Examining the meaning of the language used to communicate the nursing hand‐off

Abstract

The miscommunication and inconsistent recall of patient information due to cognitive lapses that occur during the hand‐off between healthcare providers account for 80% of sentinel events in acute care. Cognitive lapses are a consequence of the nurse experiencing cognitive overload, which impedes the nurse's ability to recall relevant information during and after the hand‐off communication. The primary cognitive and human factor contributing to cognitive overload in the hand‐off is language. The purpose of this study was to examine the meaning of the language used to communicate the nurse‐to‐nurse change of shift hand‐off occurring at bedside and nonbedside on a medical‐surgical unit in an urban medical center. A qualitative descriptive design was used. The sample was 10 audio‐recorded hand‐offs (five bedside and five nonbedside), with a total of 19 nurses participating. A natural language process program was used to analyze the data. The hand‐off is a narrative story centered on communicating patient information delivered with a high degree of confidence. The hand‐off is focused on past and current events with minimal focus on future or anticipated events. The drive to communicate is minimally based on concern, fear, or danger. There is a difference in the language used to communicate the nursing hand‐off message at bedside as compared to the nonbedside hand‐off.

Linguistic dissection of nursing handoffs: Implications for patient safety in varied‐acuity hospital settings

“…This narrative approach, with a lower analytical thinking score (14.07), may reflect a tendency towards a more personable and patientcentred communication style. These findings closely mirror prior studies examining the bedside and non-bedside handoffs (Galatzan et al, 2019;Galatzan & Carrington, 2021). Additionally, our study corroborates earlier research underscoring the primary goal of the handoff is to communicate vital patient information in a detailed chronological style (Chapman et al, 2016;Galatzan et al, 2019;Galatzan & Carrington, 2021;Streeter & Harrington, 2017;White-Trevino & Dearmon, 2018).…”

“…This suggests a certain level of preparation and formality in the communication, potentially reflecting a tension between the need for structured information delivery and the natural flow of conversation. These findings align with previous research, which also emphasized that handoff communication primarily focuses on the patient rather than reflecting the nurses' sincerity (Galatzan et al, 2019;Galatzan & Carrington, 2021).…”

“…This indicates that RNs use minimal language to convey the rationale for diagnostic results, patient conditions and interventions. These results are consistent with previous studies on handoff communication (Galatzan et al, 2019;Galatzan & Carrington, 2021). The lack of language to communicate causation and insight may be a root cause The findings, show a higher-than-average motivation to communicate based on risk, and contrast with previous research cited (Galatzan et al, 2019;Galatzan & Carrington, 2021) which suggested that nurses were not highly motivated to communicate based on risk, even when a CE had occurred.…”

“…These results are consistent with previous studies on handoff communication (Galatzan et al, 2019;Galatzan & Carrington, 2021). The lack of language to communicate causation and insight may be a root cause The findings, show a higher-than-average motivation to communicate based on risk, and contrast with previous research cited (Galatzan et al, 2019;Galatzan & Carrington, 2021) which suggested that nurses were not highly motivated to communicate based on risk, even when a CE had occurred. This discrepancy may reflect the specific environment and policies of the medical centre where the study was conducted.…”

“…The significantly high clout score (66.9) suggests that communication maintains an authoritative tone, indicating confidence and expertise, especially among ICU nurses. Across all units, RNs communicate with a high level of confidence, supporting findings from prior studies (Galatzan et al, 2019;Galatzan & Carrington, 2021).…”