General Surgery
Conditions
Brief summary
Nursing handovers are performed 2-3 times a day for each patient, with an approximate average of 2 million nursing deliveries per year in a hospital of medium size. Nursing handovers are considered essential for the continuity and safety of care. If the relevant clinical information is not shared in a precise and timely manner, it may worsen the patients' outcomes with an increase in adverse events, delays or inappropriate treatment until the omission of procedures. The modality of nursing delivery presents, therefore, a gap of vulnerability where vital information could not be considered and systematically shared. Patients should be involved in their care to promote a patient-centred approach. The involvement of patients in handovers is effective compared to other delivery methods. To date, however, the best mode to deliver handovers was still unclear due to a systematic lack of studies to identify the best practice of nursing handovers. The studies in the literature lack of sound methodologies due to not randomized designs. Thus an intervention to improve quality of handovers and to implement bedside handovers in surgical wards will be performed. The following hypotheses were made: * The introduction of nursing bedside handovers will improve the quality of the information exchanged. * The educational intervention training intervention will positively modify the nursing handovers. * There is a relationship between the qualitative level of nursing handovers and working status (expert vs novice) of the nurses. * There is a relationship between the qualitative level of nursing handovers and the patients' characteristics.
Interventions
BEHAVIORALEducation for improving handovers quality
Specific education on the importance of handovers quality will be provided. The educational session will last 4 hours. The program will be divided into the following sections: 1) a structured survey on the perception of the participants on the handovers importance; 2) Key theoretical concepts on the relevance of handovers with case studies of errors related to this critical moment; 3) showing movie clips of nursing handovers to critically interpret the clips by the participants; 4) presentation of the SBAR method recommended by WHO; 5) general presentation of the nursing delivery assessment project of the Valduce Hospital.
BEHAVIORALEducation for improving bedside handovers
In addition to the education for improving handovers quality, the following intervention will be implemented for nurses assigned to the study department. The course will be supplemented by a section of the duration of an hour, containing 1) information on the principles underlying bedside handovers; 2) how to handle information in front of the patient and on his / her direct involvement; 3) role-playing of the bedside handover will be performed, assigning the roles of nurse and patient among the participants to bring out impressions linked to the functions.
Sponsors
Valduce Hospital
University of Eastern Piedmont
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
HEALTH_SERVICES_RESEARCH
Masking
DOUBLE (Subject, Investigator)
Eligibility
Sex/Gender
ALL
Age
18 Years to 99 Years
Healthy volunteers
No
Inclusion criteria
* Surgical patients * All nurses working with surgical patients who attended the educational intervention
Exclusion criteria
* Nurses who did not participate in the educational intervention * Nursed who did not operate stably in the surgical wards included in the study * New hired nurses
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in handover quality | Baseline, at 1 month after intervention, at 6 months after intervention | Handoff CEX (Clinical Examination) \[3-9 overall on 6 items about setting, organisation, communication, content, judgment, professionalism; 3 worst - 9 best\] |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Handover length | Baseline, at 1 month after intervention | Time x handover |
| Missed care / procedures / diagnostic tests | Baseline, at 1 month after intervention, at 6 months after intervention | Number of missed care / procedures / diagnostic tests |
| Patients satisfaction | Baseline, at 1 month after intervention, at 6 months after intervention | Visual Analogic Scale for satisfaction \[0-10; 0 worst - 10 best\] |
Countries
Italy
Outcome results
None listed