Quality Of Handover Research Articles

Using 'Situation-Background-Assessment-Recommendation' Method in Palliative Care to Enhance Handover Quality and Nursing Practice: A Mix Method Study.

To evaluate the impact of using 'Situation-Background-Assessment-Recommendation' method ('SBAR') in a palliative care setting. Effective handover communication is crucial for patient safety. Standardised communication tools, such as the SBAR method, are recommended to reduce errors and improve care coordination, but their use in palliative care is not investigated. Mixed method study design, adhering to the GRAMMS guideline. From January to October 2021, a SBAR guide tailored for palliative care was developed using the Delphi method and implemented in a Hospice setting. Data on 150 nurse handovers were collected before and after implementation to assess changes in nursing outcomes, including medication errors, adverse events and the identification of psychological and spiritual needs. Nurses' perceptions on the handover process were gathered through a qualitative survey. The SBAR guide significantly improved the handovers quality, reducing medication errors and eliminating adverse events postimplementation. The identification of psychological and spiritual needs increased during postimplementation period. Nurses also reported improved clarity, accuracy and completeness of information during handover. This is the first study to evaluate the impact of SBAR for handover in palliative nursing care. Findings show the added value of using communication tools.

Exploring the Experiences and Perceptions of the Utilisation of Structured Clinical Handover Frameworks by Nurses Working in Acute Care Settings: A Scoping Review.

There is increased interest in implementing structured clinical handover frameworks to improve clinical handover processes. Research postulates that structured clinical handover frameworks increase the quality of handovers; yet inconsistencies enacting these frameworks exist which has a potential to jeopardise the quality of communication during handovers thereby defeating the purpose of these frameworks. This scoping review aims to analyse and synthesise what is currently known of the nurses' experiences and perceptions in implementing structured clinical handover frameworks and identify knowledge gaps in relation to this topic area. A scoping review guided by the PRISMA-ScR checklist. A systematic search of five electronic databases was undertaken to identify peer-reviewed primary research studies which met the predetermined eligibility criteria. In total, 301 studies were imported into COVIDENCE, screened and assessed for eligibility resulting in 23 studies remaining. From the eligible studies, data was extracted, collated, appraised, summarised and interpreted. MEDLINE, CINHAL, ProQuest, EMCARE, Web of Science and Informit. Twenty three studies were included in this review which yielded the following major themes: (1) quality and completeness of information transfer; (2) interprofessional collaboration; (3) challenges impacting the experience of implementing the structured clinical handover frameworks and (4) perceived impacts on quality, patient safety and health outcomes. There are key benefits and issues experienced and perceived by nurses implementing structured clinical handover frameworks and this review identifies opportunities for further improvements. Future research should explore the perceived associations with patient outcomes. This review highlights the importance of structured clinical handover frameworks, the nurses' experiences in implementing these frameworks and strategies to improve the effectiveness of these frameworks. No Patient or Public Contributions as this study is a review of published primary evidence.

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.

Improving the Accuracy of the Gynaecology Handover Process: An Effective Quality Improvement Project at a University Hospital in the United Kingdom.

Objectives The objective of this study was to introduce a new system of handover in the gynaecology department and ensure its effectiveness with dynamic improvement measures. This was launched as a quality improvement project in a district general hospital in the United Kingdom. The primary aim was to start and consolidate a new system of a separate gynaecology handover in the presence of consultants, registrars (incoming and outgoing), senior house officers (incoming and outgoing) and gynaecology nurses. Design The strategy for consolidation included a daily quality review on the basis of a fixed proforma, identifying the obstacles faced, and improvising dynamic solutions. A new quality check proforma was introduced which took into account: (i) Presence of team members, (ii) Following of proper SBAR (Situation, Background, Assessment, Recommendation) format in the handover, (iii) Updating of patients awaiting surgeries with every detail on the list, (iv) Proper handing over of pending referrals, (v) Mention of sick patients with proper importance, and (vi) Proper handing over of new admissions. A pilot study was done to evaluate the baseline performance of the unit regarding the gynaecology team handover on the basis of the same proforma. The result of the baseline study was noted as the reference. Each day the team receiving the handover was interviewed for the next five months about the quality of each of the parameters on the predesigned proforma and the responses were noted. The answers were designed in binary form (Yes/No). These results were compiled at the end of each month. The result from each individual month was reviewed and the problems were identified and practical solutions were applied. These changes were noted and plotted graphically as a bar diagram. The monthly audit results were tabulated in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States). Results Pilot study results and final month results were compared with the help of the Mcnemar test and statistically significant improvement was noticed in seven out of eleven parameters. There was a steady and gradual improvement in the responses. The possible limitations of the study were also noted at the same time. Conclusion The quality improvement project was highly effective in improving the quality of handover and increased patient safety to a large extent.

