Nursing Handover: Experiences and Perspectives in the Critical Care Unit at Murang’a County Referral Hospital
DOI:
https://doi.org/10.53819/81018102t6043Abstract
Continuity in delivery of nursing care to patient in the critical care unit is of utmost importance. Although nurses have a variety of guidelines and formats to conduct the handover, gaps have been detected regarding the contents of the handover and its effects on the continuity of care in the critical care unit. The focus of the study was to explore the experiences and perspectives of nurses with nursing handover in the critical care unit. The study adopted a phenomenological qualitative design. A sample of 9 critical care nurses participated in this study. The study found critical care nurses believed they were individually equipped with adequate knowledge to carry out effective departmental and interdepartmental nursing handover. The existence of handover policies in the critical care unit was considered a major enabler of the handover. The participants also believed that strained human resource, lack of standardized handover tools and deviation from the set handover rules negatively impacted the handover process. Furthermore, they reported perceived insufficiency in the management’s role in handover evaluation and feedback. Moreover, all participants advocated for improvement of the current handover practices for improved quality of patient care as well as sense of self-accomplishment among the nurses. There are pertinent implications in the findings of this research for critical care nurses, nurses in other departments and policy makers. The resultant implication for each group of stakeholders promotes the adoption and formulation of effective handover practices and consequently enhanced quality of patient care through transfer of adequate patient information and sense of self-accomplishment among nurses.
Keywords: Nursing handover, experiences, perspectives, critical care unit
References
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Barnlund, D. C. (2017). A transactional model of communication. In Communication Theory: Second Edition. https://doi.org/10.4324/9781315080918-5
Burgess, A., van Diggele, C., Roberts, C., & Mellis, C. (2020). Teaching clinical handover with ISBAR. In BMC Medical Education (Vol. 20). https://doi.org/10.1186/s12909-020-02285-0
Chien, L. J., Slade, D., Dahm, M. R., Brady, B., Roberts, E., Goncharov, L., Taylor, J., Eggins, S., & Laura Chien, C. J. (2022). Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context. J Adv Nurs, 78, 1413–1430. https://doi.org/10.1111/jan.15110
Chung, J. Y. S., Li, W. H. C., Ho, L. L. K., Cheung, A. T., & Chung, J. O. K. (2021). Newly graduate nurse perception and experience of clinical handover. Nurse Education Today, 97. https://doi.org/10.1016/j.nedt.2020.104693
Clarke, C. M., & Persaud, D. D. (2011). Leading clinical handover improvement: A change strategy to implement best practices in the acute care setting. In Journal of Patient Safety (Vol. 7, Issue 1). https://doi.org/10.1097/PTS.0b013e31820c98a8
Cowan, D., Brunero, S., Luo, X., Bilton, D., & Lamont, S. (2018). Developing a guideline for structured content and process in mental health nursing handover. International Journal of Mental Health Nursing, 27(1). https://doi.org/10.1111/inm.12337
Forde, M. F., Coffey, A., & Hegarty, J. (2018). The factors to be considered when evaluating bedside handover. In Journal of Nursing Management (Vol. 26, Issue 7). https://doi.org/10.1111/jonm.12598
Frankel, R. M., Flanagan, M., Ebright, P., Bergman, A., O’Brien, C. M., Franks, Z., Allen, A., Harris, A., & Saleem, J. J. (2012). Context, cultureand (non-verbal) communication affect handover quality. BMJ Quality and Safety, 21(SUPPL. 1). https://doi.org/10.1136/BMJQS-2012-001482
Ghosh, S., Ramamoorthy, L., & pottakat, B. (2021). Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. Journal of Patient Experience, 8. https://doi.org/10.1177/2374373521997733
Gunawan, D., Hariyati, R. T. S., & Fitri, D. (2019). Fishbone Analysis Method Of Communication Handover In The Emergency Installation In Jakarta Army Hospital. International Journal of Nursing and Health Services (IJNHS), 1(2). https://doi.org/10.35654/ijnhs.v1i2.40
