[Implementing bedside handover in neurological rehabilitation: An Action Research Approach in Practice Development]. / Implementation der patientennahen Übergabe in der neurologischen Frührehabilitation.

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.

Evaluating the efficacy of a digital App to enhance patient-centred nursing handover: A simulation study.

AIM: The study aim was to evaluate the feasibility and efficacy of a digital App developed to enhance patient communication with nurses during bedside nursing handover at shift change. METHODS: Six nurses and 11 patient actors/volunteers participated in 12 simulated nursing handovers across six simulation workshops. Over half the patients were aged 70+ years (55%); majority were female (82%). Handover video recordings were analysed using a structured observation tool and a revised Four Habits Coding Scheme to assess nurses' handover communication skills. Patient and nurse feedback was also sought. The STROBE checklist (Data S1) guided preparation of the study. RESULTS: For all simulated handovers (n = 12): Nurses greeted the patient at commencement; nurses made eye contact with the patient; patients were given opportunity to ask questions; and all patient questions were answered. Nurses explained the handover process for less than half the handovers (42%). Familiarity with the patient's history was evident in every handover. Communication behaviours identified in most handovers included: good nonverbal behaviour; allowing time for the patient to absorb information; giving clear explanations; involving the patient in decisions; and exploring acceptability of the care plan. Patient and nurse feedback on the App included: The App was easy to navigate, features were well-liked, with some improvements suggested. CONCLUSION: Patients and nurses provided positive feedback for the App during hospital stay and at handover. The App has the potential to enhance existing handover processes and increase safety of hospital care by using technology to educate and empower patients/carers to be active partners in communication with nurses during change-of-shift handover. RELEVANCE TO CLINICAL PRACTICE: The App empowers and enables patients/carers to actively participate in nursing handover and allows patients to communicate concerns and provide information to their nursing team, facilitating a new approach. PATIENT OR PUBLIC CONTRIBUTION: Patients and carers were involved in the research from the original co-design workshops that guided the development of the handover App. The research aims and outcome measures were informed by the experiences and preferences of patients/carers. Two patient representatives were involved in writing and submission of the grant application for the study to evaluate the efficacy of the App and were listed as co-authors on this paper. Patient volunteers were involved in the current study to pilot test the handover App. Patient volunteers were recruited through a consumer representative and volunteer registry at the health service. They participated in simulated nursing handovers with two nurses to assess the feasibility and acceptability of the handover App and then provided feedback and suggestions for improvement.

Evaluation of patient participation in relation to the implementation of a person-centered nursing shift handover.

BACKGROUND: It has been suggested that nursing shift-to-shift handover should be a more team-based dialogue with and for the patient rather than about a patient. AIM: The aim of this study was to evaluate patient participation in relation to the implementation of the person-centered handover (PCH). METHOD: A pretest-posttest design was used without a comparison group, including patients from nine units in a university hospital at pretest (n = 228) and after implementing PCH (posttest, n = 253) per the framework integrated-Promoting Action on Research Implementation in Health Services. The PCH is inspired by an Australian bedside handover model. The Patient Preferences for the Patient Participation tool was used to rate the preference for and experience of participation on 12 items, combined into three levels of preference-based participation (insufficient-fair-sufficient). RESULTS: There were no differences regarding experience or preference-based participation between patients at pretest-posttest; however, posttest patients experienced participation in the item Reciprocal communication to a lesser extent than the pretest patients. Only 49% of the posttest group received PCH; of those not receiving PCH, some would have wanted PCH (27%), while some would have declined (24%). Patients receiving PCH had sufficient participation (82%), to a greater extent, regarding the item Sharing one's symptoms with staff than patients at pretest (72%). Patients receiving PCH also had sufficient participation, to a greater extent, than patients at posttest who did not receive, but would have wanted PCH, regarding four items: (1) sharing one's symptoms with staff, (2) reciprocal communication, (3) being told what was done, and (4) taking part in planning. LINKING EVIDENCE TO ACTION: Most patients want to be present at PCH. Therefore, nurses should ask for the patients' preferences regarding PCH and act accordingly. Not inviting patients who want PCH could contribute to insufficient patient participation. Further studies are needed to capture what assistance nurses would want in identifying and acting in alignment with patient preferences.