Comparison of the SBAR method and modified handover model on handover quality and nurse perception in the emergency department: a quasi-experimental study

BackgroundEffective information transfer during nursing shift handover is a crucial component of safe care in the emergency department (ED). Examining nursing handover models shows that they are frequently associated with errors. Disadvantages of the SBAR handover model include uncertainty of nursing staff regarding transfer of responsibility and non-confidentiality of patient information. To increase reliability of handover, written forms and templates can be used in addition to oral handover by the bedside.AimsThe purpose of this study is to compare the ‘Situation, Background, Assessment, Recommendation (SBAR) method and modified handover model on the handover quality and nurse perception of shift handover in the ED.MethodsThis research was designed as a semi-experimental study, with census survey method used for sampling. In order to collect data, Nurse Perception of Hanover Questionnaire (NPHQ) and Handover Quality Rating Tool (HQRT) were used after translating and confirming validity and reliability used to direct/collect data. A total of 31 nurses working in the ED received training on the modified shift handover model in a one-hour theory session and three hands-on bedside training sessions. This model was implemented by the nurses for one month. Data was analyzed with SPSS (version 26) using paired t-tests and analysis of covariance.ResultsResults indicated significant difference between the modified handover model and SBAR in components of information transfer (P < 0.001), shared understanding (P < 0.001), working atmosphere (P = 0.004), handover quality (P < 0.001), and nurse perception of handover (P < 0.001). The univariate covariance test did not show demographic variables to be significantly correlated with handover perception or handover quality in SBAR and modified methods (P > 0.05).ConclusionsThe results of this study can be presented to nursing managers as a guide in improving the quality of nursing care via implementing and applying the modified handover model in the nursing handover. The resistance of nurses against executing a new handover method was one of the limitations of the research, which was resolved by explanation of the plan and goals, as well as the cooperation of the hospital matron, and the ward supervisor. It is suggested to carry out a similar investigation in other hospital departments and contrast the outcomes with those obtained in the current study.

Enhancing the quality of medicine handover at hospital discharge: a priority setting workshop.

When a patient is discharged from hospital it is essential that their general practitioner (GPs) and community pharmacist are informed of changes to their medicines. This necessitates effective communication and information-sharing between hospitals and primary care clinicians. To identify priority medicine handover issues and solutions to inform the co-design and development of a multifaceted intervention. A modified nominal group technique was used to reach consensus on medicine handover priority areas. The first hour of an interactive 2-hr workshop focused on ranking pre-identified issues drawn from literature. In the second hour, participants identified solutions that they then ranked from highest to lowest priority through an online platform. Descriptive statistics were used to analyse workshop data. In total 32 participants attended the workshop including hospital doctors (n = 8, 25.0%), GPs and hospital pharmacists (n = 6 each, 18.8%), consumers and community pharmacists (n = 4 each, 12.5%), and both hospital and aged care facility nurses (n = 2 each 6.3%). From the list of 23 issues, the highest ranked issue was high workload and time pressures impacting the discharge process (22/32). From the list of 36 solutions, the participants identified two solutions that were equally ranked highest (12/27 each). They were mandating that patients leave hospital with a discharge summary, including medication reconciliation information and, developing an integrated information technology system where medication summary and notes are accessible for primary, secondary and tertiary health provider. The consensus process highlighted challenges in hospital procedures where potential solutions may be implemented through co-design of a multifaceted intervention to improve medicine handover quality.

FACTORS RELATED TO THE QUALITY OF HANDOVER OF SITUATION, BACKGROUND, ASSESSMENT, RECOMMENDATION (SBAR) METHODS ON INTERNAL PATIENT TRANSFER

