Handover in paediatrics: junior perceptions of current practise within the North West region

Abstract

<h3>Background</h3> In August 2009 the final stage of European Working Time Directive implementation took place in the UK. Previous research has identified the handover as a vulnerable period during which information may be lost, distorted or misinterpreted. In 2006, the Royal College of Paediatrics and Child Health (RCPCH) released “Good Practice in Handover” which defines the “Who, When, Where, How and What” of best practice paediatric handover. The RCPCH have also incorporated handover as a component of good clinical care in their most recent assessment standards document for paediatric training. Despite these innovations, research has identified dissatisfaction among junior staff with current practices. <h3>Objectives</h3> To evaluate the perceptions of handover among paediatric trainees in the North West, with attention paid to each of the domains of the current RCPCH guidance. <h3>Methods</h3> The research used a descriptive, non-experimental, cross-sectional study design. An online questionnaire survey was sent to a whole population sample of North West Trainee Paediatricians, using the mailing lists held by the Deanery. The questionnaire was developed locally for this study and piloted before its delivery by email using the online service “SurveyMonkey”. It consisted of mainly closed questions, with some open ended questions to gather qualitative data. A reminder was sent 2 weeks after the initial email. Responses were collected anonymously. <h3>Results</h3> There were 64 responders, giving a response rate of 35%. Registrars were reported to be present a 96.7% of morning handovers, while consultants were present at 65.3%. Handover was reported to not be timetabled in to the working day by 25.4% of respondents and was only reported bleep free by 8.1% of responders. 28% of respondents did not report an available designated handover location and 53.2% said the location was used for other purposes during handover. 82.8% of respondents thought that handover was effective, but only 50.8% felt it was educational and 55.6% thought it was well organised. Free text responses reported a number of concerns with current practise. <h3>Conclusions</h3> Despite clear guidance on paediatric handover, trainees report weaknesses in actual practice in several key domains and this is impacting on their satisfaction with the handover process.