Enhancing active patient participation in nursing handover: A mixed methods study.

Area of Science:

• Nursing Research
• Patient Safety
• Healthcare Communication

Background:

• Patient participation in nursing handover is crucial for patient-centered care, shared decision-making, and patient safety.
• Effective nursing handover contributes to a positive healthcare experience.

Purpose of the Study:

• To determine the frequency and nature of patient involvement during nursing handover.
• To identify patient and nurse-perceived strategies for increasing patient engagement in handover.

Main Methods:

• A multi-site prospective study utilized mixed methods, including direct observation of nursing handovers and semi-structured interviews.
• Data were collected from September to December 2019 on ten randomly selected hospital wards.
• Observations (n=117) and interviews with patients (n=33) and nurses (n=20) were analyzed using descriptive and thematic analysis, respectively.

Main Results:

• Patients were present during 76.9% of observed handovers, but active participation occurred in only 33.3%, with 20% having no input.
• Factors influencing active patient participation included patient gender, surgical versus medical status, and nurse engagement behaviors.
• Thematic analysis revealed key themes: 'Being Involved,' 'Layers of Influence,' and 'Information Exchange.'

Conclusions:

• Patient participation in nursing handover is notably low, shaped by a complex interaction of patient and nurse preferences and perceptions.
• Patients actively participate when they understand handover's purpose and timing and have a good rapport with nurses.
• Improving patient involvement in handover is essential for safe patient care and enhanced patient experience.