Nurse-to-nurse handoff with distractors and interruptions: An integrative review

An integrative review of the literature was conducted to explore perceptions of distractors and interruptions during nurse-to-nurse handoff.

Handoff distractors and interruptions are recognized as barriers to effective nurse handoff and may lead to preventable and costly medical errors. However, little is known about the perception of these barriers to nurses and strategies to mitigate distractors and interruptions during nurse-to-nurse handoff.

Using the framework of Whittemore and Knafl, four electronic databases were searched for articles written in English and published in the last five years. Inclusion criteria included: qualitative, quantitative, mixed-methods or quality improvement papers focused on distractors/interruptions during nurse handoff. A multi-author independent review of articles was completed with a rigorous process of data extraction and quality assessment.

A total of 17 articles were reviewed with findings categorized into the following themes: perceptions of handoff, characteristics of handoff, or logistics of handoff. Nurses reported that interruptions and distractions were a limitation in handoff quality and handoff efficiency, occurring during inter-shift and unit-to-unit handoff. The two most common types of interruptions and distractions were people (patient, family) and environmental factors (equipment alarms). An organized and standardized approach to handoff was recommended, but few specific examples were reported.

Despite recent research related to interruptions and distractions in nurse handoff, few evidence-based strategies have been identified that effectively mitigate these patient safety problems. More evidence is needed to determine best practice methods for handoff training for nurses and nursing students.