Clinical handover at the patient's bedside key to improving safety in hospitals

Sep 5 2007

The handover of patient information during nursing shift changes is a key area under investigation in a national effort to improve patient safety in hospitals.

In one of seven projects funded by the Australian Commission on Safety and Quality in Health Care to improve the handover of clinical information in hospitals, a research team led by Griffith University will evaluate the benefits of conducting the nursing handover at the patients' bedside.

Professor Wendy Chaboyer, director of Griffith's Research Centre for Clinical and Community Practice Innovation, said face-to-face handovers at nursing shift changes were typically conducted in a separate room away from the patient.

Another common method of handover was to leave tape recordings of the patient's condition and instructions for their care.

“We believe that clinical handovers are not as effective as they could be – important information may be left out, or the timing and method of communication is not optimal.”

She said a clinical handover at the patient's bedside was likely to be more effective by providing visual cues to important information as well as the opportunity for the patient to participate.

Professor Chaboyer said her recent research had found that nurses spend about one third of their work time involved in the communication of patient information.

“Obviously nurses' communication needs to be effective to ensure high quality care and the best possible outcomes for our patients. Handover is an especially important process however as it also involves the transfer of responsibility for patient care,” she said.

The 12-month project will compare adverse clinical incidents and other performance data before and after implementation of the bedside handover, assess its key features, and determine staff attitudes and perceptions to the new process.

Professor Chaboyer's team will also develop standard operating protocols for the nursing bedside handover, which can then be adapted as necessary by hospitals.

The study, will also investigate whiteboard-assisted communication of patient information among doctors, nurses and other members of the health team.

“A significant proportion of adverse events in hospitals are attributed to breakdowns or gaps in communication between health professionals,” Professor Chaboyer said.

“Effective communication within and between the various disciplines is especially critical at times such as the transfer of a patient from an intensive care unit to a general ward or when planning ahead for the patient's discharge from hospital.”

She said whiteboard communication had been adopted by some hospitals as an additional strategy to track what was happening to a patient and facilitate high quality, multidisciplinary care.

The research team, which also includes Griffith's Professor Marianne Wallis and Professor Anne McMurray from Murdoch University and Peel Health Campus in Western Australia, will examine these innovative ways of communication of information in both the public and private hospital setting.