Nursing Inter-Shift Handover Process: Enhancing a Traditional Ritual Through Evidence-Based Practice

Tuesday, 31 July 2012: 11:05 AM

Rajni Parasuram, MEd, PGDipHE, BN, RMN, RN
Chee Lien Poh, MHSc, (Education), BN, AdvDipNursing, (Gerontology), RN
Centre for Mental Health Education / Nursing Training Department, Institute of Mental Health, Singapore, Singapore

Learning Objective 1: To outline common strengths and limitations of the existing handover practice / process

Learning Objective 2: To discuss evidence-based nursing strategies that will enhance nursing inter-shift handover process

Aims. This project aims to 1) examine existing handover practices/process in the tertiary mental health institution; 2) determine the strengths and limitations of the existing handover practice / process; and 3) identify, implement and evaluate an evidence-based nursing inter-shift handover process to enhance patient safety and service delivery.

Methods. This project was conducted in three phases using the JBI Practical Application of Clinical Evidence System (PACES) and Getting Research Into Practice (GRIP) programs. It was implemented over a period of four months from end August 2011 to beginning December 2011Evidence-based strategies such as town hall meetings and education sessions that reinforce proper handover techniques and its importance were implemented to enhance the handover processes and practices in four acute admitting wards. Pre and post audit data were observed and recorded for each case handover during each inter-shift handover session in four acute admitting wards. 

Results. The handover processes for 317 cases for four acute admitting wards were observed using the 7 audit criteria. Post implementation audit findings show that compliance rate had improved significantly for the four criteria: an improvement of 49% compliance rate in the use of standardized documentation during shift handover session;  an increased of 74% compliance rate in proper identification of patient at the start of each case report; a 31% increased in proper handing over of significant patient's history; and  18% increased compliance in providing detailed observation of patients.

Conclusion. This project had shown that handover session can be made effective by translating evidence into practice through ongoing evidence-based audit. Continuous evidence-based evaluation, identification and implementation of nursing inter-shift handover process will enhance patient safety and service delivery.