The effectiveness of bedside handovers: A multilevel, longitudinal study of effects on nurses and patients.

Abstract

To investigate the effectiveness of bedside handovers. For nurses, effects on nurse-patient communication, individualized care, coordination of the care process, job satisfaction, intention to leave, patient participation and work interruptions were measured. For patients, effects on patient activation, individualized care and quality of care were measured. This is a longitudinal, controlled, multicentred study on 13 nursing wards in five hospitals. The seven interventional wards consisted of two medical rehabilitation, two geriatric and three surgical/medical wards. A questionnaire for patients and nurses at baseline (May-June 2016), 3 (July-August 2017) and 9months (December 2017-January 2018) after implementation was completed by 799 patients and 165 nurses. Per protocol analysis was used in combination with linear mixed models analysis. With exception for work interruptions and patient participation for nurses, no overall effects could be found for both patients and nurses. For nurses, patient participation increased, and work interruptions decreased in the intervention group. Individualized care remained stable in the intervention group, whereas it decreased in the control group. The results indicate that bedside handover can be regarded as superior to more commonly used handover models as it enhances patient participation and decreases work interruptions. However, the positive image of bedside handovers, mostly based on observational, short-term and single-centred experiences, cannot be confirmed as there were no effects on any of the other measured parameters. As bedside handovers put patient participation on the agenda and negative effects are absent, implementing bedside handovers should be considered a mean for more patient-centeredness instead of a goal itself.