Hada, A., Jack, L., & Coyer, F. (2019). Using a knowledge translation framework to identify barriers and supports to effective nursing handover: A focus group study. Heliyon, 5(6). https://doi.org/10.1016/j.heliyon.2019.e01960
Hada, A., Jack, L., & Coyer, F. (2019). Using a knowledge translation framework to identify barriers and supports to effective nursing handover: A focus group study. Heliyon, 5(6). https://doi.org/10.1016/j.heliyon.2019.e01960
Halm, M. A. (2013). Nursing handoffs: Ensuring safe passage for patients. American Journal of Critical Care, 22(2). https://doi.org/10.4037/ajcc2013454
Johnson, M., & Cowin, L. S. (2013). Nurses discuss bedside handover and using written handover sheets. Journal of Nursing Management, 21(1). https://doi.org/10.1111/j.1365-2834.2012.01438.x
Li Tan, X., Park, H., Patel, J., & Murden, M. (2021). Improving Clinical Handover on an Electronic Communication Platform: A Quality Improvement Project. https://doi.org/10.7759/cureus.19156
Loefgren Vretare, L., & Anderzén-Carlsson, A. (2020). The critical care nurse’s perception of handover: A phenomenographic study. Intensive and Critical Care Nursing, 58. https://doi.org/10.1016/j.iccn.2020.102807
Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2016). Perspectives of clinical handover processes: a multi-site survey across different health professionals. Journal of Clinical Nursing, 25(1–2), 80–91. https://doi.org/10.1111/JOCN.12986
Merten, H., Van Galen, L. S., & Wagner, C. (2017). Safe handover. BMJ (Online), 359. https://doi.org/10.1136/BMJ.J4328
Methangkool, E., Tollinche, L., Sparling, J., & Agarwala, A. V. (2019). Communication: Is There a Standard Handover Technique to Transfer Patient Care? International Anesthesiology Clinics, 57(3), 35. https://doi.org/10.1097/AIA.0000000000000241
Nsemo, A. D., & Ekwere, J. (2018). Nurses handover and its implication on nursing care in the University of Calabar Teaching Hospital, Calabar, Nigeria. Journal of Nursing & Care, 07, 2167–1168. https://doi.org/10.4172/2167-1168-C3-071
Nyikuri, M. (2020). Handover among nurses working in selected newborn units in Kenya; its purpose and structure. Heliyon, 6(2). https://doi.org/10.1016/j.heliyon.2020.e03500
O’Rourke, J., Abraham, J., Riesenberg, L. A., Matson, J., & Lopez, K. D. (2018). A Delphi study to identify the core components of nurse to nurse handoff. Journal of Advanced Nursing, 74(7). https://doi.org/10.1111/jan.13565
Ogbeivor, C. (2021). Lack of Motivation Among Healthcare Professionals in the National Health Service. Volume 10, 45–54. https://doi.org/10.9790/1959-1006024554
Patarru’, F., Weu, B. Y., Handini, F. S., & Heryyanoor, H. (2020). The Role of the Nurse Unit Manager Function on Nursing Work Performance: A Systematic Review. Jurnal Ners, 14(3). https://doi.org/10.20473/jn.v14i3.17108
Pun, J. (2021). Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context. BMC Nursing, 20(1), 1–8. https://doi.org/10.1186/S12912-021-00624-0/TABLES/3
Raeisi, Rarani, M. A., & Soltani, F. (2019). Challenges of patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 8(1), 173. https://doi.org/10.4103/JEHP.JEHP_460_18
Redley, B., Botti, M., Wood, B., & Bucknall, T. (2017). Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australasian Emergency Nursing Journal, 20(3). https://doi.org/10.1016/j.aenj.2017.05.003
Riesenberg, L., Leisch, J., & Cunningham, J. M. (2010). Nursing handoffs: A systematic review of the literature. American Journal of Nursing, 110(4), 24–34. https://doi.org/10.1097/01.NAJ.0000370154.79857.09
Saville, C., Dall’Ora, C., & Griffiths, P. (2020). The association between 12-hour shifts and nurses-in-charge’s perceptions of missed care and staffing adequacy: a retrospective cross-sectional observational study. International Journal of Nursing Studies, 112. https://doi.org/10.1016j.ijnurstu.2020.103721
Shen, Y., Jian, W., Zhu, Q., Li, W., Shang, W., & Yao, L. (2020). Nurse staffing in large general hospitals in China: An observational study. Human Resources for Health, 18(1). https://doi.org/10.1186/s12960-020-0446-5
Shihundla, R. C., Lebese, R. T., & Maputle, M. S. (2016). Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province. Curationis, 39(1), 1545.
