Handover Practice Research Articles

Clinical practice guidelines for person-centred handover practices in emergency departments: a scoping review.

To review the available information on clinical practice guidelines for person-centred and current handover practices between emergency care practitioners (ECPs) and healthcare professionals in emergency departments (EDs). Collating existing clinical practice guidelines may improve handover practices. Clinical practice guidelines for person-centred handover practices between ECPs and healthcare professionals in EDs. ECPs transporting and handing patients over to healthcare professionals in EDs. Healthcare professionals including doctors and nurses working in EDs, who are involved in handovers with ECPs. Studies conducted in EDs, emergency rooms or emergency centres in any geographical area. No language or time restrictions were applied. The search included published and unpublished studies, opinion papers as well as primary sources, and evidence synthesis. All qualitative and quantitative research designs were included. The literature on clinical practice guidelines for person-centred handover practices was reviewed. Three electronic databases were searched: MEDLINE (PubMed), CINAHL (EBSCO) and Scopus from inception to May 2023 with no time limits set for the inclusion of published literature in the review. Six guideline organisations were also searched. A data extraction tool was developed, pilot-tested and used to extract data from the included studies. 19 studies met the inclusion criteria. Various mnemonics exist for handover practices. Where mnemonics are not used, participants have identified important information that should be included during handover practices. We did not find any clinical practice guidelines or information on person-centred handover practices in any of the reviewed articles. Currently, there is no gold standard for person-centred handover practices, which has led to various practices being implemented. Currently, there is a paucity of literature on person-centred handover practices. Most articles expressed a need for standardised handover practices; however, not all aspects of handover practices can be standardised and should be kept patient and context-specific. This scoping review protocol was registered on Figshare (10.6084/m9 /m9.figshare.21731528).

EP584 - The standard of evening handover in the acute surgical department of a single regional centre: a closed-loop audit

Abstract Aims Handover is an important period that represents a potential risk to patient safety. The Royal College of Surgeons of England (RCSEng) have published guidelines on safe handover practice. The aim of this closed-loop two-cycle audit was to ensure general surgery patients at a single regional centre were handed over according to RCSEng guidelines. Method Evening handovers were prospectively audited between May 2023 to July 2023 using a proforma adapted from the RCSEng guidelines. A questionnaire relating to junior doctors’ views on the night handover was electronically disseminated prior to the first cycle. The intervention was an educational guide for foundation doctors on how to effectively hand over surgical patients, based on the RCSEng guidelines. P-values were calculated using a Mann-Whitney U test. Results 15 handovers were audited in the first cycle; of 84 patients handed over, 31% (26/84) met the RCSEng handover ‘minimum’ standard. 13 handovers were audited in the second cycle; 84 patients were handed over, the ‘minimum’ standard rate increased to 67% (56/84) (p=0.003). There were 25 responses to the questionnaire, 92% (23/25) were by foundation doctors, 48% (12/25) volunteered wanting more teaching on handovers. Conclusions Introduction of an educational handover guide is a useful method to improve the quality of surgical handovers, particularly in regional centres that may have a more complex case mix. This guide was later introduced as part of the ‘induction pack’ for foundation doctors rotating into surgery.

The transition of patient care: Exploring the outcomes of prehospital to hospital patient handover practices and healthcare provider education

IntroductionInadequate patient handover is linked to numerous medical errors and lapses in communication between hospital healthcare providers and prehospital healthcare providers. Undergraduate healthcare curricula may limit programme-specific education on patient handover and shift learning to informal learning opportunities. This study aimed to investigate the outcomes of qualified healthcare provider (HCPs) educational programmes to determine the adequacy of handover practices, the source of their training, and their interprofessional acceptance of these practices. MethodsA multi-method study design was used – a document analysis of HCP programme outcomes and a two-section questionnaire. The questionnaire was sent to HCPs to determine the impact of patient handover practices on current healthcare systems and their opinion on whether the training on handovers is sufficient. ResultsHCPs indicated little educational interaction regarding patient handover. Most participants felt handover education relied predominantly on informal training. With their existing knowledge, many HCPs revealed that they were comfortable in handing over a patient. Little interprofessional confidence regarding patient handover information indicates minimal interprofessional collaboration toward standardised approaches for patient handover. ConclusionThis study indicates a lack of standardised handover procedures, which leads to HCP self-interpretations. There is low trust between HCPs regarding information received. The study highlights the need for standardised handover training in healthcare curricula to improve patient safety and interprofessional collaboration.

