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Abstract

Background:

Clinical handover is the transfer of relevant and important information and responsibility for patient care from one healthcare provider to another. An effective clinical handover is determined by the transition of critical information and the continuity of quality care for the patient. In the inpatient settings, bedside clinical handover mainly occurs during shift changes (morning to afternoon shift, afternoon to night shift and night to morning shift). Bedside clinical handover can take place in a cohort room of up to six patients or a single-bedded room with only one patient. Various nurses in the nursing hierarchy are involved in the handover, each contributing to ensure patients’ safety and continuity of quality care.

Aim:

To explore nurses’ perceptions of bedside clinical handover in an inpatient acute-care ward in Singapore.

Methodology:

An interpretive, descriptive, qualitative study was conducted using focus group interviews with semi-structured questions. The interviews were conducted with 20 nurses from an acute-care hospital in Singapore. The interviews were audiotaped and transcribed verbatim. Data collected were analyzed using thematic analysis.

Results:

Nurses described that bedside clinical handover could potentially compromise patient’s confidentiality and that the patient and/or their family members and the environment were sources of constant interruptions and distractions. Bedside clinical handover also acted as a platform for communication amongst nurses and between nurses and patients.

Conclusion:

This study provided an insight into nurses’ perceptions of bedside clinical handover and offered a foundation for nurses to improve the handover process.

Keywords

Clinical handover nurses inpatient bedside perceptions

Introduction

Clinical handover is a form of communication in the clinical setting which allow nurses to plan and prioritize patient care and manage their workload effectively.^1–3 Clinical handover encompasses the exchange of patient information from one shift to another⁴ and it has been known for benefits such as being a platform for exchange of opinions amongst nurses, expression of feelings, teaching and learning.⁵ Bedside clinical handover was reported to be a patient-centered initiative that enhanced the standards of healthcare and reduced adverse events in the healthcare setting.⁶ The implementation of bedside clinical handover was found to be time-effective, reduced the risks of error and enabled nurses to spend more time with their patients.¹

In Singapore General Hospital (SGH), clinical handover by nurses takes place three times a day, at 0700, 1300 and 2100 hours in the inpatient wards. The bedside clinical handover is a newly introduced system in SGH. Nurses conduct handover in a structured approach by using the acronym RIMMS (Respect, Introduction, Medications, Management and Safety). A typical clinical handover involves the exchange of important information such as patient’s management, medications and discharge plans from one nurse to another. Previously, nurses conducted handover outside patients’ cubicles, away from patients and family members to reduce interruptions and prevent inaccurate information being handed over. With bedside clinical handover, nurses conduct handover at patients’ bedside and are encouraged to actively involve patients and/or family members; however, engaging of patients in handover is not widely practiced in Singapore.⁷

Clinical handover is a platform for transferring important patients’ information and their plan of care. Past research has associated bedside clinical handover with positive effects on patient’s health outcomes and teamwork amongst nurses.⁸ However, differing nurses’ perceptions of bedside clinical handover were mentioned in the literature.

Clinical handover allowed nurses to clarify and receive up-to-date patient information and plan of care to ensure continuity of care.^9,10 In a cross-sectional, descriptive study conducted with 753 nurses from a South Korea hospital, 80.9% of the respondents agreed that clinical handover was a platform for nurses to clarify patients’ information and plan of care that had been provided to the incoming shift nurses. Clinical handover was also a time for the incoming nurses to query the outgoing nurses about things that were unclear.¹¹

Similarly, in another study done with doctors and nurses from a Neonatal Critical Care Unit in Australia, clinical handover was perceived to be a good form of communication which was open, timely and encouraged teamwork between the healthcare workers.¹² However, this study was conducted in a critical care area setting where the nurse–patient ratio, environment and practices may not be the same as compared to the general ward settings.

