The impact of an integrated nursing handover system on nurses' satisfaction and work practices

Aims and objectives: This study examined the impact of an Integrated Nursing Handover System" structured content, a minimum data set and an electronic module within the patient clinical information system" on nurses' satisfaction with handover and changes to practice. Background: Poor transfer of patient information between clinicians at handover has been associated with adverse patient outcomes. Design: A mixed methods pre-post evaluative approach was used. Methods: The Integrated Nursing Handover System was introduced and evaluated within an Australian hospital. Changes to nurses' satisfaction were measured using the modified Bradley Clinical Handover Survey (n = 40 pre, n = 80 post). Three focus groups with clinicians (2) and mangers and educators (1) examined changes to clinical practice. The location of handover was observed. Results: Nurses' satisfaction with handover was improved. A two stage approach to handover emerged: nurses received handover of all patients within meeting rooms followed by handover delivered at the bedside. Major categories identified through content analysis included: implementation and the transition, work practice changes and bedside handover, accessible and standardised patient information, accountability for information transfer and a central repository of patient information. Conclusion: An integrated system has been implemented with positive outcomes of: improved nurse satisfaction with handover, nurses being informed about all patients, enhanced patient transfers and improved patient information for all health professionals. Further research into the potential use of stored patient handover data for research is recommended. Relevance to clinical practice: This comprehensive system of nursing handover represents the first integrated system of this nature ever reported in the nursing and health literature. This integrated nursing handover system has been successfully implemented resulting in delivery of more comprehensive, logical and standardised patient information at handover.