Intrahospital handovers before and after an educational intervention: a quality improvement study among ICU nurses

Effective intra-hospital handovers (IHHs) are fundamental to patient safety and high-quality care in critical care settings. Research identifies a lack of standardized knowledge and handover protocols. This quality improvement study aimed to enhance nurses' performance in intra-hospital handover in ICUs by implementing an educational package.

This quality improvement study used a pre-post, single-group design. Of 167 ICU nurses, 155 nurses met the inclusion criteria and were enrolled. Each nurse's performance in intra-hospital handover was assessed twice: once before and once after the intervention, with each nurse serving as their own control. The intervention consisted of a 90-minute lecture, a printed educational booklet, and an educational poster. A validated 38-item checklist was used to evaluate nurses' performance across pre-transfer, during-transfer, and post-transfer phases. Data were analyzed using SPSS version 16, with a significance level set at p < 0.05.

Higher post-intervention frequencies were observed across all three handover phases (p < 0.001). The total median IHH score increased from 103 (IQR = 15) before the intervention to 138 (IQR = 9) afterward. For safety-related practices, checking vital signs before transfer was documented in 51.0% of pre-intervention observations compared to 89.0% post-intervention. Coordinating with the destination department rose from 54.2% to 92.3%. Providing explanations to patients or families was observed in 17.4% of pre-intervention cases versus 89.7% post-intervention. During transfer, the responsible nurse remained with the patient in 30.3% of pre-intervention observations compared to 96.1% post-intervention. In addition, clinical handover by the accompanying nurse increased from 51.6% to 93.5%.

The educational intervention was associated with improvement in adherence scores across multiple domains, including patient safety, patient/family communication, documentation, coordination, and equipment/route preparation. These findings suggest that a low-cost, multimodal educational intervention may contribute to improving handover quality in critical care settings. Nevertheless, infection control practices remained an area requiring ongoing reinforcement, highlighting the need for continued quality improvement efforts.

Not applicable.