Shift-to-Shift Information Transfer: Phenomenological Study of Nurses' Experiences

Area of Science:

• Nursing Informatics
• Patient Safety
• Healthcare Quality Improvement

Background:

• Effective nurse-to-nurse information transfer is crucial for patient safety during clinical handovers.
• Digital documentation systems, such as the Identification, Diagnosis, Evolution, Activities, Support (IDEAS) system, aim to standardize and improve handover quality.

Purpose of the Study:

• To explore nurses' perceptions of information transfer during shift changes in a hospital setting.
• To identify strengths, weaknesses, difficulties, and proposed improvements in the handover process using the IDEAS system.

Main Methods:

• Qualitative phenomenological study utilizing semistructured interviews with 15 nurses experienced with the IDEAS system.
• Inductive thematic analysis of transcribed interviews, employing axial coding, analytical triangulation, and reflexivity for data interpretation.
• Data collection occurred between June 2023 and September 2024 at Hospital Universitario Insular de Gran Canaria.

Main Results:

• Nurses perceived the IDEAS system as providing structured clinical information access but noted limitations like poor data prioritization, editing issues, and lack of integration with medical records.
• Identified challenges included training deficiencies and variable system use, especially among less experienced staff.
• Improvement suggestions focused on redesigning forms, automating updates, integrating summaries, and providing continuous training.

Conclusions:

• The IDEAS system offers improvements but is hindered by technical, organizational, and cultural barriers.
• Optimizing clinical handovers necessitates clinically focused redesigns, enhanced training, and fostering a culture of shared documentation responsibility.
• These efforts are vital for developing a safer, standardized, and patient-centered handover model.