Premium
Clinical handover practices among healthcare practitioners in acute care services: A qualitative study
Author(s) -
Fealy Gerard,
Donnelly Suzanne,
Doyle Gerardine,
Brenner Maria,
Hughes Mary,
Mylotte Elaine,
Nicholson Emma,
Zaki Marina
Publication year - 2019
Publication title -
journal of clinical nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.94
H-Index - 102
eISSN - 1365-2702
pISSN - 0962-1067
DOI - 10.1111/jocn.14643
Subject(s) - handover , qualitative research , focus group , nursing , health care , acute care , documentation , patient safety , medicine , content analysis , psychology , medical emergency , business , computer science , sociology , political science , marketing , social science , law , computer network , programming language
Aims and objectives To examine clinical handover practices in acute care services in Ireland. Objectives were to examine clinical handover practices between and within teams and between shifts, to identify resources and supports to enhance handover effectiveness and to identify barriers and facilitators of effective handover. Background Clinical handover is a high‐risk activity, and ineffective handover practice constitutes a risk to patient safety. Evidence suggests that handover effectiveness is achieved through staff training and standardised handover protocols. Design The study design was qualitative‐descriptive using inductive analysis. Methods The study involved a series of focus group discussions and interviews among a sample of healthcare practitioners recruited from 12 urban and regional acute hospitals in Ireland. A total of 116 healthcare professionals took part in 28 interviews and 13 focus group discussions. We analysed the data using the directed content analysis method. Results Data collection generated rich qualitative data, yielding five categories from which two broad themes emerged: “policy and practice” and “handover effectiveness.” The themes and their associated categories indicate that there is limited organisational‐level policy and limited explicit training in clinical handover, that medical and nursing handovers are separate activities with somewhat different purposes and different modes of execution, and that several factors in the acute care setting, including location, timing and documentation, act as either barriers or enablers to handover effectiveness. Conclusion The evidence in the current study suggests that clinical handover merits increased level of prominence in hospital policies or operating procedures. Medical and nursing handover practices represent distinct activities in their content and execution that may be related to cultural and organisational factors. Relevance to clinical practice Achieving multidisciplinary team handover requires a change in embedded traditional practices. Several aspects of the clinical handover activities of nursing and medical staff appear to diverge from best‐practice evidence.