Development and psychometric testing of the patient participation in bedside handover survey.

INTRODUCTION: When handover is conducted at the patient's bedside, active patient participation can be encouraged, which may improve the safety and quality of care. There is a need for valid and reliable tools to measure patient perceptions of participation in bedside handover, to ensure the rising number of implementation and improvement efforts are consistently and effectively evaluated. The aim of this study is to systematically develop and evaluate the psychometric properties of a self-report survey to measure patients' perceptions of participation in bedside handover. METHODS: In Phase 1, our team developed a conceptual framework and item pool (n = 130). In Phase 2, content validity was assessed with four health consumers, four nurses and four researchers. Next, 10 current hospital inpatients tested the survey for end-user satisfaction. In Phase 3, 326 inpatients completed the survey, allowing exploratory factor analysis, reliability analyses and convergent/divergent validity analyses to occur. RESULTS: Phase 1 and 2 resulted in a 42-item survey. In Phase 3, 321 surveys were available for analysis. Exploratory factor analysis revealed a three-factor solution, with 24 items, which matched our conceptual framework. The three factors were: 'Conditions for patient participation in bedside handover', 'Level of patient participation in bedside handover' and 'Evaluation of patient participation in bedside handover'. There was strong evidence for factor reliability and validity. Additionally, the correlation between factors was strong. CONCLUSION: This study furthers our conceptual understanding by showing that nurse facilitating behaviours are a strong precursor for patient participation and perceived handover outcomes, justifying the need for nursing training. A robust survey has been developed to measure patient perceptions of participation in bedside handover, which can effectively evaluate this approach to care. Engaging consumers and nurses as research team members was invaluable in ensuring that the survey is acceptable for end-users. PATIENT OR PUBLIC CONTRIBUTION: A health consumer and nurse partnered as members of the research team from study inception to dissemination.

The impact of bedside handovers on relevant clinical indicators: A matched-controlled multicentre longitudinal study.

AIM: To investigate the effects of bedside handover, as contrasted with traditional handovers, on length of hospital stay, unplanned readmission, hospital-acquired pressure ulcers (HAPUs), patient falls, unscheduled intravenous reinfusion and pain. DESIGN: A multicentre matched-controlled longitudinal design. METHOD: Bedside handover was implemented at five intervention wards in a convenience sample of four hospitals (three surgical/medical wards and two wards for medical rehabilitation). Four control wards continued to use their traditional handover (two surgical-medical wards, one medical rehabilitation ward and one mixed surgical-medical rehabilitation ward; one for each hospital). Patient records, including reports on individual patients in the electronic incident reporting systems, were consulted (N intervention = 509; N control = 265). The study was carried out between May 2016-February 2018 and data were collected between March 2018-June 2018. The data were analysed using generalized linear mixed-model analysis. RESULTS: No significant differences in length of stay, unplanned readmission, HAPUs, unnecessary intravenous drips, pain or patients falls could be attributed to the use of bedside handovers, whether over time or between the intervention and the control groups. CONCLUSION: No long-term effects were found on patient safety arising from bedside handover. This lack of significance possibly indicates that: (a) caution is needed when generalizing the results of previous smaller-scale studies; and that (b) bedside handovers do not create hazardous situations for patients. IMPACT: Nurses traditionally perform change-of-shift handovers without the patient. However, the growth in attention paid to reducing adverse events and the demand for more participative and patient-centred approaches in health care both suggest that bedside handovers might be a logical intervention. This study could not confirm the positive results found in the international literature on the impact of bedside handovers on patient safety. Bedside handover should thus be considered as an equally safe, more patient-centred alternative to traditional handover models. TRIAL REGISTRATION: ClinicalTrials.gov (NCT02714582).

