Abstract
BackgroundClinical handover is a pivotal, high-risk communicative event because it involves the transfer of responsibility and accountability for patients and their care. Nurses’ perceptions and their communication skills inevitably impact on their ability of clinical handover. Limited studies have explored nurses’ handover practice in the Hong Kong context. This study aimed to identify factors associated with and specific impact paths between the quality, communication skills and nurses’ perceptions on clinical handover.MethodsA questionnaire survey was conducted immediately after the nurses’ training in effective handover communication. A convenience sample of 206 bilingual nursing staff from a local hospital in Hong Kong participated in this paper-and-pencil survey adopted from the Nurses Handover Perceptions Questionnaire survey.ResultsThe path analysis revealed that except the opportunity to ask questions and high perceptions of the ISBAR communication protocol, other factors were significantly correlated with improved quality of handover. In addition, nurses who had updated information were likely to ask more questions and obtain a better understanding of the patient care plan during handover.ConclusionsThe quality of nursing handover depended on the degree of nurses’ grasp of the patient care plan. The ISBAR communication protocol was considered helping nurses to improve their communication skills with other colleagues and indirectly enhance patient’s safety. However, although ISBAR facilitated nurses to structure clearer handover communication, it was not the most important predictive factor for determining handover quality.
Highlights
Handoff or handover was a fundamental routine clinical practice for the effective transfer of patient care plan between health professionals [1]
Whilst studies have reported that many handover practices are not structured, which suggests that there was a lack of meticulousness and efficiency when sharing important clinical information among all nursing staff
Research demonstrated that a clear communication structure for nursing handover was highly beneficial to ensure that clinicians cover each important area of information [10] and provide opportunities for clarification to both the giver and the receiver of patients’ responsibility [11,12,13]
Summary
Handoff or handover was a fundamental routine clinical practice for the effective transfer of patient care plan between health professionals [1]. Whilst studies have reported that many handover practices are not structured, which suggests that there was a lack of meticulousness and efficiency when sharing important clinical information among all nursing staff. On top of the complexity of handover communication in today’s dynamic clinical management, there has been a surge in using communication protocols such as the I-PASS mnemonic or ISBAR (Introduction, Situation, Background, Assessment, Recommendation) [4, 5], currently known as ISBARQ (Introduction, Situation, Background, Assessment, Recommendation and Question and answer), in the hospitals to guide nurses to deliver information regarding patients’ conditions in a structured and effective manner [6,7,8], as well as promoting seamless exchange and complete understanding of a patient’s condition and care plan [9]. A handover communication structure allows the facilitation of interdisciplinary clinical teams and hospital staff at different levels of hierarchy to work together [16, 17]
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