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Nurses’ Perceived Barriers to Bedside Handover and Their Implication for Clinical Practice
Author(s) -
Tobiano Georgia,
Whitty Jennifer A.,
Bucknall Tracey,
Chaboyer Wendy
Publication year - 2017
Publication title -
worldviews on evidence‐based nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.052
H-Index - 49
eISSN - 1741-6787
pISSN - 1545-102X
DOI - 10.1111/wvn.12241
Subject(s) - handover , patient safety , context (archaeology) , viewpoints , medicine , nursing , promotion (chess) , psychological intervention , psychology , medical emergency , politics , health care , computer science , art , computer network , paleontology , political science , law , economics , visual arts , biology , economic growth
ABSTRACT Background and Rationale Bedside handover during the change of shift allows nurses to visualize patients and facilitate patient participation, both purported to improve patient safety. But, bedside handover does not always occur and when it does, it may not involve the patient. Aim To explore and understand barriers nurses perceive in undertaking bedside handover. Methods A cross‐sectional survey was administered to 200 nurses working on medical wards, recruited from two Australian hospitals, one private and one public. As part of the survey, there was one open‐ended question asking about perceived barriers to bedside handover. Content analysis was used to analyze data. Barriers were assessed using a determinant framework. Results The open‐ended question was answered by 176 (88%) participants. Three categories were identified. First, censoring the message showed nurses were concerned about patients and third‐parties hearing sensitive information. In the second category, disrupting the communication flow, nurses perceived patients, family members, other nurses and external sources, interrupted the flow of handover and increased its duration. Finally, inhibiting characteristics demonstrated that individual patient and nurse views or capabilities hindered bedside handover. Barriers to bedside handover were determined to relate to individual nurse factors, patient factors, social, political and legal factors, and guideline factors. Linking Evidence to Action Suggestions for enhancing bedside handover include debunking nurses’ misconceptions, reflecting on nurses’ viewpoints, using active educational approaches, and promotion of legal requirements to heighten nurses’ confidence dealing with sensitive information. Regular patient rounding, and standardized handover may enable patient involvement in handover. Finally, reviewing the local context to ensure organizational processes support bedside handover is recommended.