Bedside handover at the change of nursing shift: A mixed-methods study.

AIM: To describe the structures, processes and content of bedside handover at the change of nursing shift in an acute-care context. BACKGROUND: The handover of patient information and care at the change of nursing shift is an essential, albeit risk-laden, time-consuming activity in clinical practice. DESIGN: A convergent parallel mixed-methods design was used. METHODS: Thirty episodes of bedside handover were concurrently audio-recorded and observed using a researcher-developed tool modelled on the five domains of the British Medical Association's Safe Handover-Safe Patients framework. The audio recordings were analysed using content analysis. Quantitative and qualitative data generated were then triangulated to develop a more complete interpretation of the structure, process and content of information transferred at the patient's bedside during the change of nursing shift. This study followed Good Reporting of Mixed Methods Study guidelines. RESULTS: Bedside handover was observed to be mainly conducted at a fast pace. However, within these timeframe large volumes of complex information were shared and important nurse-patient interactions occurred. Analysis of the audio recordings provided evidence that the dialogue during handover was nurse-dominated and the outgoing nurse appeared to influence the degree of patient participation. CONCLUSION: Bedside handover at the change of nursing shift involves three key stakeholders: outgoing nurse, incoming nurse and the patient. A combination of intricate communication skills both verbal and nonverbal facilitates the rapid sharing of large volumes of complex information which is necessary for the continuity and safety of patient care across nursing shifts. RELEVANCE TO CLINICAL PRACTICE: The comprehensive description of the complexities of bedside handover in this study provides an insight into this frequently occurring, important nursing practice and can be used to support nurse education and practice development.

Improved patient satisfaction 2 years after introducing person-centred handover in an oncological inpatient care setting.

AIMS AND OBJECTIVES: To investigate patients' satisfaction with care, 2 years after the introduction of person-centred handover (PCH) in an oncological inpatient setting, and to describe patients' perceptions of individualised care. BACKGROUND: To obtain higher levels of patient satisfaction, bedside nursing handovers have been evaluated with positive results. One such model is PCH, which blends aspects of person-centred care with the bedside report and provides the opportunity for nursing staff and patients to perform the handover together. DESIGN: A survey-based design was used with one data collection period. Patient satisfaction scores were compared with baseline data from a previous study that has been conducted in the same wards. METHOD: Patient satisfaction was measured with the EORTC IN-PATSAT32 questionnaire, and individualised care was assessed with the Individualized Care Scale. A total of 120 adult patients with cancer were invited to participate from August 2017-March 2018. Of these, 90 chose to participate. The STROBE checklist for cross-sectional studies was used when preparing the paper. RESULTS: Compared to the previous study, statistically significant improvements in patient satisfaction were observed in the subscales "Exchange of information between caregivers" and "Nurses' information provision" postimplementation of PCH. Regarding patients' perceptions of individualised care, the highest scores were in the ICS-A subscale "Clinical situation" and ICS-B "Decisional control," while "Personal life situation" scored the lowest overall. CONCLUSIONS: Person-centred handover seems to have sustainable positive effects on important outcomes regarding patient satisfaction. A novel finding is the positive impact on nurses' information provision, indicating that PCH can facilitate effective information exchange between patients and nurses. RELEVANCE TO CLINICAL PRACTICE: Person-centred handover seems to improve patients' satisfaction with nurses' provision and exchange of information. Nurses and managers should carefully consider the implementation process of PCH and evaluate its long-term effects. PCH can be recommended in the oncology inpatient setting.

Patients experiences of bedside handover: findings from a meta-synthesis.

