Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context.
Laura J Chien, Diana Slade, Maria R Dahm and 6 others
PMID 35038346WHAT IT FOUND
Nurses on a rehabilitation ward reported moving handover from the corridor to the bedside and using ISBAR and CARE to involve patients more directly.
The ward also changed huddles, handover sheets and mentoring.
Key findings
01Pre-intervention handovers were often in the corridor or just inside the room, and patients were rarely involved beyond a greeting.
02Post-intervention interviews and a recorded handover showed bedside handover, direct patient engagement, and use of ISBAR and CARE.
03The intervention paired communication training with ward-level changes, including an ISBAR handover sheet, a risk-focused huddle, patient allocation before handover, and mentoring.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study was based on one rehabilitation ward and a small qualitative sample of 19 handover interactions and 3 huddles. Multiple changes were implemented together, so the contribution of any single component cannot be separated. Follow-up was 6 weeks after the intervention, so longer-term sustainability was not assessed. There was no comparison group, so confounding factors were not controlled. The patient safety data were not assessed by the qualitative study and were reported without a control group.
Declared interests
Laura Chien, Diana Slade, Maria Dahm, Bernadette Brady, Liza Goncharov and Suzanne Eggins declared no conflict of interest. Elizabeth Roberts, Joanne Taylor and Anna Thornton were employees of St Vincent's Health Network Sydney. St Vincent's Curran Foundation funded the study.
The easy way to misread this
Do not read the reported reductions in falls, pressure injuries and medication errors as proof that the handover intervention caused them. The study was qualitative, did not assess these outcomes, had no comparison group, and multiple ward changes were implemented together.