Bedside Nursing Handovers in the Surgical Context

NCT03465839 | Completed

• 1 other identifier: UPO1
• Study Type: interventional
• Target: 318
• Locations: 1 country
• Sites: 1

Brief 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.

Conditions

General Surgery

Outcome Measures

Primary Outcomes (1)

• 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 Outcomes (3)

• Handover length

  Baseline, at 1 month after intervention

• Missed care / procedures / diagnostic tests

  Baseline, at 1 month after intervention, at 6 months after intervention

• Patients satisfaction

  Baseline, at 1 month after intervention, at 6 months after intervention

Study Arms (2)

Bedside handover

EXPERIMENTAL

Education for improving handovers quality + Education for improving bedside handovers

Behavioral: Education for improving handovers quality; Behavioral: Education for improving bedside handovers

Control

ACTIVE COMPARATOR

Education for improving handovers quality

Behavioral: Education for improving handovers quality

Interventions

Education for improving handovers quality BEHAVIORAL

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.

Bedside handover; Control

Education for improving bedside handovers BEHAVIORAL

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.

Bedside handover

Eligibility Criteria

• Age: 18 Years - 99 Years
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Surgical patients
• All nurses working with surgical patients who attended the educational intervention

You may not qualify if:

• 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

Sponsors & Collaborators

• University of Eastern Piedmont: lead
• Valduce Hospital: collaborator

Study Sites (1)

Valuduce Hospital

Como, 22100, Italy

Location

Related Publications (4)

• Smeulers M, Lucas C, Vermeulen H. Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients. Cochrane Database Syst Rev. 2014 Jun 24;2014(6):CD009979. doi: 10.1002/14651858.CD009979.pub2.

  PMID: 24957503 BACKGROUND

• Abraham J, Kannampallil T, Patel VL. A systematic review of the literature on the evaluation of handoff tools: implications for research and practice. J Am Med Inform Assoc. 2014 Jan-Feb;21(1):154-62. doi: 10.1136/amiajnl-2012-001351. Epub 2013 May 23.

  PMID: 23703824 BACKGROUND

• Clemow R. Care plans as the main focus of nursing handover: information exchange model. J Clin Nurs. 2006 Nov;15(11):1463-5. doi: 10.1111/j.1365-2702.2006.01524.x. No abstract available.

  PMID: 17038108 BACKGROUND

• Chaboyer W, McMurray A, Johnson J, Hardy L, Wallis M, Sylvia Chu FY. Bedside handover: quality improvement strategy to "transform care at the bedside". J Nurs Care Qual. 2009 Apr-Jun;24(2):136-42. doi: 10.1097/01.NCQ.0000347450.90676.d9.

  PMID: 19287252 BACKGROUND

MeSH Terms

Interventions

Educational Status

Intervention Hierarchy (Ancestors)

Socioeconomic Factors; Population Characteristics

Study Officials

• Marco Clari, RN, PhD s

  University of Eastern Piedmont

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: DOUBLE
• Who Masked: PARTICIPANT, INVESTIGATOR
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Adjunct professor

Study Record Dates

• First Submitted: February 27, 2018
• First Posted: March 14, 2018
• Study Start: July 26, 2018
• Primary Completion: November 1, 2018
• Study Completion: January 31, 2019
• Last Updated: April 16, 2019

Record last verified: 2019-04

Data Sharing

• IPD Sharing: Will not share

Locations

IT (1)