BACKGROUND: Bedside shift reports have been recently recommended to ensure handovers. However, no evidence summarising studies designed to determine the qualitative approaches capable of better understanding patient experience have been published to date. AIM: The aim of this study was to acquire a deeper understanding of the experiences of patients regarding bedside shift reports. DATA SOURCES AND REVIEW METHODS: A systematic review of qualitative studies followed by a meta-synthesis method based upon Sandelowski's and Barroso's guidelines was performed. Four databases were systematically explored (PubMed, CINAHL, Scopus and PsycINFO) without any limitation in time and up to the 31 August 2018. A total of 10 studies were included and evaluated in their methodological quality; then, a thematic synthesis was developed to synthetize the findings. RESULTS: Three major themes reflect patients' experience regarding the bedside shift reports: (i) 'Being involved'; (ii) 'Being the centre of nursing care processes'; and (iii) 'Experiencing critical issues'. Patients are supportive of bedside shift reports as a right, as an opportunity to be involved, and of being in the centre of the nursing care process. By designing and implementing bedside shift reports, nurses also have an opportunity to increase patient safety and to provide concrete proof of the advancements achieved by the nursing profession in recent years. CONCLUSIONS: The bedside shift reports experience has been little studied to date from the perspective of patients. According to the findings, implementation of the bedside shift reports should include providing education to nurses with regard to the preferences and expectations of patients, as well as the critical issues that they can experience during the bedside shift reports. Presenting the bedside shift reports method, asking patient consent, discussing potential critical issues and the degree of involvement preferred at hospital admission, is strongly recommended.

Is privacy a problem during bedside handovers? A practice-oriented discussion paper.

Bedside handover is the delivery of the nurse-to-nurse handover at the patient's bedside. Although increasingly used in nursing, nurses report many barriers for delivering the bedside handover. Among these barriers is the possibility of breaching the patient's privacy. By referring to this concept, nurses add a legal and ethical dimension to the delivery of the bedside handover, making implementation of the method difficult or even impossible. In this discussion article, the concept of privacy during handovers is being discussed by use of observations, interviews with nurses, and interviews with patients. These findings are combined with international literature from a narrative review on the topic. We provide a practice-oriented answer in which two mutually exclusive possibilities are discussed. If bedside handover does pose problems concerning privacy, this situation is not unique in healthcare and measures can be taken during the bedside handover to safeguard the patient. If bedside handover does not pose problems concerning privacy, privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward patient participation. Therefore, a possible breach of privacy-whether a justified argument or not-is not a reason for not delivering the bedside handover.

Bedside shift handover implementation quantitative evidence: Findings from a scoping review.

AIM: To map the research methods, frameworks, structures, processes and outcomes investigated to date when implementing nursing bedside shift reports (BSRs). BACKGROUND: BSRs have become an area of increased interest among nurse managers (NMs) with several projects aiming at implementing bedside reports also as a strategy to increase nursing surveillance and reduce adverse events. However, to date, no summary of the available evidence has been provided with regard to research methods, theoretical frameworks underpinning BSR implementation and outcomes aiming at supporting NM decision-making in this field. EVALUATION: A scoping review including quantitative studies written in English and retrieved from five databases was performed in 2018. KEY ISSUES: Twenty-two studies originating from USA, Australia, Finland and Sweden, largely monocentric in nature and involving mainly medical/surgery units, have been performed to date. BSR implementation has been conducted mainly under organisational change theories, patient safety and nursing conceptual models. The BSR outcomes have been measured at the patient, nurse and organisational levels and reported positive trends. CONCLUSION: Professional reports-describing success transitions from traditional methods of handover to BSRs, and scientific studies aimed at improving evidence in the field, have been conducted to date, in order to document BSR implementation processes and outcomes. IMPLICATIONS FOR NURSING MANAGEMENT: BSRs should be designed and conducted under a theory of organisational change; moreover, clinical nurses should be trained and supported in the transition from the traditional shift report to the BSR; while implementing this transition, outcomes should be set at the patient, nurses and organisational levels with the aim of tracing the comprehensive effects of the change.

Nurses' perceptions of mandatory bedside clinical handovers: An Australian hospital study.

