Evaluation of a nursing handoff educational bundle to improve nursing student handoff communications: A pilot study

Abstract

Background: Inadequate handoff education in prelicensure nursing programs may pose a significant latent safety risk. This pilot study evaluates a Nursing Handoff Educational Bundle (NHEB) for a cohort of Accelerated Bachelor of Science (ABS) nursing students. The Evidence-Based Bundle consists of an educational workshop, a standardized handoff format, clinical faculty education, and structured, formative evaluation of student handoffs. This study was implemented during Adult Health clinical experiences conducted at four different University-affiliated healthcare institutions in the Northeastern United States. Methods: A pre-test, post-test design was used with a convenience sample of 28 ABS nursing students. Fourteen students who received the NHEB were compared to a similar group (n = 14) who were not exposed. Student handoffs were observed and rated using the Handoff Clinical Examination (CEX) tool while providing and receiving handoffs during clinical experiences. Data was obtained at the beginning and the end of a 15-week time period. Results: The provider handoff scores in the intervention group improved significantly (M = 4.64, SD = 1.3) over the comparison group change scores (M = 1.5, SD 1.34) when measured by independent samples t-test (t = 7.33, p = .000). The handoff recipients' scores in the intervention group also improved significantly (m = 5.5, SD = 1.01) compared to no improvement in the recipient control group (M = -0.36, SD = 1.39), (t = 12.7, p = .000). Conclusions: Without structured handoff education, nursing students are passive recipients during handoffs and do not engage in safety communication practices. Exposure to a NHEB improves student handoff communication skills and provides an opportunity to practice evidence-based handoff skills with structured support during clinical experiences. The NHEB could be considered for incorporation into prelicensure programs. Further study using a larger sample size is recommended based on these preliminary findings. Additionally, this intervention should be evaluated in novice nurse cohorts.

Effectiveness of Handoff Educational Program on Nurses Interns’ Knowledge, and Communication Competence

“…Consistently with the current research result [34] describes the necessity of both provider and receiver actively participating in the co-construction of the oncoming caregiver's understanding of the patient in order to promote patient safety. In the same issue [30] found that the nursing handoff educational training program improved handoff communication skills in nursing students.…”

“…From the researcher's point of view, this result can be explained as, the training program has its immediate positive effect and nurse's intern's starts to apply the knowledge they gained which was reflected on their communication competence, and they recognized pertinent critical health information that needed to be communicated to their peers. In the same issue [30] concluded that nursing students performed significantly better when providing and receiving handoff after they gain handoff knowledge in training program. Additionally, [33] has described the positive effect of handoff training in handoff receiver skills.…”

“…A nursing handoff, or handover, is a complex communication process that transfers essential information, responsibility, and accountability for the care of a patient from one nursing professional to another. Handoff education has been identified as a quality and safety education in Nursing (QSEN) pre-licensure competency [30].…”

Educational Interventions to Improve Handover in Health Care: An Updated Systematic Review

“…The median number of participants in a study was 51.5 (the range was 11–1,206). The studies included 9 pre–post studies, 25 , 51 , 55 , 56 , 58 – 61 , 65 6 prospective studies, 27 , 52 , 54 , 62 – 64 1 randomized controlled trial, 53 and 2 observational studies. 9 , 57 Sixteen of the studies reported on interventions undertaken in the United States, and only 1 each reported on an intervention in the United Kingdom 57 and the Netherlands.…”

“…Only 4 articles provided details about the educational theory underpinning the intervention, 55 , 57 , 58 , 64 and 10 did not even mention an educational theory. Similarly, only 6 articles clearly explained the pedagogy used for the interventions, 51 , 55 , 57 , 58 , 61 , 62 and 4 did not mention a pedagogy at all. We did find, however, that authors were likely to provide information about context, learners, and teaching approaches.…”