Nurses' perceptions regarding transfer of patient information between shifts in adult critical care settings.

Abstract

This study used an exploratory descriptive research design to explore nurses' perceptions regarding patient handover between shifts in adult critical care settings. Particular aspects explored were nurses' perceptions on different methods of hand over in critical care settings, important content topics of handover, perceived hindering factors to a patient handover and nurses' perceptions regarding reporting for handover error. Nurses' views on other functions of hand over in critical care settings were also explored. Data was collected from the whole population of nurses (N=76) and managers (N=8) from the Intensive Therapy Unit and the Critical Care Unit in the local general hospital. A self administered questionnaire formulated by the researcher was used to collect data from the nurses whilst a structured interview schedule was used for the managers. Statistical tests were used to analyze quantitative data whilst qualitative data was analyzed through content analysis. Findings revealed that nurses In critical care settings felt that verbal hand over, global handover and bedside written hand over are the methods suitable for patient information transfer in inter shift hand over. However the managers felt that there should be an improvement on the format and content of handover. Level of consciousness, ventilation status, vital signs and pending investigations were the topics given most importance as regards content of nursing handover. Interruptions, reliance on verbal handover, lack of guidelines, and presence of relatives together with illegible handwriting were regarded as the most hindering factors during handover. Measures to counteract these factors included guidelines, revision of the format of handover, and minimization of interruption. Handover was also perceived by the nurses to have other functions which included team building and strengthening of group cohesion. The results highlighted several management implications and a number of Recommendations were identified. Literature shows that 70% of sentinel events are caused by a breakdown in communication. (JCAHO 2007). Consequently it is being recommended that the handover practices in these settings be revised and guidelines developed with the hope to minimize the possibility of handover errors. Moreover it is recommended that educational preparation is increased and wherever appropriate, a non punitive approach should be adopted.