Siriwardena, E. M., & Mudalige, A. D. (2017). Quality and safety of handover in intensive care. Sri Lankan Journal of Anaesthesiology, 25(2), 89–93. https://doi.org/10.4038/SLJA.V25I2.8232/PRINT/
Smeulers, M., Lucas, C., & Vermeulen, H. (2014). Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients. In Cochrane Database of Systematic Reviews (Vol. 2014, Issue 6). https://doi.org/10.1002/14651858.CD009979.pub2
Spooner, A. J., Chaboyer, W., Corley, A., Hammond, N., & Fraser, J. F. (2013). Understanding current intensive care unit nursing handover practices. International Journal of Nursing Practice, 19(2). https://doi.org/10.1111/ijn.12058
Titu, H. L. (2019). Observing and evaluating nursing handover practice and culture in a coronary care unit. British Journal of Cardiac Nursing, 14(9). https://doi.org/10.12968/bjca.2017.0012
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: examples from two case reports. Wellcome Open Research, 4. https://doi.org/10.12688/WELLCOMEOPENRES.15042.1
Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W., & Vogelaers, D. (2015). Communication in healthcare: A narrative review of the literature and practical recommendations. In International Journal of Clinical Practice (Vol. 69, Issue 11). https://doi.org/10.1111/ijcp.12686
Wang, B., Zou, G., Zheng, M., Chen, C., Teng, W., & Lu, Q. (2021). Nurses’ trust in managers and its relationship with nurses’ performance behaviors: a descriptive- correlational study. BMC Nursing. https://doi.org/10.1186/s12912-022-00864-8
Wanigasinghe, N. (2016). Audit on effective handover of critically ill patients in intensive care units between shifts by the medical and nursing officers. Sri Lankan Journal of Anaesthesiology, 24(2), 76–81. https://doi.org/10.4038/SLJA.V24I2.8150/PRINT/
Wibrandt, I., & Lippert, A. (2020). Improving patient safety in handover from intensive care unit to general ward: A systematic review. Journal of Patient Safety, 16(3), 199–210. https://doi.org/10.1097/PTS.0000000000000266
Alrajhi, A., Sormunen, T., & Alsubhi, H. (2018). Factors Affecting Bedside Handover between Nurses inCritical Care Area. IOSR Journal of Nursing and Health Science, 7(4).
Barnlund, D. C. (2017). A transactional model of communication. In Communication Theory: Second Edition. https://doi.org/10.4324/9781315080918-5
Burgess, A., van Diggele, C., Roberts, C., & Mellis, C. (2020). Teaching clinical handover with ISBAR. In BMC Medical Education (Vol. 20). https://doi.org/10.1186/s12909-020-02285-0
Chien, L. J., Slade, D., Dahm, M. R., Brady, B., Roberts, E., Goncharov, L., Taylor, J., Eggins, S., & Laura Chien, C. J. (2022). Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context. J Adv Nurs, 78, 1413–1430. https://doi.org/10.1111/jan.15110
Chung, J. Y. S., Li, W. H. C., Ho, L. L. K., Cheung, A. T., & Chung, J. O. K. (2021). Newly graduate nurse perception and experience of clinical handover. Nurse Education Today, 97. https://doi.org/10.1016/j.nedt.2020.104693
Clarke, C. M., & Persaud, D. D. (2011). Leading clinical handover improvement: A change strategy to implement best practices in the acute care setting. In Journal of Patient Safety (Vol. 7, Issue 1). https://doi.org/10.1097/PTS.0b013e31820c98a8
Cowan, D., Brunero, S., Luo, X., Bilton, D., & Lamont, S. (2018). Developing a guideline for structured content and process in mental health nursing handover. International Journal of Mental Health Nursing, 27(1). https://doi.org/10.1111/inm.12337
Forde, M. F., Coffey, A., & Hegarty, J. (2018). The factors to be considered when evaluating bedside handover. In Journal of Nursing Management (Vol. 26, Issue 7). https://doi.org/10.1111/jonm.12598
