Information structure and organisation in change of shift reports: An observational study of nursing hand-offs in a Paediatric Intensive Care Unit

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.

Handover in Nursing: A Concept Analysis

BACKGROUND AND PURPOSE

The broad use of the term handover to describe any activity involving the transfer of professional responsibility from one person to another has led to an ambiguous understanding. Recently, handover has become a process central to the delivery of high-quality and safe patient care. The aim of this analysis was to clarify the concept of handover within the context of nursing practice.

METHODS

Rodgers's evolutionary approach was used as the analysis method along with some aspects of the dimensional analysis guided by Caron and Bowers, to understand the perspectives of senders and receivers.

RESULTS

The analysis revealed four attributes of handover: transfer of information, interaction for disambiguation, process, and strategy. Handover is defined as a process for transferring responsibility from sender to receiver through communication through the transfer of information, the interaction for disambiguation, and the context-sensitive strategy for accomplishing the continuity and safety of patient care. The salient dimension of handover was process, and the sub-dimensions were transfer of information, interaction for disambiguation, and strategy. From the sender's perspectives, it is the process of transferring information organized by the sender, and from the receiver's perspective, handover is the process establishing care plan through interactive strategy.

IMPLICATIONS FOR PRACTICE

The definition and identified attributes serve as a heuristic for designing strategies and further developing the construct of handover in nursing.