Logo image
The ins and outs of change of shift handoffs between nurses: a communication challenge
Journal article   Open access   Peer reviewed

The ins and outs of change of shift handoffs between nurses: a communication challenge

John S Carroll, Michele Williams and Theresa M Gallivan
BMJ quality & safety, Vol.21(7), pp.586-593
07/01/2012
DOI: 10.1136/bmjqs-2011-000614
PMID: 22328456

View Online

Abstract

Communication breakdowns have been identified as a source of problems in complex work settings such as hospital-based healthcare. The authors conducted a multi-method study of change of shift handoffs between nurses, including interviews, survey, audio taping and direct observation of handoffs, posthandoff questionnaires, and archival coding of clinical records. The authors found considerable variability across units, nurses and, surprisingly, roles. Incoming and outgoing nurses had different expectations for a good handoff: incoming nurses wanted a conversation with questions and eye contact, whereas outgoing nurses wanted to tell their story without interruptions. More experienced nurses abbreviated their reports when incoming nurses knew the patient, but the incoming nurses responded with a large number of questions, creating a contest for control. Nurses' ratings did not correspond to expert ratings of information adequacy, suggesting that nurses consider other functions of handoffs beyond information processing, such as social interaction and learning. These results suggest that variability across roles as information provider versus receiver and experience level (as well as across individual and organisational contexts) are reasons why improvement efforts directed at standardising and improving handoffs have been challenging in nursing and in other healthcare professions as well.
Clinical Competence Continuity of Patient Care - standards Health Knowledge, Attitudes, Practice Hospitals, Urban Humans Interdisciplinary Communication Interprofessional Relations Nurse-Patient Relations Nursing Care - methods Nursing Care - psychology Nursing Care - statistics & numerical data Nursing Staff, Hospital - psychology Observer Variation Personnel Staffing and Scheduling - statistics & numerical data Qualitative Research Surgery Department, Hospital Surveys and Questionnaires Time and Motion Studies

Details

Logo image