Research on nursing handoffs for medical and surgical settings: an integrative review

Abstract

Aims To synthesize outcomes from research on handoffs to guide future computerization of the process on medical and surgical units. Background Handoffs can create important information gaps, omissions and errors in patient care. Authors call for the computerization of handoffs; however, a synthesis of the literature is not yet available that might guide computerization. Data sources PubMed, CINAHL, Cochrane, PsycINFO, Scopus and a handoff database from Cohen and Hilligoss. Design Integrative literature review. Review methods This integrative review included studies from 1980–March 2011 in peer‐reviewed journals. Exclusions were studies outside medical and surgical units, handoff education and nurses' perceptions. Results The search strategy yielded a total of 247 references; 81 were retrieved, read and rated for relevance and research quality. A set of 30 articles met relevance criteria. Conclusion Studies about handoff functions and rituals are saturated topics. Verbal handoffs serve important functions beyond information transfer and should be retained. Greater consideration is needed on analysing handoffs from a patient‐centred perspective. Handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs is not supported by available evidence. The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames.

The clinician in the driver’s seat: Part 2 – Intelligent uses of space in a drag/drop user-composable electronic health record

“…Perhaps the most similar and illuminating studies were done by Staggers et al, examining nurses’ use of user-created paper ‘brains’ – summary sheets, each designed by the nurse, which are carried throughout the day and consulted and amended frequently [30–32]. Staggers reports that most nurses eschewed the computerized summaries made available for handoff, preferring their own for several reasons, with customizability and ‘fit to their way of thinking’ being the most important.…”

“…Staggers reports that most nurses eschewed the computerized summaries made available for handoff, preferring their own for several reasons, with customizability and ‘fit to their way of thinking’ being the most important. Other reasons included incompleteness, excessive density, poor layout, lack of changeability, and design not fitted to the way nurses were used to finding or processing information or the way they worked [30–32]. Ability to tailor the report form and take notes was deemed critical by nurses.…”

Nurse Perceptions of Electronic Handoff

“…A preferred handoff method included a face-toface verbal exchange with the electronic medical record information displayed on a computer screen to verify and supplement the information reported. (Staggers & Blaz, 2013). Participants were also asked to describe, in short answer form, what they perceived to be missing from the SBARP summary screen used for handoff.…”

“…An integrative literature review by Staggers and Blaz (2013) to meet specific unit needs may be more effective. For successful transition to electronic handoff process, pertinent information for handoff needs to be determined through research (Staggers & Blaz, 2013).…”

“…For successful transition to electronic handoff process, pertinent information for handoff needs to be determined through research (Staggers & Blaz, 2013).…”