Frankel, R. M., Flanagan, M., Ebright, P., Bergman, A., O’Brien, C. M., Franks, Z., Allen, A., Harris, A., & Saleem, J. J. (2012). Context, cultureand (non-verbal) communication affect handover quality. BMJ Quality and Safety, 21(SUPPL. 1). https://doi.org/10.1136/BMJQS-2012-001482
Ghosh, S., Ramamoorthy, L., & pottakat, B. (2021). Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. Journal of Patient Experience, 8. https://doi.org/10.1177/2374373521997733
Gunawan, D., Hariyati, R. T. S., & Fitri, D. (2019). Fishbone Analysis Method Of Communication Handover In The Emergency Installation In Jakarta Army Hospital. International Journal of Nursing and Health Services (IJNHS), 1(2). https://doi.org/10.35654/ijnhs.v1i2.40
Hada, A., Jack, L., & Coyer, F. (2019). Using a knowledge translation framework to identify barriers and supports to effective nursing handover: A focus group study. Heliyon, 5(6). https://doi.org/10.1016/j.heliyon.2019.e01960
Hada, A., Jack, L., & Coyer, F. (2019). Using a knowledge translation framework to identify barriers and supports to effective nursing handover: A focus group study. Heliyon, 5(6). https://doi.org/10.1016/j.heliyon.2019.e01960
Halm, M. A. (2013). Nursing handoffs: Ensuring safe passage for patients. American Journal of Critical Care, 22(2). https://doi.org/10.4037/ajcc2013454
Johnson, M., & Cowin, L. S. (2013). Nurses discuss bedside handover and using written handover sheets. Journal of Nursing Management, 21(1). https://doi.org/10.1111/j.1365-2834.2012.01438.x
Li Tan, X., Park, H., Patel, J., & Murden, M. (2021). Improving Clinical Handover on an Electronic Communication Platform: A Quality Improvement Project. https://doi.org/10.7759/cureus.19156
Loefgren Vretare, L., & Anderzén-Carlsson, A. (2020). The critical care nurse’s perception of handover: A phenomenographic study. Intensive and Critical Care Nursing, 58. https://doi.org/10.1016/j.iccn.2020.102807
Manias, E., Geddes, F., Watson, B., Jones, D., & Della, P. (2016). Perspectives of clinical handover processes: a multi-site survey across different health professionals. Journal of Clinical Nursing, 25(1–2), 80–91. https://doi.org/10.1111/JOCN.12986
Merten, H., Van Galen, L. S., & Wagner, C. (2017). Safe handover. BMJ (Online), 359. https://doi.org/10.1136/BMJ.J4328
Methangkool, E., Tollinche, L., Sparling, J., & Agarwala, A. V. (2019). Communication: Is There a Standard Handover Technique to Transfer Patient Care? International Anesthesiology Clinics, 57(3), 35. https://doi.org/10.1097/AIA.0000000000000241
Nsemo, A. D., & Ekwere, J. (2018). Nurses handover and its implication on nursing care in the University of Calabar Teaching Hospital, Calabar, Nigeria. Journal of Nursing & Care, 07, 2167–1168. https://doi.org/10.4172/2167-1168-C3-071
Nyikuri, M. (2020). Handover among nurses working in selected newborn units in Kenya; its purpose and structure. Heliyon, 6(2). https://doi.org/10.1016/j.heliyon.2020.e03500
O’Rourke, J., Abraham, J., Riesenberg, L. A., Matson, J., & Lopez, K. D. (2018). A Delphi study to identify the core components of nurse to nurse handoff. Journal of Advanced Nursing, 74(7). https://doi.org/10.1111/jan.13565
Ogbeivor, C. (2021). Lack of Motivation Among Healthcare Professionals in the National Health Service. Volume 10, 45–54. https://doi.org/10.9790/1959-1006024554
Patarru’, F., Weu, B. Y., Handini, F. S., & Heryyanoor, H. (2020). The Role of the Nurse Unit Manager Function on Nursing Work Performance: A Systematic Review. Jurnal Ners, 14(3). https://doi.org/10.20473/jn.v14i3.17108
Pun, J. (2021). Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context. BMC Nursing, 20(1), 1–8. https://doi.org/10.1186/S12912-021-00624-0/TABLES/3
Raeisi, Rarani, M. A., & Soltani, F. (2019). Challenges of patient handover process in healthcare services: A systematic review. Journal of Education and Health Promotion, 8(1), 173. https://doi.org/10.4103/JEHP.JEHP_460_18
