Perspectives of clinical handover processes: a multi‐site survey across different health professionals

Abstract

Aims and objectives. To examine the perspectives of health professionals of different disciplines about clinical handover. Background. Ineffective handovers can cause major problems relating to the lack of delivery of appropriate care. Design. A prospective, cross-sectional design was conducted using a survey about clinical handover practices. Methods. Health professionals employed in public metropolitan hospitals, public rural hospitals and community health centres were involved. The sample comprised doctors, nurses and allied health professionals, including physiotherapists, social workers, pharmacists, dieticians and midwives employed in Western Aus-tralia, New South Wales, South Australia and the Australian Capital Territory. The survey sought information about health professionals' experiences about clinical handover; their perceived effectiveness of clinical handover; involvement of patients and family members; health professionals' ability to confirm understanding and to clarify clinical information; role modelling behaviour of health professionals ; training needs; adverse events encountered and possibilities for improvements. Results. In all, 707 health professionals participated (response rate = 14%). Represented professions were nursing (60%), medicine (22%) and allied health (18%). Many health professionals reported being aware of adverse events where they noticed poor handover was a significant cause. Differences existed between health professions in terms of how effectively they gave handover, perceived effectiveness of bedside handover vs. nonbedside handover, patient and family involvement in handover, respondents' confirmation of understanding handover from their perspective, their observation of senior health professionals giving feedback to junior health professionals, awareness of adverse events and severity of adverse events relating to poor handovers. What does this study contribute to the wider global clinical community? • No previous published survey research has involved an exploration of perceptions and experiences of health professionals of multiple disciplines in relation to clinical handover. In this exploratory study, we examined the perceptions and experiences of health professionals of different disciplines about clinical handover, comprising doctors, nurses and allied health professionals, including physiotherapists , social workers, dieticians, pharmacists and midwives. • Despite extensive measures available worldwide aimed at improving clinical handover processes, participating health professionals experienced adverse events relating to clinical handover in seven areas. These were: delays in treatment or procedure, or, prolonged treatment or procedure; lack of monitoring information given on clinical assessment, leading to patient deterioration; errors involving medications; patient falls; disruptive, aggressive behaviour and confused state leading to injury; putting patients at risk of infection and putting infants at risk. Greater levels of innovation are needed in training a...

Mental health nurses’ attitudes towards consumer involvement in nursing handover pre and post an educational implementation

“…Manias et al . () also note that with effective, consumer involved handover, adverse events could be reduced.…”

“…In contrast, participants in the study by Manias et al . () believed that adverse events were a possible consequence of poor handover. Conversely, bedside handover has been reported to improve patient safety (Street et al .…”

“…Poor handover practice by health professionals is a multifaceted problem and has been the subject of urgent attention including education, the use of handover tools/templates, and role modelling (Manias et al . ).…”

“…It is an element of National Safety and Quality Health Service Standards of Australia (Australian Commission on Safety and Quality in Health Care, 2012) and World Health Organization Collaboration Centre for Patient Safety Solutions (2007) and similar standards internationally. Recent evidence shows that nurses and other health professionals consider poor handover practices may be the source of adverse events and yet having patient and family present contributes to more effective handover and potentially improves care (Manias et al 2015). Poor handover practice by health professionals is a multifaceted problem and has been the subject of urgent attention including education, the use of handover tools/templates, and role modelling (Manias et al 2015).…”

“…Recent evidence shows that nurses and other health professionals consider poor handover practices may be the source of adverse events and yet having patient and family present contributes to more effective handover and potentially improves care (Manias et al 2015). Poor handover practice by health professionals is a multifaceted problem and has been the subject of urgent attention including education, the use of handover tools/templates, and role modelling (Manias et al 2015).…”