Handover: Faster and safer

Abstract

Objective: This study aimed to introduce bedside handover to three rural South Australian hospitals.

Design: A mixed‑method, pre‑test post‑test evaluative approach involving quantitative (quasi‑experimental) and qualitative (ethnographic) elements was used.

Setting: This study was set in three acute hospital wards.

Subjects: The sample comprised forty‑eight self‑selected enrolled/registered nursing staff; forty‑seven females and one male. Main outcome measure(s) A 7‑point Likert scale (19 items) and ethnographic interview questions covered themes relating to nurses satisfaction of pre and post‑handover processes, frequency of incidents and estimations of time taken to conduct handover processes. Pre and post‑handover processes were digitally timed. Documentation review of pre and post incident frequencies and journaling were also undertaken.

Results: With regard to handover duration, the average total time taken to conduct handover had decreased between 13% and 70% depending on the site. From a practical aspect, this can be regarded as significant. With regard to incident comparison, there is a clear trend from pre to post; the total number of incidents dropping from eighteen to seven.

Conclusions: The results of this study indicate that bedside handover approach is significantly less time consuming than the closed door approach previously adopted. The findings indicate a trend in the reduction of frequency of incidents under the bedside handover process. Literature suggests that incident reduction is directly correlated with increased information accuracy, however, this was not found to be the case in this study. Further research is warranted into factors, other than information accuracy, that may increase safety in clinical settings.