AIMS: The research explores (a) nurses' views of the change to mandatory bedside handovers, and (b) these nurses' perceptions of their skills in managing this new practice in an Australian hospital. BACKGROUND: In Australia, nursing bedside handovers are now considered essential in many hospitals, although most nurses received minimal training at the time this policy was instituted. This research establishes a unique quantitative tool to investigate nurses' views of, and self-reported actions related to, bedside handovers. METHOD: Prior to the implementation of mandatory bedside handovers in a hospital in Canberra, Australia, nurses in two wards (n = 66) were recruited to complete the new Bedside Handover Attitudes and Behaviours (BHAB) questionnaire. RESULTS: Most nurses strongly value bedside handovers and have confidence in their ability to lead this clinical practice. CONCLUSIONS: Researchers identified a high level of alignment between the nurses' acceptance of bedside handovers and nurses' self-reported actions in conducting this communication process. IMPLICATIONS FOR NURSING MANAGEMENT: Future research should explore the links between nurses' views of, and skills in, the management of bedside handovers, as well as the effects of professional training for this practice. Furthermore, the BHAB questionnaire may be employed in different nursing contexts in future research.

Barriers and Facilitators for the Use of NURSING Bedside Handovers: Implications for Evidence-Based Practice.

BACKGROUND: Previous studies on bedside handovers have identified nurse-related barriers and facilitators for implementing bedside handovers, but have neglected the existing ward's nursing care system as an important influencing factor. AIMS: To determine the association between the existing nursing care system (i.e., decentralized, two-tier, or centralized) on a ward and the barriers and facilitators of the bedside handover. METHODS: Structured individual interviews (N = 106) on 14 nursing wards in eight hospitals were performed before implementation of bedside handovers. The structured interview guide was based on a narrative review. Direct content analysis was used to determine the nursing care system of a ward and the degree to which barriers and facilitators were present. Pearson's Chi-square analysis was used to determine whether there were associations between the nursing care systems concerning the presence of barriers and facilitators for implementing bedside handovers. RESULTS: Twelve barriers and facilitators were identified, of which three are new to literature: the possible loss of opportunities for socializing, collegiality, and overview; head nurse's role; and role of colleagues. The extent to which barriers and facilitators were present differed across nursing care systems, with the exception of breach of confidentiality (barrier), and an existing structured handover (facilitator). Overall, nurses working in decentralized nursing care systems report fewer barriers against and more facilitators in favor of using bedside handovers than nurses in two-tier or centralized systems. LINKING EVIDENCE TO ACTION: Before implementing bedside handovers, the context of the nursing care system may be considered to determine the most effective process to implement change. Based on these study findings, implementing bedside handovers could be more challenging on wards with a two-tier or centralized care system.

The factors to be considered when evaluating bedside handover.

AIM: This paper sought to identify the factors that should be considered in the study of bedside handover at the change of nursing shift. BACKGROUND: The introduction of bedside handover at the change of nursing shift has been linked to increased patient safety; bedside handover is not a simple change of location but a fundamental change in nursing practice. METHOD: An integrative review of the literature was performed, to identify factors that should be considered when exploring and describing the process and content of nursing handover when performed at the patient bedside. RESULTS: Nursing handover conducted at the patient's bedside is different to other forms of clinical handover in that the patient is part of the process. A dedicated tool is required to comprehensively study and understand the complexities of the bedside handover at the change of nursing shift. CONCLUSION: The factors identified in this literature review should be used to develop a tool to study the phenomenon that is nursing bedside handover. IMPLICATIONS FOR NURSING MANAGEMENT: Handover at the change of nursing shift is a high risk, high volume nursing practice, therefore the introduction of bedside handover should be systematically studied.

Do Bedside Handovers Reduce Handover Duration? An Observational Study With Implications for Evidence-Based Practice.

