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.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE
Enrollment
318
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.
Valuduce Hospital
Como, Italy
Change in handover quality
Handoff CEX (Clinical Examination) \[3-9 overall on 6 items about setting, organisation, communication, content, judgment, professionalism; 3 worst - 9 best\]
Time frame: Baseline, at 1 month after intervention, at 6 months after intervention
Handover length
Time x handover
Time frame: Baseline, at 1 month after intervention
Missed care / procedures / diagnostic tests
Number of missed care / procedures / diagnostic tests
Time frame: Baseline, at 1 month after intervention, at 6 months after intervention
Patients satisfaction
Visual Analogic Scale for satisfaction \[0-10; 0 worst - 10 best\]
Time frame: Baseline, at 1 month after intervention, at 6 months after intervention
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