An Evidence-Based, Nursing Handover Standard for a Multisite Public Hospital in Switzerland: Web-Based, Modified Delphi Study

Abstract

Background Ineffective communication procedures create openings for errors when health care professionals fail to transfer complete, consistent information. Deficient or absent clinical handovers, or failures to transfer information, responsibility, and accountability, can have severe consequences for hospitalized patients. Clinical handovers are practiced every day, in many ways, in all institutional health care settings. Objective This study aimed to design an evidence-based, nursing handover standard for inpatients for use at shift changes or internal transfers between hospital wards. Methods We carried out a modified, multiround, web-based, Delphi data collection survey of an anonymized panel sample of 264 nurse experts working at a multisite public hospital in Switzerland. Each survey round was built on responses from the previous one. The surveys ended with a focus group discussion consisting of a randomly selected panel of participants to explain why items for the evidence-based clinical nursing handover standard were selected or not selected. Items had to achieve a consensus of ≥70% for selection and inclusion. Results The study presents the items selected by consensus for an evidence-based nursing handover standard for inpatients for use at shift changes or internal transfers. It also presents the reasons why survey items were or were not included. Conclusions This modified Delphi survey method enabled us to develop a consensus- and evidence-based nursing handover standard now being trialed at shift changes and the internal transfers of inpatients at our multisite public hospital in Switzerland.

Designing and Validating an Evidence-Based, Shift-to-Shift Handover Bundle for Nurses and Physicians

“…2 The information transferred during handoff could be informal, or unstructured, and rely on the discretion of the informant and interpersonal relationships. 3 Thus, the information communicated during handoff needs to be accurate, current, and sufficient about the patient's condition, and recent or anticipated changes to enable the next caregivers to form a holistic picture of the patient, thus helping them make effective decisions for subsequent care. The available literature of a uniform structure of handover is limited, and there is great variability in the protocols, methods, and standards.…”

“…Transferring responsibility for a patient's care to another health care professional increases the risk of potentially severe error, especially if key information is communicated inaccurately and inefficiently 2. The information transferred during handoff could be informal, or unstructured, and rely on the discretion of the informant and interpersonal relationships 3. Thus, the information communicated during handoff needs to be accurate, current, and sufficient about the patient's condition, and recent or anticipated changes to enable the next caregivers to form a holistic picture of the patient, thus helping them make effective decisions for subsequent care.…”

The Leadership Practices of Nurses in the New Zealand Hospital Ward: A Focused Ethnography

“…In these wards, nursing handover occurred a minimum of three times over the 24-hour period. Handovers are a critical meeting time when two teams of nurses interact with one another to pass patient care from one shift team to the next (Tacchini-Jacquier et al, 2020). The findings from this research draw attention to an opportunity to change the focus and structure of hand-over to include leadership practices and teamwork as these are vital for the functioning of the team and nursing care.…”