INTRODUCTION: Bedside handover is increasingly used and studied in nursing due to the method's acclaimed positive effects on patient safety, patient participation, communication, and efficiency. Still, reported results about its impact on handover duration are ambiguous. Revealing the root cause of these ambiguous effects is important, as increased duration could lead to overtime, lower job satisfaction, and failure in implementation. In contrast, decreased handover duration could lead to more efficient nursing care and facilitate implementation. AIM: To explore the effects of bedside handovers on the handover duration by comparing wards before and after the implementation of bedside handovers. METHODS: As part of a multicentered longitudinal study, observations (N = 638) with time measurement were performed. Approximately 22% of the observations were performed by two researchers to check reliability. These time measurements were compared to the handover duration before the implementation of bedside handover, determined through interviews (n = 105), unstructured observations (n = 40), and a review of time schedules (n = 12). A descriptive, comparative research design was used. RESULTS: On average, a bedside handover takes 146 s for one patient (83 s-204 s). Depending on the previously used handover model, the number of patients allocated to each nurse, and the use of a structured handover content, time gain or loss as a result of introducing the bedside handover can be expected. LINKING EVIDENCE TO ACTION: The effect on time depends on the organizational changes necessary for the implementation of bedside handovers, most importantly the use of a decentralized handover model and structured handover content. Implementing bedside handover will therefore not always lead to a decrease in time use. A matrix for estimating the effects of bedside handover on time use is presented. While using bedside handovers will not always lead to decreased handover time, it will increase direct patient contact, increasing the possibilities for patient participation and enhancing patient safety.

Nurses' Perceived Barriers to Bedside Handover and Their Implication for Clinical Practice.

BACKGROUND AND RATIONALE: Bedside handover during the change of shift allows nurses to visualize patients and facilitate patient participation, both purported to improve patient safety. But, bedside handover does not always occur and when it does, it may not involve the patient. AIM: To explore and understand barriers nurses perceive in undertaking bedside handover. METHODS: A cross-sectional survey was administered to 200 nurses working on medical wards, recruited from two Australian hospitals, one private and one public. As part of the survey, there was one open-ended question asking about perceived barriers to bedside handover. Content analysis was used to analyze data. Barriers were assessed using a determinant framework. RESULTS: The open-ended question was answered by 176 (88%) participants. Three categories were identified. First, censoring the message showed nurses were concerned about patients and third-parties hearing sensitive information. In the second category, disrupting the communication flow, nurses perceived patients, family members, other nurses and external sources, interrupted the flow of handover and increased its duration. Finally, inhibiting characteristics demonstrated that individual patient and nurse views or capabilities hindered bedside handover. Barriers to bedside handover were determined to relate to individual nurse factors, patient factors, social, political and legal factors, and guideline factors. LINKING EVIDENCE TO ACTION: Suggestions for enhancing bedside handover include debunking nurses' misconceptions, reflecting on nurses' viewpoints, using active educational approaches, and promotion of legal requirements to heighten nurses' confidence dealing with sensitive information. Regular patient rounding, and standardized handover may enable patient involvement in handover. Finally, reviewing the local context to ensure organizational processes support bedside handover is recommended.

Nurse handover: patient and staff experiences.

AIM AND OBJECTIVES: to understand the purpose, impact and experience of nurse handover from patient and staff perspectives. BACKGROUND: poor communication is increasingly recognised as a major factor in healthcare errors. Handover is a key risk point. Little consensus exists regarding the practice in nursing but the trend is towards bedside handover. Research on patient and staff experiences of handover is limited. DESIGN: a qualitative and observational study on two acute wards in a large urban hospital in the UK. METHODS: interviews conducted with patients and staff and observation of handovers, ward rounds and patient-staff interactions. RESULTS: diverse forms of nurse handover were found, used in combination: office based (whole nursing team), nurse in charge (NIC) to NIC, and bedside. Patients' and nurses' views concurred on the purpose of bedside handover--transference of information about the patient between two nurses--and about the medical ward round, which was seen as a discussion with the patient. Views diverged regarding the purpose and value of office handover. Bedside handover differed in style, content, and place of delivery, often driven by concerns regarding confidentiality and talking over patients, and there were varied views on the benefits of patient involvement in bedside handover. Nurses worked beyond their shift end to complete handover. Communication problems within the clinical team were identified by staff and patients. CONCLUSIONS: while it is important to agree the purpose of handover and develop appropriate structure, content and style, it need not be a uniform process in all clinical areas. Nurse training to deliver bedside handover and patient information on the purpose of handover and the patient's role would be beneficial.

