Is privacy a problem during bedside handovers? A practice-oriented discussion paper

Abstract

Bedside handover is the delivery of the nurse-to-nurse handover at the patient's bedside. Although increasingly used in nursing, nurses report many barriers for delivering the bedside handover. Among these barriers is the possibility of breaching the patient's privacy. By referring to this concept, nurses add a legal and ethical dimension to the delivery of the bedside handover, making implementation of the method difficult or even impossible. In this discussion article, the concept of privacy during handovers is being discussed by use of observations, interviews with nurses, and interviews with patients. These findings are combined with international literature from a narrative review on the topic. We provide a practiceoriented answer in which two mutually exclusive possibilities are discussed. If bedside handover does pose problems concerning privacy, this situation is not unique in healthcare and measures can be taken during the bedside handover to safeguard the patient. If bedside handover does not pose problems concerning privacy, privacy is misused by nurses to hide professional uncertainties and/or a reluctance toward patient participation. Therefore, a possible breach of privacy-whether a justified argument or not-is not a reason for not delivering the bedside handover.

Patients experiences of bedside handover: findings from a meta‐synthesis

“…In the last 20 years, patient participation has been highlighted as the central paradigm in healthcare setting and BSR as a concrete example (Malfait et al. ) as documented in the retrieved studies published mainly from 2013. However, although handovers were initiated at the end of the 1970s [e.g., Feeley ], only in recent years they have been recommended in the form of the BSR , while patients’ experiences regarding this method of handover is still little studied.…”

The effectiveness of bedside handovers: A multilevel, longitudinal study of effects on nurses and patients

“…The study on the underlying reasons for this reluctance is still ongoing, but several recent studies show that patient participation during bedside handovers is a significant barrier for nurses (Anderson et al., ; McMurray et al., ; Tobiano, Bucknall, et al., ; Tobiano, Whitty, Bucknall, & Chaboyer, ), making them dismissive towards the method (Malfait, Van Hecke, Van Biesen, & Eeckloo, ). Although the origins for this reluctance towards patient participation remains unclear, research suggests that it is a result of the feeling of time constraint amongst nurses (Gregory et al., ), the complexity of patient participation (Malfait, Eeckloo, & Van Hecke, ), or nurses’ concerns about confidentiality (Malfait, Van Hecke, et al., ). This should perhaps not be so surprising, as patient participation could be regarded as an advanced nursing skill (Malfait, Eeckloo, & Van Hecke, ).…”

Nurse perceptions of person-centered handovers in the oncological inpatient setting: A qualitative study

“…The literature provides examples of perceived barriers among nurses towards the implementation of models of bedside handovers in inpatient settings. Commonly, concerns about patients' integrity recur (56,65,88), as well as worries about handovers being too lengthy and disrupting the work-flow (28,56,89), and hindering individual characteristics of both patients and nurses (56). In the PCH project, the ward nurses expressed similar worries.…”

“…In previous studies, integrity issues seem to be primarily brought up by nurses rather than patients. Malfait et al (88) provides an interesting discussion paper on the topic where they describe how nurses sometimes use patients' integrity as an excuse not to perform bedside handovers, instead of taking measures to minimize the breach of patients' privacy. The authors argue that patients' need for information is more important than integrity, especially considering that bedside handovers do not impair privacy more than other nursing activities performed daily at an inpatient ward.…”