Construction and Validation of a Standardized Bedside Handover Process and Visual Diagnosis-Symptom System in Emergency.

To construct and examine the effects of a Standardized Bedside Handover Process and Visual Diagnosis-symptom System. According to the application of standardized procedure and Diagnosing-symptom System, we divided three groups: control group, process group and process + visualization group. Study outcomes included nursing handover practices and patient bedside nursing handover satisfaction, which were measured by the Chinese version of Nursing Assessment of Shift Report (NASR) and the Patients Views on Nursing Care with implementation bedside report (PVNC-BR), respectively.The effects were estimated using t-test and ANOVA. Compared with the control group, NASR and PVNC-BR scores of the process group and the process + visualization group were significantly higher. Standardized process for bedside handover and the application of visual diagnosis-symptom libraries could improve the quality of nursing bedside handover in emergency observation room.

Status of Handover Practice of Postoperative Patient from Operating Room to Postanaesthesia Care Unit in Muhimbili Orthopedic Institute Operating Theatre Recovery Room

Background: Postoperative period is a time of significant physiological flux, patient recover from the acute derangements resulting from anaesthesia and surgery. On arrival at PACU, the patient is re-evaluated by the anaesthesia provider gives a handover to the responsible PAC provider. Incomplete handover increase risk of morbidity and mortality to patients. Objective: Study assessed the handover practice of postoperative patient from operating room to post-anaesthesia care unit in Muhimbili Orthopedic Institute operating theatre recovery room. Methodology: This was a hospital based cross-sectional observational study which was conducted at Muhimbili Orthopedic Institute Hospital located at Upanga. Handover conducted by Anaesthetic Provider to PACU nurse in the Recovery rooms were Observed and information communicated were marked using SBAR handover checklist. Then anaesthetic providers and PACU nurse were surveyed to know which item in the checklist was relevant to be communicated during handover. Data collected was analyzed using Statistical Package for Social Scientists (SPSS version 23). Results: 319 PACU handover were observed. 17.5% of the handover were completed and rated as Good, 50.8% were satisfactory and 31.7% poorly completed. Most communicated items were Vital Sign 90.6%, Operation Underwent 86.8% and Type of anaesthesia 85.9% and the least was ASA 24.5%. Items providers thought should be communicated were Name of the patient (0.954), Age and Gender (0.938), Type of Anaesthesia (0.925). Among the Anaesthetic Provider Cadre Physician Providers provided Good and Satisfactory handover compared to Nurse Provider. Conclusion: Majority of the handover were satisfactorily completed, with Vital Sign, type of anaesthesia and Operation underwent being the most communicated items in checklist.

The Nursing Inter Shift Handover: A Moment of Care for Patients and Their Family Caregivers.

Precedents: The transfer between nursing shifts must guarantee the quality of care for patients and their families in the hospital. This study aimed to transform the handover between nursing shifts to strengthen the care capacity of patients and their family caregivers, and improve the care capacity of nursing staff, in a Latin American university hospital. Methods: This is a Nursing Methodology Research developed in the following phases: (a) identification of the best handover practices between nursing shifts to apply them within the institutional culture; (2) diagnosis of the transfer between shifts in the hospital; (3) design and validation of the transformation proposal; (4) measurement of transfer indicators; and (5) definition of a path to improve this transfer. Results: The proposal developed focuses on the patient and their family caregiver. The proposed protocol considered the perspective of the care recipients, the nursing staff, and the best available evidence. The overall transfer rating over 10 months went from 65% to 84%. Conclusions: The adjustment to the transfer process made it possible to strengthen the care capacity of patients and their family caregivers and improve the care capacity of the nursing staff.

