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

María-Josefa Montoya-Garrido1, Claudio-Alberto Rodríguez-Suárez1,2, Noa Mateos-López1

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Summary

Digital documentation systems like IDEAS improve nursing handovers but face challenges. Optimizing patient safety requires addressing technical, organizational, and cultural barriers through system redesign and training.

Keywords:
communicationcontinuity of patient careelectronic health recordsnursingpatient handoffpatient safetyqualitative research

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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.