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Interruptions During Senior Nurse Handover in the Intensive Care Unit: A Quality Improvement Study
Amy J Spooner1, Wendy Chaboyer, Leanne M Aitken
1Adult Intensive Care Services, The Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia (Ms Spooner); School of Nursing and Midwifery, Griffith University, Queensland, Australia (Ms Spooner and Drs Chaboyer and Aitken); Menzies Health Institute Queensland, Gold Coast, Queensland, Australia (Drs Chaboyer and Aitken); and School of Health Sciences, City, University of London, London, United Kingdom (Dr Aitken).
Background:
Interruptions during handover may compromise continuity of care and patient safety.
Local Problem:
Interruptions occur frequently during handovers in the intensive care unit.
Methods:
A quality improvement study was undertaken to improve nursing team leader handover processes. The frequency, source, and reason interruptions occurred were recorded before and after a handover intervention.
Interventions:
The intervention involved relocating handover from the desk to bedside and using a printed version of an evidence-based electronic minimum data set. These strategies were supported by education, champions, reminders, and audit and feedback.
Results:
Forty handovers were audiotaped before, and 49 were observed 3 months following the intervention. Sixty-four interruptions occurred before and 52 after the intervention, but this difference was not statistically significant. Team leaders were frequently interrupted by nurses discussing personal or work-specific matters before and after the intervention.
Conclusions:
Further work is required to reduce interruptions that do not benefit patient care.
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