Communication errors are one of the causes of patient safety incidents. Handover of internal patient transfers using the SBAR methodis a form of communication whose implementation has not been carried out optimally. Purpose: To determine the factors associatedwith the quality of the SBAR handover method in internal patient transfers. Research method: Type of correlational quantitativeresearch. Cross-sectional research design. The population consisted of 94 nurses who carried out internal patient transfers. Thesample consisted of 76 nurses who transferred level 0 patients. The sampling technique uses purposive sampling. Measuring toolsuse questionnaires and observation sheets. Statistical tests use the Chi-Square test. Results: Nurse attitude (P-value = 0.000) andOdds Ratio 8.543, receive motivation (P-value = 0.003) and Odds Ratio 5.315, Head of Space leadership (P-value = 0.001) and OddsRatio 6.367, and head of room supervision (P-value = 0.002) and Odds Ratio 5.769. has a P-value of &lt;0.005, using Chi-Square Testanalysis and Logistic Regression to see the most influential variable, nurse attitude. Conclusion: The attitude sub-variable is the mostinfluential on the quality of SBAR method handover in internal patient transfer. Suggestion: Hospitals must conduct periodic andcontinuous evaluations of handover activities. The nurse's attitude that needs to be improved is the understanding of the sta ges andadjustment of the appropriate internal transfer time of the patient.

An empirical investigation on the use of building handover information and its quality requirements for commercial building management

Purpose Global building failures, such as the Grenfell Tower fire in London, UK, emphasised the need for trustworthy building handover information for safety. However, a notable gap remains in understanding how reliable handover information can ensure the safety of occupants. This study aims to investigate the use and essential quality of handover information to understand the effects of the quality of information on the management of commercial buildings. Design/methodology/approach Ninety-four participants from nine organisations who regularly use handover information to manage multiple commercial buildings participated in the semi-structured interviews. Qualitative thematic coding using interview transcripts was performed to identify the utilisation of handover information and its quality requirements. Findings This study reveals that as-built drawings and product information are predominately used to fulfil statutory obligations, comply with the organisation’s internal policies, evaluate asset valuation and make informed decisions about capital investment and operating expenses. The quality dimensions of “accuracy”, “timeliness”, and “completeness” are preferred in combination to achieve desired outcomes. Research limitations/implications This study focused on using handover information in the management of commercial buildings. However, its results can offer valuable perspectives for improving its application across various sectors in the built environment. Practical implications The findings affirm the need for quality handover information for safety, compliance and efficient management in commercial buildings. Originality/value This research significantly contributes to the current knowledge of handover information in the building sector. Given the study findings, building owners are equipped to define specific handover information requirements and quality requisites.

6300791 Tell me about it! Improving the quality of anaesthetic handover in Obstetric Recovery

6300791 Tell me about it! Improving the quality of anaesthetic handover in Obstetric Recovery

Mobile Handoff with 6LoWPAN Neighbour Discovery Auxiliary Communication

The importance of the topic under investigation stems from the burgeoning prominence of the Internet of Things (IoT) paradigm and the consequent imperative to devise and institute an efficacious methodology for neighbour detection that facilitates supplementary connections to mobile nodes. This research primarily aims to elucidate a mobile handover technique aligning with the neighbour discovery paradigm inherent in 6LoWPAN. The methodological framework employed herein amalgamates a systematic analysis of the foundational tenets governing 6LoWPAN communication standards over the IPv6 protocol in the context of IEEE 802.15.4aa personal wireless networks, supplemented with empirical evaluation of message propagation dynamics among discrete nodes of a designated personal wireless network. The findings of this investigation underscore the pre-eminence of the 6LoWPAN networking standard as a prime vehicle for bolstering the dependable communication of IoT&amp;#39;s remote entities, contingent upon the utilization of the IPv6 communication protocol. This iteration of the Internet protocol is superior, particularly in surveillance contexts, given its expansive address capacity (128 bits) juxtaposed against its antecedent, the IPv4 protocol (32 bits). The inherent adaptability of this network connection augments the quality of mobile handover, especially when one considers the real-world application of 6LoWPAN&amp;#39;s neighbour discovery auxiliary communication standard. The tangible implications of these findings beckon their potential utility in satiating the demands of IoT system users and actualizing the network collaboration ethos intrinsic to the 6LoWPAN communication standard.&amp;nbsp;

The use of information technology to improve interdisciplinary communication during infectious diseases ward rounds on the paediatric intensive care unit

Prospective audit with feedback during infectious diseases ward rounds (IDWR) is a common antimicrobial stewardship (AMS) practice on the Paediatric Intensive Care Unit (PICU). These interdisciplinary meetings rely on the quality of handover, with high risk of omission of information. We developed an electronic platform integrating infection-related patient data (COSARAPed). In the mixed PICU of a Belgian tertiary hospital we conducted an observational prospective cohort study comparing patient handovers during IDWRs using the COSARAPed-platform to those with access only to conventional resources. The quality of handover was investigated directly by assessment if the narrative was in accordance with Situation-Background-Assessment-Recommendation principles and if adequate demonstration of diagnostic information occurred, and also indirectly by registration if this was only achieved after intervention by the non-presenting AMS team members. We also recorded all AMS-recommendations. During a 6-month study period, 24 IDWRs and 82 patient presentations were assessed. We could only find a statistically significant advantage in favor of COSARAPed by indirect evaluation. We registered 92 AMS-recommendations, mainly resulting in reduced antibiotic pressure. We concluded that the IDWR is an appropriate platform for AMS on the PICU and that the utilisation of COSARAPed may enhance the quality of patient handover.