Assessing current handover practices in surgery: A survey of non-consultant hospital doctors in Ireland

BackgroundHandovers of care are potentially hazardous moments in the patient journey and can lead to harm if conducted poorly. Through a national survey of surgical doctors in Ireland, this paper assesses contemporary surgical handover practices and evaluates barriers and facilitators of effective handover. MethodsAfter ethical approval and pre-testing with a representative sample, a cross-sectional, online survey was distributed to non-consultant hospital doctors (NCHDs) working in the Republic of Ireland. A mixed-methods approach was used, combining data using triangulation design. Main findingsA total of 201 responses were received (18.5%). Most participants were senior house officers or senior registrars (49.7% and 37.3%). Most people (85.1%) reported that information received during handover was missing or incorrect at least some of the time. One-third of respondents reported that a near-miss had occurred as a result of handover within the past three months, and handover-related errors resulted in minor (16.9%), moderate (4.9%), or major (1.5%) harm. Only 11.4% had received any formal training. Reported barriers to handover included negative attitudes, a lack of institutional support, and competing clinical activities. Facilitators included process standardisation, improved access to resources, and staff engagement. ConclusionsSurgical NCHDs working in Irish hospitals reported poor compliance with international best practice for handover and identified potential harms. Process standardisation, appropriate staff training, and the provision of necessary handover-related resources is required at a national level to address this significant patient safety concern.

STUDY OF HANDOVER PRACTICES AMONG NURSING STAFF OF A TERTIARY CARE TEACHING HOSPITAL IN NORTH INDIA

The study aimed to implement a standardized guiding nursing handover protocol and assess its impact on handoff practices. A total of 282 handover observations were analyzed before and after the intervention, and various factors related to handoffs were examined, including time specificity, place of handoffs, methods used, patient involvement, and nursing staff satisfaction. The study found that less experienced nurses faced challenges with handoffs, and the majority of handoffs occurred during evening and night shifts. Patient involvement during handovers was minimal, particularly in emergency and ward settings. The study also revealed the need for training and guidance on handoffs, as many nurses had not received adequate instruction in this area. Following the intervention, improvements were observed in terms of timing precision, duration of handovers, inclusion of bedside handoffs, and satisfaction with the information received during handovers. The study highlights the importance of effective handover practices in ensuring patient safety and suggests the implementation of training programs and standardized guidelines for handoffs.

Implementing a ward-level intervention to improve nursing handover communication with a focus on bedside handover-A qualitative study.

To improve the effectiveness of nursing clinical handover through a qualitative, tailored communication intervention. A multisite before and after intervention using qualitative ethnography combined with discourse analysis of nursing handover interactions. We implemented a tailored ward-based intervention to redesign nursing handover practice with co-constructed recommendations for organisational and cultural change on seven wards across three affiliated metropolitan hospitals between February 2020 and November 2022. The intervention was informed by pre-implementation interviews and focus groups with nursing, medical and allied health staff and patients (n = 151) and observed and/or audio-recorded handover events (n = 233). Post-intervention we conducted interviews and focus groups (n = 79) and observed and/or audio-recorded handover events (n = 129) to qualitatively evaluate impact. Our translational approach resulted in substantial changes post-intervention. Nurses conducted more shift-to-shift handovers at the bedside, with greater patient interaction and better structured and more comprehensive information transfer, supported by revised handover documentation. Redesigned group handovers were focused and efficient, communicating critical patient information. Contextualised training combined with changes to ward-level systemic factors impeding communication results in improved nursing handovers. Practice change requires strong executive leadership and project governance, combined with effective ward-level leadership, collaboration and mentoring. The speed and degree of change post-intervention demonstrates the power of interdisciplinary collaborative research between hospital executive, ward leadership and communication specialists. Nurses are more likely to conduct efficient group handovers and informative, patient-centred bedside handovers in line with policy when they understand the value of handover and have practical strategies to support communication. Communication training should be combined with broader ward-level changes to handover practice tailored to the ward context. A multilevel approach results in more effective practice change. We adhered to the COREQ guidelines. We interviewed patients on study wards pre and post intervention.

