction to handovers; training regarding how to extract important information for handovers; and strategies using informatic and thematic structures, such as mnemonics, and concept mapping. The patient cases for role-play were provided in forms of written scenarios, virtual electronic charts, videos, scenario-based simulated situations, and actual patient cases assigned in clinical practice. The effects of the educational interventions were evaluated regarding knowledge, performance, and self-efficacy. Performance and self-efficacy were significantly higher in a study in which the intervention group was provided additional individual feedback compared to the control group and in a study in which the intervention group received multiple additional practice opportunities.

CONCLUSIONS

Handover education for nursing students and nurses should include individual feedback, demonstrations, and opportunities to practice to improve their performance and self-efficacy. Feedback methods should be further developed to increase the effectiveness of educational programs. Sample cases involving patients should be devised to increase these opportunities, and methods for improving educator efficiency should be identified.

Evaluating the Methodological Approaches of Cross-Cultural Adaptation of the Bedside Handover Attitudes and Behaviours Questionnaire into Portuguese

Nurse managers need culturally adapted assessment instruments to support the implementation of change to Nursing Bedside Handover (NBH) in healthcare institutions. This study aimed to cross-culturally adapt the Bedside Handover Attitudes and Behaviours (BHAB) questionnaire to the Portuguese context and evaluate the methodological approaches used for this purpose. To guide this study, we followed a guideline for cross-cultural translation and adaptation measurement instruments in healthcare. The results of the content validity testing suggested that the BHAB questionnaire is a valid instrument for use in the Portuguese context. To obtain these results we showed 1) using of a new methodological approach, the dual focus, to resolve the divergences and ambiguities in the translators' committee and the multi-professional committee; 2) the lack of a conceptual definition of the construct of the instrument as a requirement to retain items with I-CVI <0.70 after validity relevance pretesting and 3) the cognitive debriefing and relevance pretesting as methodological approaches which can be used alone or together to reinforce the evaluation of cultural relevance of the items. We concluded there is a need for guidelines to support the decision-making process of healthcare researchers with comprehensive information about the different methodological approaches they can follow.

Under the chest pain center mechanism, whether the nursing handover affects the nursing efficiency and the outcomes of patients with STEMI in the emergency department? A retrospective study

BACKGROUND

The introduction of chest pain centers (CPC) in China has achieved great success in shortening the duration of nursing operations to significantly improve the treatment and outcomes of patients with ST-segment elevation myocardial infarction (STEMI). The nursing handover period is still considered the high incidence period of adverse events because of the distractibility of nurses' attention, potential interruption, and unclear responsibilities. Under the CPC mechanism, the nursing efficiency and patients' outcome, whether affected by the nursing handover, is still a knowledge gap in research. This is also the aim of this study.

METHODS

A retrospective study was conducted with data from STEMI patients from a tertiary hospital in the north of Sichuan Province from January 2018 to December 2019 through the Chinese CPC database. Patients are divided into handover and non-handover groups according to the time they presented in the Emergency Department. D2FMC, FMC2FE, FMC2BS, FMC2CBR, FMC2FAD, and D2W were selected to measure nursing efficiency. The occurrence of major adverse cardiovascular events, the highest troponin values within 72 h of hospitalization, and the length of hospitalization were selected to measure the patient outcomes. Continuous variables are summarized as mean ± SD, and t-tests of the data were performed. P-values < 0.05 (two-tailed) were considered statistically significant.

RESULTS

A total of 231 cases were enrolled, of which 40 patients (17.3%) were divided into the handover period group, and 191 (82.6%) belonged to the non-handover period group. The results showed that the handover period group took significantly longer on items FMC2BS (P < 0.001) and FMC2FAD (P < 0.001). Still, there were no significant differences in D2FMC and FMC2FE, and others varied too little to be clinically meaningful, as well as the outcomes of patients.

CONCLUSION

This study confirms that nursing handover impacts the nursing efficiency of STEMI patients, especially in FMC2BS and FMC2FAD. Hospitals should also reform the nursing handover rules after the construction of CPC and enhance the triage training of nurses to assure nursing efficiency so that CPC can play a better role.

Correlation of safety behavior, handover quality, and risk perception: A cross-sectional study among Chinese psychiatric nurses

Background

Nurses' safety behaviors played an important role in patients' safety goal realization, and it varies from person to person. However, less research has explored the safety behavior level of psychiatric nurses and its influencing factors. Thus, this research aimed to assess the level of safety behavior and explore whether risk perception mediated the relationship between handover quality and safety behavior among psychiatric nurses.

Methods

A total of 186 registered psychiatric nurses in a Chinese hospital were recruited for this study, through the convenience sampling method. Handover quality, risk perception, and safety behavior were measured. Hayes' PROCESS macro was used to evaluate the mediation of risk perception between handover quality and safety behavior.

Results

Scores of psychiatric nurses' safety behaviors were (47.98 ± 7.45), and handover quality and risk perception could predict the variance of nurses' safety behaviors. Risk perception could partially mediate between handover quality and nurses' safety behaviors, and the value of the mediating effect was 49.17%.

