Bedside Nursing Handovers in the Surgical Context
Condition: General Surgery
Study type: Interventional

Summary: 
      Nursing handovers are performed 2-3 times a day for each patient, with an approximate average
      of 2 million nursing deliveries per year in a hospital of medium size. Nursing handovers are
      considered essential for the continuity and safety of care. If the relevant clinical
      information is not shared in a precise and timely manner, it may worsen the patients'
      outcomes with an increase in adverse events, delays or inappropriate treatment until the
      omission of procedures.

      The modality of nursing delivery presents, therefore, a gap of vulnerability where vital
      information could not be considered and systematically shared.

      Patients should be involved in their care to promote a patient-centred approach. The
      involvement of patients in handovers is effective compared to other delivery methods.

      To date, however, the best mode to deliver handovers was still unclear due to a systematic
      lack of studies to identify the best practice of nursing handovers. The studies in the
      literature lack of sound methodologies due to not randomized designs.

      Thus an intervention to improve quality of handovers and to implement bedside handovers in
      surgical wards will be performed.

      The following hypotheses were made:

        -  The introduction of nursing bedside handovers will improve the quality of the
           information exchanged.

        -  The educational intervention training intervention will positively modify the nursing
           handovers.

        -  There is a relationship between the qualitative level of nursing handovers and working
           status (expert vs novice) of the nurses.

        -  There is a relationship between the qualitative level of nursing handovers and the
           patients' characteristics.
    


Intervention name(s): Education for improving handovers quality; Education for improving bedside handovers
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Specific education on the importance of handovers quality will be provided. The educational session will last 4 hours. The program will be divided into the following sections: 1) a structured survey on the perception of the participants on the handovers importance; 2) Key theoretical concepts on the relevance of handovers with case studies of errors related to this critical moment; 3) showing movie clips of nursing handovers to critically interpret the clips by the participants; 4) presentation of the SBAR method recommended by WHO; 5) general presentation of the nursing delivery assessment project of the Valduce Hospital.; In addition to the education for improving handovers quality, the following intervention will be implemented for nurses assigned to the study department. The course will be supplemented by a section of the duration of an hour, containing 1) information on the principles underlying bedside handovers; 2) how to handle information in front of the patient and on his / her direct involvement; 3) role-playing of the bedside handover will be performed, assigning the roles of nurse and patient among the participants to bring out impressions linked to the functions.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Double (Participant, Investigator)
Primary purpose: Health Services Research