Task uncertainty and communication during nursing shift handovers

Aims To synthesize outcomes from research on handoffs to guide future computerization of the process on medical and surgical units. Background Handoffs can create important information gaps, omissions and errors in patient care. Authors call for the computerization of handoffs; however, a synthesis of the literature is not yet available that might guide computerization. Data sources PubMed, CINAHL, Cochrane, PsycINFO, Scopus and a handoff database from Cohen and Hilligoss. Design Integrative literature review. Review methods This integrative review included studies from 1980–March 2011 in peer‐reviewed journals. Exclusions were studies outside medical and surgical units, handoff education and nurses' perceptions. Results The search strategy yielded a total of 247 references; 81 were retrieved, read and rated for relevance and research quality. A set of 30 articles met relevance criteria. Conclusion Studies about handoff functions and rituals are saturated topics. Verbal handoffs serve important functions beyond information transfer and should be retained. Greater consideration is needed on analysing handoffs from a patient‐centred perspective. Handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs is not supported by available evidence. The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames.

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“…Handoff context has not been sufficiently considered, until very recently (Mayor et al . , Staggers et al . ) despite its importance.…”

Section: Discussionmentioning

confidence: 99%

“…Task uncertainty in different contexts lengthened handoff duration (Mayor et al . ). In a review of surgical malpractice claims, 60 cases involved 81 communication breakdowns; 43% were with handoffs (Greenberg et al .…”

Section: Introductionmentioning

confidence: 97%

Research on nursing handoffs for medical and surgical settings: an integrative review

Staggers

Blaz

2012

Journal of Advanced Nursing

102

104

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“…As conversation analysis is primarily interested in the (re)production of social order at the level of the interaction, it is a privileged method for investigating these three potential themes (of which only the first is thoroughly discussed in the literature, as we will see). We also expected mediated communication to be an important theme in these publications, from previous research we carried out in clinical settings, and other settings as well (e.g., Bangerter et al, 2011;Bietti and GalianaCastelló, 2013;Bietti et al, 2016;Mayor et al, 2012;Bangerter, 2015, 2016). We decided not to focus only on these aspects in preparing this review as the complementarity of deductive and inductive approaches leads to an enrichment of the understanding of the studied object (e.g., Vaismoradi et al, 2013).…”

Section: Thematic Analysismentioning

confidence: 99%

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

Mayor

Bietti

2017

International Journal of Nursing Studies

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A B S T R A C TObjectives: Researchers in nursing science interested in the study of nurse-patient and nurse-relative interactions have displayed an ever increasing interest in ethnomethodology and conversation analysis. This review assesses the scope of this literature. We categorize the papers in thematic categories determined both inductively and deductively and synthesize the main findings of this literature within category. Finally we discuss the interactional determinants of the lack patient participation, the limitations of the field, and focus on implications. Design: A scoping review on nurse-patient and nurse-relative interactions. Data sources: Forty articles focusing on nurse-patient interactions and nurse-relative interactions. All the articles relied on ethnomethodology and/or conversation analysis. Review methods: A literature search has been carried out on Medline (all articles until June 2016; keywords were: nurs*.ab. and "conversation analysis"; nurs*.ab. and ethnomethodology). A similar search was performed on other platforms. The scope of the literature was identified by inductively and deductively analyzing the themes of the relevant articles. Results: Six thematic categories emerged: Organization of nurse-patient interaction (eleven articles); Organization of mediated nurse-patient interaction (seven articles); Information, explanation and advice (eight articles); Negotiation and influence asymmetry (six articles); Managing emotions in critical illness (two articles); and Interacting with patients presenting reduced interactional competences (six articles). Conclusions: Across most thematic categories it appeared that patient participation is far from ideal as interactional asymmetry was most observed in favor of nurses. When the encounters occurred at the patients' homes this pattern was reversed. Computer-mediated interactions were often reported as nonoptimal as the standardized process constrained communication and delayed patients' presentation of their ailments. Micro-analyses of interaction present a clear potential for the development of guidelines for nurse-patient interactions. Implications for practice are described.

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“…In addition, they considered other functions of handoffs beyond communicating clinical information, for instance, social interactions and in-service education. [9,10] On the other hand, nurse unit managers of 80 clinical units in 18 hospitals were interviewed in 2008 regarding topics, functions, and durations of handoffs in their units. The clinical units were categorized according to type, with a gradually increase in task uncertainty.…”

Section: The Need For Effective Handoff Communicationmentioning

confidence: 99%

Nurses’ perceptions regarding using the SBAR tool for handoff communication in a tertiary cancer center in Qatar

Nagammal¹,

Nashwan²,

Nair³

et al. 2016

JNEP

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Background: Communication failure has been reported in the literature as the primary source of medical errors and patient harm. Among various methods of handoff communication, Situation, Background, Assessment, and Recommendation (SBAR) is a reliable and efficient framework that nurses worldwide use. The investigators sought to assess the perceptions of nurses with regard to using the SBAR tool for hand-off communication at a cancer hospital in Qatar. Methods: A cross-sectional descriptive study was carried out to assess perceptions regarding the use of SBAR among 117 staff nurses working in inpatient units of National Center for Cancer Care and Research (NCCCR). A handover evaluation tool was used, enabling nurses to self-report their perceptions. Results: The majority of staff nurses opined that SBAR followed a logical sequence, with a reduction in communication errors after its use. Also, 53.9% of the nurses reported that they would always recommend the SBAR framework in other areas. The majority (87.3%) of the nurses had good perceptions regarding the use of the SBAR framework, and none of them had poor perceptions regarding the same. The mean duration of handovers reduced after their use of SBAR. There was no association between perceptions and demographic variables. Conclusions: SBAR is safe and efficient, and it can be recommended for all healthcare settings. The SBAR communication technique provides an organized logical sequence and improved communication that has been proved to ensure patient safety.

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Task uncertainty and communication during nursing shift handovers

Abstract: Task uncertainty and its relationship with functions and topics of handover should be taken into account during the design of handover procedures.

Cited by 27 publications

References 39 publications

Research on nursing handoffs for medical and surgical settings: an integrative review

Research on nursing handoffs for medical and surgical settings: an integrative review

Ethnomethodological studies of nurse-patient and nurse-relative interactions: A scoping review

Nurses’ perceptions regarding using the SBAR tool for handoff communication in a tertiary cancer center in Qatar

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