Redley, B., Botti, M., Wood, B., & Bucknall, T. (2017). Interprofessional communication supporting clinical handover in emergency departments: An observation study. Australasian Emergency Nursing Journal, 20(3). https://doi.org/10.1016/j.aenj.2017.05.003
Riesenberg, L., Leisch, J., & Cunningham, J. M. (2010). Nursing handoffs: A systematic review of the literature. American Journal of Nursing, 110(4), 24–34. https://doi.org/10.1097/01.NAJ.0000370154.79857.09
Saville, C., Dall’Ora, C., & Griffiths, P. (2020). The association between 12-hour shifts and nurses-in-charge’s perceptions of missed care and staffing adequacy: a retrospective cross-sectional observational study. International Journal of Nursing Studies, 112. https://doi.org/10.1016j.ijnurstu.2020.103721
Shen, Y., Jian, W., Zhu, Q., Li, W., Shang, W., & Yao, L. (2020). Nurse staffing in large general hospitals in China: An observational study. Human Resources for Health, 18(1). https://doi.org/10.1186/s12960-020-0446-5
Shihundla, R. C., Lebese, R. T., & Maputle, M. S. (2016). Effects of increased nurses’ workload on quality documentation of patient information at selected Primary Health Care facilities in Vhembe District, Limpopo Province. Curationis, 39(1), 1545.
Siriwardena, E. M., & Mudalige, A. D. (2017). Quality and safety of handover in intensive care. Sri Lankan Journal of Anaesthesiology, 25(2), 89–93. https://doi.org/10.4038/SLJA.V25I2.8232/PRINT/
Smeulers, M., Lucas, C., & Vermeulen, H. (2014). Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients. In Cochrane Database of Systematic Reviews (Vol. 2014, Issue 6). https://doi.org/10.1002/14651858.CD009979.pub2
Spooner, A. J., Chaboyer, W., Corley, A., Hammond, N., & Fraser, J. F. (2013). Understanding current intensive care unit nursing handover practices. International Journal of Nursing Practice, 19(2). https://doi.org/10.1111/ijn.12058
Titu, H. L. (2019). Observing and evaluating nursing handover practice and culture in a coronary care unit. British Journal of Cardiac Nursing, 14(9). https://doi.org/10.12968/bjca.2017.0012
Tiwary, A., Rimal, A., Paudyal, B., Sigdel, K. R., & Basnyat, B. (2019). Poor communication by health care professionals may lead to life-threatening complications: examples from two case reports. Wellcome Open Research, 4. https://doi.org/10.12688/WELLCOMEOPENRES.15042.1
Vermeir, P., Vandijck, D., Degroote, S., Peleman, R., Verhaeghe, R., Mortier, E., Hallaert, G., Van Daele, S., Buylaert, W., & Vogelaers, D. (2015). Communication in healthcare: A narrative review of the literature and practical recommendations. In International Journal of Clinical Practice (Vol. 69, Issue 11). https://doi.org/10.1111/ijcp.12686
Wang, B., Zou, G., Zheng, M., Chen, C., Teng, W., & Lu, Q. (2021). Nurses’ trust in managers and its relationship with nurses’ performance behaviors: a descriptive- correlational study. BMC Nursing. https://doi.org/10.1186/s12912-022-00864-8
Wanigasinghe, N. (2016). Audit on effective handover of critically ill patients in intensive care units between shifts by the medical and nursing officers. Sri Lankan Journal of Anaesthesiology, 24(2), 76–81. https://doi.org/10.4038/SLJA.V24I2.8150/PRINT/
Wibrandt, I., & Lippert, A. (2020). Improving patient safety in handover from intensive care unit to general ward: A systematic review. Journal of Patient Safety, 16(3), 199–210. https://doi.org/10.1097/PTS.0000000000000266
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Published
2022-11-04
How to Cite
Murigi, M., Mbuthia, N., & Meng’anyi, L. (2022). Nursing Handover: Experiences and Perspectives in the Critical Care Unit at Murang’a County Referral Hospital. Journal of Medicine, Nursing & Public Health, 5(3), 35–58. https://doi.org/10.53819/81018102t6043
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