Learning from reflection – good practice in handover with neurodiverse clients

This article details the reflection process that arose as a result of our recent experiences with client handover within a national, specialist, adult neurodevelopmental psychology service, following one clinician leaving the service. The departing clinician and the team used this ‘learningfrom experience’ opportunity to collectively reflect on handover with neurodiverse clients, thinking about what went well with the whole process, what could have been done differently and to consider the adaptations that this population may require in order to make handovers as smooth as possible. We have summarised the learning points from these reflections into ‘good practice guidance’ for our own service. Literature on best handover practice is limited, especially with respect to neurodiversity, and given the increasing number of neurodiverse clients accessing local or secondary care services, we are sharing our first-hand experiences in the hope that this may be relevant, helpful and/or stimulate discussion for other services experiencing similar situations.

Reaching consensus on the definition of person-centred handover practices in emergency departments: A modified online Delphi.

To reach consensus on the definition and attributes of 'person-centred handover practices' in emergency departments. Handover practices between emergency care practitioners and healthcare professionals in emergency departments are important and should be conducted meticulously. Person-centred handover practices may enhance the delivery of person-centred care in emergency departments. A three-round online Delphi survey. Nine experts participated in a three round Delphi survey. The expert panel comprised experts from nine countries. Quantitative data were descriptively analysed, and qualitative data were thematically analysed. A consensus of 80% had to be reached before an attribute and definition could be accepted. Experts reached a consensus of 79% in round one, 95% in round two and 95% in round three. A final set of six attributes were agreed upon and the final concept definition was formulated. Person-centred handover practices have not been implemented in emergency departments. Yet, person-centred handover practices may enhance the delivery of person-centred care, which has multiple benefits for patients and healthcare practitioners. Person-centred care is not generally implemented in emergency departments. Person-centred handover practices can lead to person-centred care. Handover practices in emergency departments are a high-risk activity. Despite numerous calls to standardise and improve handover practices, they remain a problem. Developing a standardised definition could be a first step towards implementing person-centred handover practices in emergency departments. The study adhered to the relevant EQUATOR reporting guidelines: Guidance on Conducting and Reporting Delphi Studies (CREDES) checklist. Improve handover practices and patient care. Improve person-centred care in emergency departments. Emergency care practitioners and nurses experienced in handover practices and/or person-centred care, working in clinical and academic fields, participated in the study by sharing their expert knowledge during each of the Delphi rounds.

A tool to assess the components of a safe and quality medical handover

Background: Robust medical handovers are paramount to ensure patient safety throughout the course of a hospital admission. Anecdotal evidence within our Australian tertiary hospital suggested that medical handovers were typically less structured when compared to allied health handovers. Medical handovers at our hospital had never been evaluated before, and the development of a questionnaire to assess the key components of a safe and quality handover was necessary. This tool would evaluate our medical handovers, and identify potential areas for improvement in both the tool, and medical handover practice. Methods: Based upon a literature search, and local and national guidelines of best practice, the tool was created around six key components of quality medical handovers—members involved in handover, environment and logistics, structure and content, management plans, patient-related and documentation. The tool was developed to audit the after-hours team handover at our 600-bed tertiary hospital. The tool was trialled at 20 medical handovers for our after-hours team, results were captured on REDCap, and data analyzed. Results: The tool was useful in assessing a wide range of key medical handover components and highlighting areas for improvement within our medical handovers. Through this trial, limitations were discovered in the tool that can be incorporated into future revisions of the tool. Conclusion: Overall, this study provided valuable insight into medical handovers by identifying current clinical practice and highlighting areas for improvement. The broader utility of this tool is the ability of other health services to evaluate their own medical handover, or serve as a starting point to develop their own audit tool.