Attitudes of emergency department patients about handover at the bedside.

AIMS AND OBJECTIVES: To explore patients' perspectives of bedside handover by nurses in the emergency department (ED). BACKGROUND: International guidelines promote standardisation in clinical handover. Poor handover can lead to adverse incidents and expose patients to harm. Studies have shown that nurses and patients have favourable opinions about handover that is conducted at the bedside in hospital wards; however, there is a lack of evidence for patients' perspective of nursing handover in the ED environment. DESIGN: Qualitative descriptive study. METHODS: Semi-structured interviews with 30 ED patients occurred within one hour of bedside handover. Data were analysed using thematic content analysis. RESULTS: Two main themes were identified in the data. First, patients perceive that participating in bedside handover enhances individual care. It provides the opportunity for patients to clarify discrepancies and to contribute further information during the handover process, and is valued by patients. Patients are reassured about the competence of nurses and continuum of care after hearing handover conversations. Second, maintaining privacy and confidentiality during bedside handover is important for patients. Preference was expressed for handover to be conducted in the ED cubicle area to protect privacy of patient information and for discretion to be used with sensitive or new information. CONCLUSIONS: Bedside handover is an acceptable method of performing handover for patients in the ED who value the opportunity to contribute and clarify information, and are reassured that their information is communicated in a private location. RELEVANCE TO CLINICAL PRACTICE: From the patients' perspective, nursing handover that is performed at the bedside enhances the quality and continuum of care and maintains privacy and confidentiality of information. Nurses should use discretion when dealing with sensitive or new patient information.

Towards patient-centred care: perspectives of nurses and midwives regarding shift-to-shift bedside handover.

The aim of this descriptive qualitative study was to explore perspectives of nurses and midwives towards the introduction of shift-to-shift bedside handover. Semistructured interviews with nurses (n = 20) and midwives (n = 10) occurred 12 months after the introduction of bedside handover. Data were analyzed using thematic content analysis. Two main themes were identified: enhanced individual patient care and documentation, along with improved patient-clinician partnerships; and protection of confidentiality and privacy. The newly introduced bedside handover model improved efficiency and accuracy of the handover process and led to the provision of safe, high-quality care. Development of ward-specific tools and relevant educational resources, along with clinical support, are identified as the facilitators to ensure the new model can be successfully integrated into normal clinical practice.

Bedside nursing handover: patients' opinions.

Within the context of contemporary nursing practice, bedside handover has been advocated as a potentially more suitable mode for achieving patient-centred care. Given that patients can play an important role in the process, better understanding of patients' perspectives of bedside handover could be a critical determinate for successful implementation of the practice. Using a phenomenological approach, this study attempted to explore patients' perceptions of bedside nursing handover. Four key themes emerged from the patient interviews: 'a more effective and personalised approach', 'being empowered and contributing to error minimization', 'privacy, confidentiality and sensitive topics', and 'training need and avoidance of using technical jargon'. Patients welcome bedside handover as they can be empowered through participation in the process. Nevertheless, attention is needed to ensure that adequate training is provided to nurses and to minimize the use of technical jargon so that handover is delivered with a professional and consistent approach.

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

OBJECTIVES: To construct and examine the effects of a Standardized Bedside Handover Process and Visual Diagnosis-symptom System. METHODS: 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. RESULTS: Compared with the control group, NASR and PVNC-BR scores of the process group and the process + visualization group were significantly higher. CONCLUSIONS: 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.