Conclusion

Psychiatric nurses' safety behaviors have a large promotion space. Therefore, healthcare professionals should endeavor to improve the handover quality of psychiatric nurses and decrease their risk perception, thereby promoting nurses' safety behaviors.

Quality and efficiency of a standardized e-handover system for pediatric nursing: A prospective interventional study

AIM

This study examined the effect on pediatric nursing handover quality and efficiency when a standardized e-handover system was implemented.

BACKGROUND

Handover quality is an important aspect of nursing quality management; however, handover quality among nursing staff is poor.

METHODS

A prospective interventional study was carried out in a general pediatrics ward from December 2019 to November 2020. The tools included a standardized e-handover system. The intervention strategies included workflow remodeling and employee training on oral handover using the standardized e-handover system.

RESULTS

The omission frequency of critical handover elements decreased from 47.32% to 2.94% (p < .01), among which the omission frequencies of nine out of 16 key elements significantly decreased. Integrity also showed improvement. Specifically, the integrity of five types of critical information was significantly improved, including vital signs, signs and symptoms, laboratory test results, radiologic examination results, and treatment regimen (2.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 3.00 vs. 5.00, p < .01; 5.00 vs. 5.00, p = .009; 3.00 vs. 4.00, p < .01, respectively). Information accuracy was 100%. Workflow and efficiency significantly improved, communication duration with patient/family during work hours significantly increased (24.00 vs. 56.00, p < .01), and prehandover preparation duration significantly decreased (32.00 vs. 2.50, p < .01). Nurse handover satisfaction showed improvement (56.88 ± 15.08 vs. 74.31 ± 9.22, p < .01).

CONCLUSION

The standardized e-handover system effectively improved nurse handover quality, optimized workflow, increased work efficiency, and promoted teamwork.

IMPLICATIONS FOR NURSING MANAGEMENT

Standardized e-handover systems have great potential for ensuring the safety of pediatric patients and improving the quality of handover.

Effective nursing shift handover in critical care: A concept analysis

To explore the concept of effective shift handover in critical care settings. Ineffective handover is one of the leading causes of adverse events in healthcare settings. Nursing shift handover in the intensive care unit (ICU) is more complex and detailed than in other in-patient wards due to the complexity of medical issues experienced by ICU patients. It is, therefore, critical that nurses be able to conduct handover effectively. Despite the importance of handover, the definition and attributes of effective handover are not clearly understood. Walker and Avant's eight-step approach to concept analysis. Effective handover in nursing is an interactive process between two nurses, resulting in the direct transfer of adequate patient-specific recent information in a manner that creates a shared understanding of information. Its defining attributes are (1) content-related and (2) process-related attributes. The antecedents of effective handover are organizational support, interpersonal relationship, and work environment. Its consequences include patient and nurse satisfaction, improved care, and continuity of care. Empirical referents include several tools developed to measure some of the effective handover attributes. The definition provides a connotative meaning and is the first step toward concept validation and instrument development to measure effective handover practice in the ICU.

Experiences of handovers between shifts among nurses in small and medium-sized hospitals: a focus-group study

Nursing handovers represent an important and complex form of communication in healthcare organizations that involve the exchange of patient-related information between nurses. This qualitative descriptive study aimed to identify the intershift handover experiences among nurses working in small and medium-sized hospitals. Focus-group interviews were conducted with 30 nurses who directly participated in patient care in such hospitals in South Korea. The reporting of the study findings adhered to the Consolidated Criteria for Reporting Qualitative Research checklist. The data were analysed using content analysis. Under the main theme of "baton touch in a relay", 6 categories, 17 subcategories and 45 codes (concepts) were derived. The six categories were "procedural rituals for shifts", "non-standardized handover training", "inconsistent handover style", "stress due to handovers", "coping strategies for handovers" and "interruptions of handovers". Nurses in small and medium-sized hospitals strive to improve the quality of handovers by preparing individual-level coping strategies under difficult conditions. This indicates that standardized handover education strategies need to be developed for nurses that are suitable for the personnel systems of small and medium-sized hospitals.

Correlation between the quality of nursing handover, job satisfaction, and group cohesion among psychiatric nurses

Background

Nursing handovers are a critical component of patient safety. Researchers have performed many primary studies in this field, mainly reporting findings from changes in nursing handover patterns. However, few quantitative studies have explored the factors that influence handover quality. Therefore, this study aimed to investigate the quality of handovers and explore the associations between handover quality, job satisfaction, and group cohesion among psychiatric nurses.

Methods

This cross-sectional study included 186 registered psychiatric nurses from a Chinese hospital, who responded to the Handover Evaluation Scale, McCloskey/Mueller Satisfaction Scale, and Group Cohesion Scale. Bootstrap analyses were used to evaluate the mediating effect between variables.

Results

The average item score for handover quality was (5.85 ± 1.14), and job satisfaction and group cohesion could predict the variance of handover quality. Job satisfaction could partially mediate between group cohesion and handover quality, and the value of the mediating effect was 45.77%.

Conclusion

The quality of psychiatric nursing handovers has enhanced space. Thus, hospital managers should take various measures to strengthen group cohesion and promote job satisfaction, both of which help improve the quality of psychiatric nursing handovers.