Analysis of Nurses' Perceptions of Handover Practices: A Comparative Study in Different Medical Settings.

This article reports a comparative prospective study aimed to explore and compare nurses' perceptions of bedside clinical handover in 3 different settings (emergency unit, ICU, and medical ward). Results revealed that the participant nurses' perceptions varied significantly for different aspects of the handover process. Our data demonstrate department-specific variations in perceptions related to the adequacy, organization, relevance, availability of charts, use of charts for review, ease of following the information, and timeliness of the information.

Enhancing Teamwork Through Effective Handover Practices Among Nurses in Elder Care Setting

Introduction: This study aims to investigate how effective handover practices among nurses contribute to enhancing teamwork within elder care settings. It will explore the impact of clear communication, structured handover processes, and collaboration among nursing teams during handovers on various aspects of teamwork, including coordination, information sharing, and mutual support. Methods: A qualitative, descriptive study employed semi-structured interviews with nurses and other healthcare professionals involved in handover processes. Participants included nurses and various healthcare professionals. Thematic analysis, guided framework, was utilized to examine handover practices and their impact on patient care. Responses were meticulously coded manually to identify recurring themes and subthemes. Results: The study identified three key themes in healthcare handover practices: the importance of objective and clear documentation, including essential information for continuity of care, and the role of effective documentation in promoting understanding and accountability among healthcare professionals. These practices enhance communication, teamwork, and accountability, leading to improved patient outcomes. Effective communication involves aspects such as frequency, timeliness, accuracy, problem-solving, shared knowledge, goals, and mutual respect among team members, fostering a culture of teamwork and accountability that benefits both staff and patients. Conclusion: Achieving optimal teamwork in professional hierarchies requires insights and experiences on handover implementation from an interprofessional perspective. This collaborative approach involves professionals working together to provide comprehensive patient care. Interprofessional collaboration encourages effective communication, mutual respect, and shared decision-making among team members, ultimately enhancing patient outcomes.

Enhancing Teamwork Through Effective Handover Practices among Nurses in Elder Care Setting

This study aims to investigate how effective handover practices among nurses contribute to enhancing teamwork within elder care settings. It will explore the impact of clear communication, structured handover processes, and collaboration among nursing teams during handovers on various aspects of teamwork, including coordination, information sharing, and mutual support. Methods:Aqualitative, descriptive study employed semi-structured interviews with nurses and other healthcare professionals involved in handover processes. Participants included nurses and various healthcare professionals. Thematic analysis, guided framework, was utilized to examine handover practices and their impact on patient care. Responses were meticulously coded manually to identify recurring themes and subthemes.Results:The study identified three key themes in healthcare handover practices: the importance of objective and clear documentation, including essential information for continuity of care, and the role of effective documentation in promoting understandingandaccountabilityamonghealthcareprofessionals.Thesepracticesenhance communication, teamwork, and accountability, leading to improved patient outcomes. Effective communication involves aspects such as frequency, timeliness, accuracy, problem-solving, shared knowledge, goals, and mutual respect among team members, fostering a culture of teamwork and accountability that benefits both staff and patients. Conclusion:Achieving optimal teamwork in professional hierarchies requires insights and experiences on handover implementation from an interprofessional perspective. This collaborative approach involves professionals working together toprovidecomprehensivepatientcare.Interprofessionalcollaborationencourageseffective communication, mutual respect, and shared decision-making among team members, ultimately enhancing patient outcomes.

Nurses' Versus Physicians' Perceptions of the Bedside Handover Practice in the Intensive Care Unit: An Egyptian Prospective, Comparative Study.