Implementasi Handover Sbar Pada Perawat di Ruang Rawat Inap Sebagai Upaya Peningkatan Kualitas Pelayanan

&lt;em&gt;SBAR handover for nurses is an indicator of the quality of hospital services. SBAR handover quality in nurses affects patient satisfaction, patient safety, and length of patient stay. In its implementation in the field, this method has not been widely used or has been used but has not been maximized, there needs to be focused training so that it can provide good quality SBAR handovers.This PKM aims to increase the knowledge and skills of nurses about SBAR Handover in the inpatient room one of the government hospitals in Bukittinggi city. The method used in this PKM includes dissemination of knowledge related to SBAR Communication during nurse handovers, socialization of SBAR Handover SOPs and Roleplay. The results of this PKM obtained an increase in the knowledge and skills of nurses in carrying out SBAR Handovers, as well as the creation of SOPs for implementing Nurse Handovers with SBAR Communication. From the results of monitoring and evaluating PKM activities, it is known that nurses understand and are able to practice independently implementing the SBAR Handover in each shift. It is hoped that this activity can continue to be improved by inaugurating the SOP and supervision of the head of the room so that nurses are competent in SBAR Handover as an effort to improve the quality of health services in hospitals.&lt;/em&gt;

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.

A study on the effect of applying a bedside handover checklist on the quality of handover by junior physicians in EICU.

A study on the effect of applying a bedside handover checklist on the quality of handover by junior physicians in EICU.

861 Getting the Surgical Handover Right: A Closed-Loop Audit

Abstract Aim The European Working Time Directive has led to a reduction in hours worked by junior doctors and subsequently increased the number of handovers between colleagues. Ineffective handovers introduce the opportunity for clinical error and adversely affect patient safety. We sought to improve the quality of patient handovers in a busy surgical department, by assessing compliance with a twelve-point guideline from the Royal College of Surgeons (RCS) as the gold standard. Method An audit was performed across a seven-day period. For each patient discussed during the morning or evening handover, compliance was measured according to twelve domains pertaining to a patient’s admission as per RCS recommendations (e.g., diagnosis, location, relevant investigation results). Following intervention with a ‘safe handover’ checklist, we repeated the audit across a subsequent seven-day period. Secondary outcomes, such as environmental and human factors, were also assessed by a junior team member. Results A total of 28 handovers, incorporating 337 patients, were included. Following implementation of the checklist, compliance improved across most domains—particularly with highlighting the necessity for an additional review (33.3% vs. 91.0%) and the handover of outstanding tasks (31.5% vs. 84.3%). Compliance with discussion of resuscitation status remained low (7.0% vs 9.2%). Improvements were noted with environmental and human factors, including performance of team introductions and the opportunity to raise concerns. Conclusions We have demonstrated an improvement in the quality of patient handovers as per RCS guidance following the implementation of a handover checklist. Further interventions are warranted to improve handover of resuscitation status.

649 Closed Loop Audit: Improving Surgical Handover in a Major Trauma Centre (RSCH)

Abstract Aim The goal of handover is the accurate reliable communication of task-relevant information across shift changes or between teams. Effective and safe transfer of clinical information is critical for patient safety. The aim of this study to assess Surgical handover in Royal Sussex County Hospital comparing it to the RCS guidelines as standard as well as improving the current practice. Method We undertook two cycles each cycle lasted for 6 weeks. These cycles aimed to assess the surgical handover and comparing them with RCS guidelines using checklists. A teaching session was conducted between the two cycles. In addition, RCS guidelines were handed over to all surgical doctors. Results we discussed a total of 2348 patients in morning surgical handover, over a period of 12 weeks (first cycle: 1203, second cycle:1145). Following conduction of teaching sessions and handing over guidelines, there was a significant improvement in documentation of patients age (from 73% to 97%), responsible consultant (from 92% to 98%), significant investigations (from 60% to 93%) and management plan (from 64% to 96%). Conclusions Education about proper handover was proven to be successful in improving the quality of surgical handover in a major trauma center.

