31 Experience of ambulance workers, nurses and doctors of handover of patients who are transported by ambulances to emergency departments in iceland: a qualitative interview study

Abstract

Background Adverse events healthcare are often caused by communication failure. Patient handover from ambulance personnel to specialized nurses and doctors in Emergency Departments carries the risk that that important information will be lost during the process, with consequences that may adversely affect patient well-being. The objective of this qualitative study was to analyze communication and transfer of responsibility during handover of patients arriving with ambulances in Emergency Departments in Iceland. Method Vancouver school method of phenomenology was used. Participants were selected with a purpose sampling. Semi-structured individual interviews were conducted and supported by interview guide. The interviews were themed, followed by construction of an individual analysis model and overall analysis model. Results A total of 17 ambulance workers, registered nurses and doctors described their experience of a patient handover in Emergency Department and the process of exchange of written and verbal information between health professionals involved in the handover of care. The main finding of the study was that structured communication and information disclosure have a great impact on the quality of patient handover. This is described in four main themes (Transfer of professional responsibility; Information dialogue; Personal and professional factors and Organizational factors) and nine sub-themes. Conclusion Standardized handover protocol, clear procedures and education to healthcare professionals can potentially improve communication and transfer of responsibility for patients brought to emergency departments with ambulances, thus potentially improving patient safety.