This article reports a prospective, comparative study using a semistructured interview technique, to compare the perceptions of nursing professionals and physicians about the bedside handover practice, in intensive care units (ICUs). Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Despite increasing demand for structured processes to guide clinical handovers, the perception may differ between nurses and physicians, particularly in the ICU. The results of the current study showed that the quality of the information provided during handovers was perceived by both the nurses and physicians as satisfactory and relevant to the patient's care. The findings of this study could have impacts on the daily medical practices in the ICU. The results of this study could be utilized to design programs that will improve nurses' and physicians' understanding and practices of the handover process as well as the information needed to be communicated.

Pilot study to develop a pre-operative "Cardiothoracic Clinical Handover Tool" and its effect on handover quality.

Clinical handover is an essential step in the surgical patient's hospital journey, but one that is not without risk. Within cardiothoracic surgery, endeavours to protocolise post-operative handover from cardiac theatre to cardiac intensive care units have resulted in enhanced patient safety, but little to no effort has focused on the pre-operative setting and the dissemination of information throughout the surgical team. We designed a pre-post study examining the quality of pre-operative cardiothoracic patient handovers before and after the introduction of an intra-departmentally designed "Cardiothoracic Clinical Handover Tool" based on the Royal College of Surgeons of England's guidelines for "Safe Handover". Forty clinical handovers were assessed in each arm of the study. Handover quality improved from a score of 63.75% to 88.57% (p = < 0.001). This prolonged handover duration from a mean of 72.1 to 102.4seconds per case (p = 0.003). Interruptions occurred in 27.5% of pre- and 25% of post-intervention handovers. Interruptions resulted in increased handover duration in both pre- and post-intervention groups (114.6 vs 77.7seconds, p = 0.012) and poorer quality handovers in the pre-intervention group (51.28% vs 68.42%, p = 0.03) but failed to impact handover quality in the post-intervention group (88.57% vs 88.57%, p = 1). Clinical handover tools have the potential to enhance the quality of pre-operative handover and protect against poor handover practices such as interruptions, safe-guarding patient welfare. We provide the first cardiothoracic specific pre-operative handover tool based on the RCSE guidelines.

Long-Term Sustainability and Adaptation of I-PASS Handovers.

Inadequate communication during transitions of care is a major health care quality and safety vulnerability. In 2013 Massachusetts General Hospital (MGH) embarked on a comprehensive training program using a standardized handover system (I-PASS) that had been shown to reduce adverse events by 30% even when not completely executed on each patient. In this cross-sectional study, the authors sought to characterize handover practices six years later. Using a standardized interview tool, the researchers evaluated handovers between responding clinicians in 10 departments and then validated these findings through direct observations, allowing for flexibility and customization in the I-PASS elements. The study qualitatively compared I-PASS element use in verbal handovers to MGH early postintervention data, as well as verbal and written handovers with the I-PASS Study Group's postintervention results. The authors observed 156 verbal and reviewed 182 written patient handovers. Ninety percent of departments adhered at least partially to the I-PASS system. Average handover duration ranged from 0.6 to 2.1 minutes per established patient. The service with best I-PASS adherence also consistently included the most information per unit of time. Acknowledging substantial differences in study technique, MGH adherence was, on average, comparable or better on all I-PASS elements in verbal handovers and on three of four elements of written handovers compared with the I-PASS Study Group's postintervention results. Although uptake has varied across services, six years after hospitalwide implementation of I-PASS, the majority of services are performing structured and sequenced handovers, most of which include some elements of the I-PASS system. Those services with the best I-PASS adherence conducted the most efficient handovers.

