Bedside Nursing Handovers in the Surgical Context

Study Overview
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Brief Summary
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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.

Official Title
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The Efficacy of Bedside Nursing Handovers in Improving Information Exchange Quality in Surgical Patients: a Randomised Controlled Trial

Conditions
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General Surgery

Intervention / Treatment
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* Behavioral: Education for improving handovers quality
* Behavioral: Education for improving bedside handovers


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Surgical patients All nurses working with surgical patients who attended the educational intervention Exclusion Criteria: Nurses who did not participate in the educational intervention Nursed who did not operate stably in the surgical wards included in the study New hired nurses

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 99 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Health Services Research
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Bedside handover<br>Education for improving handovers quality + Education for improving bedside handovers | Behavioral: Education for improving handovers quality<br>* 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.<br>Behavioral: Education for improving bedside handovers<br>* 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.<br>|
| Active Comparator: Control<br>Education for improving handovers quality | Behavioral: Education for improving handovers quality<br>* 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.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in handover quality | Handoff CEX (Clinical Examination) [3-9 overall on 6 items about setting, organisation, communication, content, judgment, professionalism; 3 worst - 9 best] | Baseline, at 1 month after intervention, at 6 months after intervention | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Handover length | Time x handover | Baseline, at 1 month after intervention | 
| Missed care / procedures / diagnostic tests | Number of missed care / procedures / diagnostic tests | Baseline, at 1 month after intervention, at 6 months after intervention | 
| Patients satisfaction | Visual Analogic Scale for satisfaction [0-10; 0 worst - 10 best] | Baseline, at 1 month after intervention, at 6 months after intervention |