Georgia Tobiano1, Jennifer A Whitty2, Tracey Bucknall3, Wendy Chaboyer4. 1. Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia. 2. Professor, Norwich Medical School, University of East Anglia, Norwich, UK; School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Woolloongabba, QLD, Australia. 3. Professor and Foundational Chair in Nursing, Centre for Quality and Patient Safety, School of Nursing and Midwifery, Faculty of Health, Deakin University and Alfred Health, Burwood, VIC, Australia. 4. Director, National Centre of Research Excellence in Nursing Interventions for Hospitalised Patients, Menzies Health Institute Queensland, Griffith University, Southport, QLD, Australia.
Abstract
BACKGROUND AND RATIONALE: Bedside handover during the change of shift allows nurses to visualize patients and facilitate patient participation, both purported to improve patient safety. But, bedside handover does not always occur and when it does, it may not involve the patient. AIM: To explore and understand barriers nurses perceive in undertaking bedside handover. METHODS: A cross-sectional survey was administered to 200 nurses working on medical wards, recruited from two Australian hospitals, one private and one public. As part of the survey, there was one open-ended question asking about perceived barriers to bedside handover. Content analysis was used to analyze data. Barriers were assessed using a determinant framework. RESULTS: The open-ended question was answered by 176 (88%) participants. Three categories were identified. First, censoring the message showed nurses were concerned about patients and third-parties hearing sensitive information. In the second category, disrupting the communication flow, nurses perceived patients, family members, other nurses and external sources, interrupted the flow of handover and increased its duration. Finally, inhibiting characteristics demonstrated that individual patient and nurse views or capabilities hindered bedside handover. Barriers to bedside handover were determined to relate to individual nurse factors, patient factors, social, political and legal factors, and guideline factors. LINKING EVIDENCE TO ACTION: Suggestions for enhancing bedside handover include debunking nurses' misconceptions, reflecting on nurses' viewpoints, using active educational approaches, and promotion of legal requirements to heighten nurses' confidence dealing with sensitive information. Regular patient rounding, and standardized handover may enable patient involvement in handover. Finally, reviewing the local context to ensure organizational processes support bedside handover is recommended.
BACKGROUND AND RATIONALE: Bedside handover during the change of shift allows nurses to visualize patients and facilitate patient participation, both purported to improve patient safety. But, bedside handover does not always occur and when it does, it may not involve the patient. AIM: To explore and understand barriers nurses perceive in undertaking bedside handover. METHODS: A cross-sectional survey was administered to 200 nurses working on medical wards, recruited from two Australian hospitals, one private and one public. As part of the survey, there was one open-ended question asking about perceived barriers to bedside handover. Content analysis was used to analyze data. Barriers were assessed using a determinant framework. RESULTS: The open-ended question was answered by 176 (88%) participants. Three categories were identified. First, censoring the message showed nurses were concerned about patients and third-parties hearing sensitive information. In the second category, disrupting the communication flow, nurses perceived patients, family members, other nurses and external sources, interrupted the flow of handover and increased its duration. Finally, inhibiting characteristics demonstrated that individual patient and nurse views or capabilities hindered bedside handover. Barriers to bedside handover were determined to relate to individual nurse factors, patient factors, social, political and legal factors, and guideline factors. LINKING EVIDENCE TO ACTION: Suggestions for enhancing bedside handover include debunking nurses' misconceptions, reflecting on nurses' viewpoints, using active educational approaches, and promotion of legal requirements to heighten nurses' confidence dealing with sensitive information. Regular patient rounding, and standardized handover may enable patient involvement in handover. Finally, reviewing the local context to ensure organizational processes support bedside handover is recommended.
Authors: Owis Eilayyan; Regina Visca; Diana Zidarov; Patrick Ware; André Bussières; Sara Ahmed Journal: BMC Health Serv Res Date: 2020-08-25 Impact factor: 2.655