[Nursing handover: an observational study at the inpatient wards - cardiothoracic department]

The handover has relevant implications in terms of patient safety. An effective handover requires the use of a standardized and shared communication tool.

This observational study explored the nursing handover at shift change in order to detect eventual omissions. Furthermore, it investigated the quality perceived by the nurses involved.

At each shift change, an external observer detected the referred and omitted information by the delivering nurse, through the use of a direct observational grid (modified ISBAR). The percentage of the omitted information was calculated excluding any unforeseen information, not linked to the patient care pathway and detected through the consultation of the nursing record. The quality perceived by the nurses involved was investigated through the use of the Handoff CEX tool. The data was processed through a descriptive and inferential statistical analysis.

256 handovers were observed and 256 nursing records were reviewed. The omissions were detected in 43.17% of the cases. The results highlight a propensity for a prospective approach. A high statistical significance emerges in relation to the modality of handover, the type of patient, the nurse/patients ratio and the number of interruptions. Referring to the perceived quality, 40 Handoff CEX evaluation forms were completed. The results show a more than satisfactory perception. However, the thematic analysis highlights scarcely detailed and dispersive handovers as well as the difficulty to focus on the information to deliver.

According to the findings of this research, it is necessary to implement a standardized tool which supports the handover process.