Nursing handover in the Indonesian hospital context: Structure, process, and barriers

Abstract

Background: Nursing handover is an essential part of nursing practice to safe patient care, which occurs among nurses between shifts for transferring professional responsibility and accountability. However, there is limited information about the implementation and evaluation of nursing handover in Indonesian hospitals. Objective: This study aimed to describe the structures, processes, and barriers of the nursing handover in the Indonesian hospital context. Methods: This study employed a case study design in five inpatient units, especially in the medical-surgical wards of a referral hospital in Indonesia. The study was conducted from August to November 2018. A total of 100 handovers and 76 nurses were included. Focus group discussions were conducted in head nurses, nurse team leaders, and registered nurses. Observations were implemented to capture the handover process, including the number of the nurses in and out and the content of the information covered situation, background, assessment, and recommendations (SBAR). Data were analyzed using content analysis and fishbone analysis.Results: The nursing handover consisted of three phases: before, during, and after. The handover barriers were divided into manpower, material, money, method, environment, and machine. The content of handover varied according to nurses’ familiarity with the patients and their complexity. The nurses also actively participated during the handover process, although some nurses were absent in the handover time. About 75% of nurses had sufficient knowledge about the shift handover process using SBAR. The SBAR was adopted as a standard for handover, but no specific guideline or standard operating procedure.Conclusion: The results of this study can be used as basic information to develop a guideline of nursing handover and supervision in the context of hospitals in Indonesia and beyond. This study was funded by the Department of Nursing, Universitas Indonesia, Indonesia.

Greater accountability in nursing handover

“…Several of the findings from Yetti et al ( 2021 ) also hold interest. First, their insights about the importance of having clear guidelines are relevant because it helps nurses structure their handover communication to a greater extent.…”

“…The letter aims to draw attention to a recent article published in the Belitung Nursing Journal that sheds light on nurses’ narratives in the implementation and evaluation of handover. I read the article “Nursing handover in the Indonesian hospital context: Structure, process, and barriers” by Yetti et al ( 2021 ) with great interest. This fundamental aspect of nursing is receiving more attention, and it represents an important example of an effort to address the issue of patient safety and continuity of care.…”

“…It displays the nurse’s professional ethics and the integrity of the profession. When Yetti et al ( 2021 ) observed that some nurses were absent during the handover time, I was unconvinced that this was a one-time narrative that could potentially lead to communication failures. According to some evidence, one of the leading causes of reduced safety and quality of services and patient discontent is a lack of communication between incoming and outgoing nurses during the handover process (Raeisi et al, 2019 ).…”

“…Furthermore, while Yetti et al (2021) propose reinforcing the importance of supervision, which I completely agree with, I believe that the responsibility for maintaining consistent handover quality should fall not just on nurse managers but Open Access also on those who perform the actual handover activities. In summary, this crucial article sheds light on nurses' narratives in the implementation and evaluation of handover.…”

Development of a clinical learning model to enhance patient safety awareness competency among Thai nursing students

“…In terms of the nursing context, patient safety problems are related to human factors and work processes, such as infection control procedures, medication errors, infection control procedures, medication errors, and communication failure. Therefore, raising awareness requires the development of a safe patient care management system and the human factor related to individual nurses due to the high workload, negligence, lack of knowledge or skill, and miscommunication (Tella et al, 2014 ; Yetti et al, 2021 ). Thus, the cultivation of patient safety in nursing students must be from nursing theory and learning from experiences in nursing practice.…”