Perceived Quality of Postoperative Handover by Saudi Nurses: A Single-Center Cross-Sectional Study.

Handover is considered a basic nursing practice in which a patient's care information is moved to another nurse. Handover of patients after surgery is critical due to a number of care transitions, the presence of a surgical procedure, and the influence of anesthesia. High-quality postoperative handover is essential to safe patient care. Few studies have been conducted to evaluate the quality of current postoperative handover practices and the factors contributing to the quality of such processes, especially in Saudi Arabia. The present research aimed at evaluating nurses' perceptions of postoperative handover quality and assessing factors impacting this process.This cross-sectional study targeted registered nurses with at least one year of professional experience who were actively involved in the conduction of postoperative handovers across various surgical departments. A total sample of 143 nurses was selected via a convenient sampling technique. Study instruments included Handover Quality Rating Form, patient status, and nurses' background characteristics. Overall, postoperative handover quality was perceived as high by handing over and receiving nurses. Generally, 55.2% of nurses agreed on the different items supporting the positive circumstance for handover, and 92.3% agreed on the good conduct of handover compared to only 7.69% disagreement (p˂0.001). Significant agreements were observed for teamworking (p˂0.001), as well as four indicators (out of five) measuring the overall handover quality (p<0.001). The type of involved departments impacted significantlythe handover quality perception(p=0.004). The respondents' age had asignificant effect onquality (p=0.036), as well as circumstances of postoperative handover (p=0.046). Moreover, significant statistical differences were found for the circumstance of handover (p=0.031), as well as teamwork (p=0.019) according to the nurses' roles.Finally, the patient's blood circulation and respiration had a significant effect (p=0.023, p=0.033, respectively), as did the patient's level of consciousness (p=0.006) in the nurses' perception of the overall postoperative handover quality. Postoperative handover quality was highly perceived by nurses. This research explored a multitude of factors such as patient health status and nurses' socio-demographic variables and their impact on nurses' perception of handover quality. Several nurse and patient-related factors were found to impact the handover process. This current research provided findings that could direct future improvements in nursing handover practice to ensure high-quality patient care.

Quality of Postoperative Handover as Perceived by Nurses in Saudi Arabia: A Cross-Sectional Study

Quality of Postoperative Handover as Perceived by Nurses in Saudi Arabia: A Cross-Sectional Study

Quality of Postoperative Handover as Perceived by Nurses in Saudi Arabia: A Cross-Sectional Study

Background: Handover is considered a basic nursing practice in which a patient's care information is moved to another nurse. Handover of patients after surgery is critical due to number of care transitions, presence of a surgical procedure, and the influence of anesthesia. High-quality postoperative handover is essential to safe patient care. Few studies have been conducted to evaluate the quality of current postoperative handover practices and the factors contributing to quality of such process, especially in Saudi Arabia.

Effectiveness of handover practices between emergency department and intensive care unit nurses.

Nurses from the emergency department (ED) and the intensive care unit (ICU) must interact during the handover procedure. Factors such as unit boundaries, the interaction between different specialities, patient acuities, and treatment adjustments generate specific negotiating and teamwork problems during the transition of patients from ED to ICU. This study aimed to describe the opinions of nurses regarding the effectiveness of handover practices between nurses in the ED and ICU in a major academic hospital in Gauteng province, South Africa. An analytical cross-sectional survey design was used. Data were collected using a 16-item handover evaluation tool. It comprises two sections (1) biographical details and (2) 16 statements about handover quality divided into five constructs, namely information transfer, shared understanding, working atmosphere, overall handover quality, and circumstances of handover. Data analysis was done utilising descriptive and non-parametric statistics. The majority (51.8%; n=115) of the handovers occurred during the day. Out of 171 nurses, there were specialist practice emergency (19.2%; n=33) and intensive care (28.0%; n=48) nurses. There was statistical significance in information transfer between the ED and ICU nurses. (Me=4.0, p<0.05), compared to ICU nurses (Me=3.0). Nurse specialist and non-specialist nurses' handovers differed statistically significantly on 12 of the 16 items on the rating scale, compared to 10 for non-specialist nurses' handovers. The study showed that ED and ICU nurses have significantly different requirements and expectations for handover procedures. In addition to completed documentation, subtle interpretations of the information provided and received also impact the need. The ED and ICU nurses would need to agree on the contents of a structured handover framework because different specialities and departments have varied expectations to achieve an effective handover.