Translating evidence-based nursing clinical handover practice in an acute care setting: A quasi-experimental study.

Effective transfer of information during the nursing handover contributes to patient safety. This study aimed to translate the best practice nursing shift handover recommendations in an acute care setting using the Ottawa Model for Research Use and to explore its effect on patient adverse outcomes (falls, pressure injuries, and medication errors). Using a quasi-experimental design, the study was conducted in four internal medicine wards in a major tertiary hospital. A total of 88 nurses and 110 patients participated in 152 handover observations. The findings showed clinically important increases in percentages and odds of nurses' compliance with shift handover recommendations after the intervention. The patient adverse outcomes after the intervention were compared to the corresponding period of previous year. A reduction was observed for all adverse patient outcomes with incident rate ratios of 0.762 (p = 0.027) for falls, 0.624 for pressure injuries (p = 0.010), and 0.782 for medication errors (p = 0.023). Replicating this study's methodology across multiple clinical settings will increase the generalizability of findings and provide further evidence to inform nursing practice and policy.

Shift-to-shift nursing handover interventions associated with improved inpatient outcomes-Falls, pressure injuries and medication administration errors: An integrative review.

The aim of this integrative review was to identify which nursing handover interventions were associated with improved patient outcomes, specifically patients' falls, pressure injuries and medication administration errors, in the hospital setting. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was used to guide the review. A systematic search of seven electronic databases was conducted, and retrieved articles were assessed by two independent reviewers. The quality of included studies was assessed using the Mixed Methods Appraisal Tool. Eight studies met the inclusion criteria. The findings of this review indicate that improvements in handover communication had a clinically important positive effect on patient outcomes. Across the studies, reductions in falls varied from 9.3 to 80%, pressure injuries from 45 to 75%, and medication errors from 11.1 to greater than 50%. This review highlights that the implementation of bedside nursing handover and the adoption of standardized handover tools to improve nursing handover communication reduce patient adverse events, specifically falls, pressure injuries, and medication errors. These findings should be considered by clinicians to inform their clinical handover practice.

Using a knowledge translation framework to identify barriers and supports to effective nursing handover: A focus group study.

The aims of this study were to systematically assess the barriers and facilitators to evidence-based nursing handover in a clinical environment, and to identify potential adopters and attributes of evidence-based nursing handover for translation into practice. The study was conducted in the medical wards of a major tertiary referral hospital in Brisbane, Australia. Participants comprised registered and enrolled nurses permanently employed in the participating wards for at least three months prior to the commencement of study. Using a qualitative focus group design, a context specific assessment of the barriers and enablers to knowledge translation was performed through five semi-structured focus groups. Focus groups discussions were recorded by a registered court reporter using a stenotype machine for voice to text transcription, transcribed verbatim and de-identified for analysis. Focus group data were analysed using thematic analysis. Three themes emerged from the focus group discussions: 1) Content (information transferred); 2) Process (steps used to transfer accountability and responsibility for care); and 3) Environment (factors impacting on safe handover). Participants identified barriers to effective nursing handover including variability of handover content and process, uncertainty around sharing sensitive information, inconsistency around clarifying gaps through questioning during the handover, superficial patient involvement, time constraints and environmental challenges. Key facilitators discussed during the focus groups were the use of integrated electronic medical records, support and clear expectations from the nursing leadership and targeted handover education. During the focus group discussions, participants identified several barriers and facilitators to effective handover. These findings will guide the development of research translation strategies to support the implementation of best practice, standardised clinical handover.