In the field of nursing, bedside handover is a procedure performed at a patient’s bedside that involves transferring patient information and patient care responsibilities during a nursing shift change (Spinks et al., 2015, p. 1). The goal of this procedure is to improve nurse to nurse and nurse to patient communication (Eggins & Slade, 2015, p. 197). The result of improving this communication is decreased readmissions and increased patient participation and satisfaction (Kullberg et al., 2018, p. 44). Additionally, research has revealed other advantages such as organizational improvements from improved handover efficiency resulting from the decrease in irrelevant patient information and commencement of direct care which in turn enables nurses to utilize their time more efficiently (Watson et al., 2014, p. 9). The above benefits make it clear that bedside handover is necessary in improving the quality of clinical handovers. Combined with the advantages in clinical and patient outcomes, research had found bedside handover to significantly reduce overtime leading to financial savings (Dorvil, 2018, p. 23).
A structured handover method promotes quality care and enables nurses to gain a comprehensive understanding of the patient and helps strengthen the relationship between nurse and patient leading to patient satisfaction. Bedside handover also averts the likelihood of nurses stereotyping and making uninformed judgements of patients which may introduce negative attitudes in the nursing staff (Kerr et al., 2014, p. 11-12). It is also used as a strategy to enhance patient-centered care (Khuan & Juni, 2017, p. 216). Supporters of this type of handover argue that it helps patients gain insight into their conditions and the medical interventions prescribed by making the patient a part of the handover process (Ofori-Atta et al., 2015, p. 1).  Bedside handover enables nurses to welcome patient involvement in the care plan by providing the patient’s medical report at the bedside. This method has offered solutions to issues associated with other handover methods such as patients having the chance to clarify what they may not understand (Salmon, 2014). By providing a written patient report by the bedside, this process avoids issues that arise from verbal communication only and puts the patient at the center of all care activities. Involved patients gain access to pertinent information that provides then with a speedy comfortable recovery (McMurray et al., 2015, p. 19-20). By having patients discuss and ask questions concerning their health issues, nurses are able to make appropriate and relevant changes to cater to the specific needs of each patient thus improving the quality of care and improving the continuity and consistency of patient care (DeCelie, 2020, p. 123).
The National Safety and Quality Health Service (NSQHS) based on best-practices standards outlines the minimum requirements for a quality and satisfactory clinical handover and the individuals involved in the process. This is done because of the need to have relevant and accurate patient care information transferred and communicated during handovers to ensure high quality and safe patient care. The information required may be different depending on the situation and type of clinical handover occurring. Dot voting is one of the ways to define the minimum pertinent patient information required and it entails the collection of opinions from the entire care team involved about what should be included (Davey, 2015, p. 30). One key action is the documentation of the information needed for bedside handover. This is necessary in order to avoid errors in communication and to standardize the bedside handover. This document should then be made available to all team members involved in the care of a patient to ensure that all relevant personnel are aware of the minimum information required for a bedside handover. This further ensures that everyone is following the best-practice standards. Furthermore, this also allows for clarification of each person’s role in the process and their responsibility in in communicating and receiving this information. Training and orientation are required in order to streamline this process.
Another key action at the bedside handover is environmental awareness. The environment where the handover is happening may lower the bedside handover’s quality particularly in critical care. A stressful setting may cause the nurses to be unwilling to cooperate and interact with the patient or other nurses (Forde et al., 2020, p. 3733). The other action point is to identify the patient by evaluating their history and evaluating their care plan. This ensures that the correct intervention is performed on the correct patient at the planned time and improves patient safety. This requires a minimum of 3 official patient identifiers in line with best-practice standards (RCH, 2021). There also needs a process of accountability to ensure efficient patient flow and management information transfer from one shift to the other and issues associated with planning patient discharge. A safety check is recommended in order to prioritize patient safety at the end of a bedside handover. This may involve documenting and reporting any safety concerns including socioeconomic and environmental factors, risks, alerts or allergies. Tools such as ISBAR and SHARED area available in helping structure the handover process to allow flexibility and adaptation of the workforce and the environment involved (ASCQH, 2019).
In the case study presented, as a graduate nurse in a surgical ward, I would have some questions to the RN before the shift change. The first query would concern the quality of the handover. As discussed above, the environment is a crucial factor in a clinical handover (Tacchini-Jacquier et al., 2020, p. 13). The nursing station, despite being quiet may prove a deterrent due to the many interruptions that happen in a working hospital especially a surgical ward. These distractions may lead to miscommunication of information during the handover process. This would need to be addressed. Second, identification of patients is another crucial factor when it comes to handovers. Despite having the medical reports of the 3 patients, identifying each to their individual intervention ensures the correct procedures are carried out on the right patient. I would ask the RN to have the handover done at the bedside if possible. Finally, I would ask if safety checks have been performed on all the patients. This would enable the incoming team to be aware of aspects that would affect the quality of the handover such as the uncertainty over sensitive information sharing, patient involvement and other environmental challenges such as noisy environments (Hada et al., 2019, p. 5).

References

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