Learning Objective #1: Explain the origins of the current focus on nursing handoffs

Learning Objective #2: Describe the purposes of a nursing handoff other than the transfer of patient information

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The transfer of information at the time of intershift nursing reports:  Not the only handoff function.
A qualitative analysis of nursing handoff studies was conducted to provide a better understanding of the phenomenon of nursing handoffs. The handoff or transfer of patient care responsibilities from one practitioner to another is a hospital procedure used to promote continuity. Handoffs occur multiple times a day on nursing units. Critical thinking, and therefore patient safety, is enhanced when there is valuable communication during the shift report, and where the primary objective is the accurate transfer of information about a patient's state and care plan. The transfer of information, however, is not the only function of a handoff. This study examined qualitative studies to determine purposes served other than the transfer of information.
Methods: Noblit and Hare's meta-ethnographic, comparative approach was used. This method involves comparing study findings and translating each into the other through seven phases. The final sample consisted of 16 qualitative studies that observed a total of 175 handoffs on 27 acute care nursing units and one intensive care unit. The CINAHL, PUBMED and PROQUEST and Virginia Henderson Library databases were searched between 1990 and 2005 with such key words and combinations as nursing, handoffs, handovers, signoffs, intershift reports, and intershift communication. Forty-one studies were found, and 14 met the inclusion criteria of: 1) qualitative study of nursing handoffs; 2) acute care setting.
Results: The metasynthesis revealed three metaphors that were related to important functions other than the transfer of information. These themes centered on reciprocal connecting that consisted of cohesiveness and shared meanings, personal protection, and teaching.

Conclusions: It was concluded that while intershift handoffs are used primarily to communicate care, they fulfill a wide range of other activities that are important to retention and a sense of belonging.