Bedside Nursing Handovers in the Surgical Context

General Surgery Clinical Trial

Official title:

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

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03465839
• Other study ID #: UPO1
• Status: Completed
• Phase: N/A
• Start date: July 26, 2018
• Est. completion date: January 31, 2019

Study information

• Verified date: April 2019
• Source: University of Eastern Piedmont
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 318
• Est. completion date: January 31, 2019
• Est. primary completion date: November 1, 2018
• Accepts healthy volunteers: No
• Gender: All
• Age group: 18 Years to 99 Years

Eligibility

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

Related Conditions & MeSH terms

• General Surgery

Intervention

Behavioral:
• Education for improving handovers quality
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.
• Education for improving bedside handovers
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.

Locations

Country	Name	City	State
Italy	Valuduce Hospital	Como

Sponsors (2)

Lead Sponsor	Collaborator
University of Eastern Piedmont	Valduce Hospital

Country where clinical trial is conducted

Italy, 

References & Publications (4)

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. Review. — View Citation

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. — View Citation

Clemow R. Care plans as the main focus of nursing handover: information exchange model. J Clin Nurs. 2006 Nov;15(11):1463-5. — View Citation

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;(6):CD009979. doi: 10.1002/14651858.CD009979.pub2. Review. — View Citation

Outcome

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