Teamwork and mental workload in postsurgical pediatric patient handovers: Prospective effect evaluation of an improvement intervention for OR-PICU patient transitions

Postsurgical handover of pediatric patients from operating rooms (OR) to pediatric intensive care units (PICU) is a critical step. This transition is susceptible to errors and inefficiencies particularly if poor multidisciplinary teamwork occurs. Despite wide adoption of standardized handover interventions, comprehensive investigations into joint effects for patient care and provider outcomes are scarce. We aimed to improve OR-PICU handovers quality and sought to evaluate the intervention with particular attention to patient care effects and provider outcomes. A prospective, before-after-study design with an interrupted-series and a multi-source, mixed-methods evaluation approach was established. Drawing upon a participative plan-do-study-act approach, a standardized, checklist-based handover process was designed and implemented. For effect assessments, we observed OR-PICU handovers on site (pre implementation: n = 31, post: n = 30), respectively, with standardized expert observation and provider self-report tools (n = 111, n = 110). Setting was a tertiary Pediatric University Hospital. Supplementary qualitative, semi-structured interviews were conducted, and a general inductive content analysis approach was used to identify key facilitators and barriers on implementation. Improvement efforts focused on stepwise implementation of (1) standardized handover process and (2) a checklist for multi-professional OR-PICU handover communication. We observed significant increases in team and patient setup (pre: 79.3%, post: 98.6%, p < .01), enhanced team engagement (pre: 50%, post: 81.7%, p < .01), and comprehensive information transfer by the anesthesia sub-team (pre: 78.6%, post: 87.3%, p < .01). Expert-rated teamwork outcomes were consistently higher, yet self-reported teamwork did not change over time. Provider perceived stress and disruptions did not change, mental workload tended to decrease over time (pre: M = 3.2, post: 2.9, p = .08). Comprehensiveness of post-operative patient information reported by PICU physician increased significantly: pre: 65.9%, post: 76.2%, p < .05. After implementation, providers acknowledged the importance of standardized handover practices and associated benefits for facilitation of information transfer and comprehensiveness. Among reported barriers were obstacles during implementation as well as insufficient consideration of professionals’ individual workflow after surgery.Conclusion: A multidisciplinary intervention for postsurgical pediatric patient handovers was associated with improved expert-rated teamwork and fewer omissions of key patient information over time. Inconsistent results were obtained for provider-rated mental workload and teamwork outcomes. The findings contribute to a better understanding concerning the interplay of teamwork and provider cognitions in the course of establishing safe patient transitions in pediatric care.What is Known:• Transfer of critically ill children conveys significant challenges for interprofessional communication and teamwork. Prospective research into interventions for safe and efficient handover practices of OR PICU patient transitions is necessary.• Checklists are assumed to facilitate cognitive load among providers in acute clinical environments.What is New:• A standardized, checklist-based handover intervention was associated with improvements in team set-up and information transfer. Provider outcomes such as mental workload and stress did not change over time.• The combination of teamwork and provider assessments allows a more nuanced understanding of implementation barriers and sustainable effects in course of OR-PICU handover interventions.

Implementing bedside handover in neurological rehabilitation: An Action Research Approach in Practice Development

Implementing bedside handover in neurological rehabilitation: An Action Research Approach in Practice Development Abstract. Background: Nursing handovers are considered high-risk tasks but are also an important resource for conveying pertinent insights in the patients' situation and engaging them in the care process. As part of a broader action research project, a participatory approach was used to implement bedside handovers. Aims: It seemed central to sustainable change to gain insights which underlying factors motivate nurses to change handover practices. Methods: A qualitative design was chosen, in which five exploratory interviews were conducted with nurses. Results: The biggest challenges are privacy concerns and dealing with cognitively impaired patients. The motivations for bedside handover are a less error-prone transfer of information and a more accurate impression of the patient, in addition to a patient contact which is experienced as valuable. Discussion: The change in handover structure is accompanied by changes in the ward culture. The challenges faced by the staff require high communication skills to bridge them. The main factor for the preference of the handover form is the effect on the patients. Limitations: Transferability is limited due to the high contextual relevance. Transfer: With the help of a structured implementation strategy, even rituals can be modified. The bedside handover has a beneficial influence on patient-centredness.