In another recent study, Yang et al.¹⁰ found that physicians were able to prioritize their tasks better with a good, informative and effective handover. However, disruptions from the environment such as high ambient noises when handing over at the resident room or the nurses’ station were also reported.¹⁰ Likewise, another cross-sectional study conducted in 10 European countries showed that there were too many distractions and disturbances during clinical handover, which resulted in a lack of time to conduct a proper clinical handover and an insufficient exchange of patients’ information.¹³ In addition, 61% of the respondents shared that dissatisfaction with shift handovers was one of the main reasons for nurses wanting to leave the organization.¹³

In general, clinical handovers were associated with positive benefits and gave nurses the opportunity to communicate amongst themselves and ensure continuity of care for the patients. When patients’ information were unclear, nurses were able to ask questions and clarify. However, distractions from the environmental factors could cause disruption, leading to insufficient patient information exchange and lack of time to conduct a proper handover to the incoming shift nurses.

Bedside clinical handover was reported to be the most preferred method for clinical handover. An integrated review concluded that bedside clinical handover was highly recommended as it allowed nurses to conduct clinical handover in the presence of the patient, and some, with the family members.¹⁴ Bedside clinical handover have several advantages, including the promotion of a two-way communication between the outgoing and incoming shift nurses, and between nurses and patients.^15,16 Bedside clinical handover also enabled nurses to have a visual reference of the patient during handover at the patients’ bedside, allowing nurses to be more focused on the vital patient information to handover to the next shift nurses.¹⁵ A multi-site study that observed a total of 15 medical clinical handovers and 33 nursing clinical handovers, showed that bedside clinical handover allowed medical professionals to be more focused with the presence of the patient during the handover; the medical professionals were also able to handover systematically and did not miss out important patient information.¹⁶

Another descriptive survey conducted with nurses reported that bedside clinical handover allowed clarifications and was associated with better patient and staff satisfaction. With the presence of the patient during the bedside clinical handover, it prompted the outgoing shift nurses to handover pertinent patients’ information and also reminded the incoming shift nurses to clarify and ask questions related to the patient and their plan of care.¹⁷

Conversely, a qualitative study carried out in a mental health rehabilitation unit of a hospital in New South Wales, Australia, shared that nurses described shift handover as just a form of communication to handover responsibility to the incoming nurses without having to include the patients.¹⁸ Some nurses believed that bedside clinical handover confused patients with the medical jargons used and patients felt excluded during the handover process, as nurses perceived that patients viewed the nurses to be interacting amongst themselves without involving the patients.¹⁸

Some nurses found bedside clinical handover to be time-consuming and involved frequent interruptions by patients, family members, other healthcare providers and the environment. A quantitative, descriptive study in Scotland also reported negative outcomes from bedside clinical handovers conducted in one Emergency Department. Some 69% of the medical staff felt that handover delayed the transfer of patients onto the trolley in the resuscitation room and 72.7% of the respondents reported insufficient time to conduct an adequate handover without compromising patients’ care. The respondents reported that the delivery of treatment for the patients were delayed because bedside clinical handovers were constantly interrupted by other emergencies in the unit and answering queries from worried and anxious family members.¹⁹ However, the setting and study population of this study focused on the ambulance staff, doctors and nurses from the Emergency Department, which may not be applicable to nurses in the general ward settings.

Past research has shown mixed views of nurses towards bedside clinical handover. The majority of studies were carried out in western countries and none have explored the nurses’ perceptions of bedside clinical handover in a local (Singapore) setting. Handover is a predominant practice in healthcare and problems such as medication errors and delays in treatment can arise from poor communication during handover.²⁰ Hence, a study is much needed to gain an in-depth understanding of the local nurses’ perceptions and experiences of bedside clinical handover and to lay a foundation to improve future bedside clinical handover processes. In this study, we therefore explore nurses’ perceptions of bedside clinical handover in an acute-care inpatient unit in Singapore.

Method

Design

An interpretive, descriptive, qualitative research approach was used to gain an insight into nurses’ understanding and their perceptions of the bedside clinical handover.²¹ Focus group interviews with semi-structured questions were conducted with nurses who met the inclusion criteria.

Participants

Purposive sampling was adopted.²² Nurses of various grades and cultural backgrounds that reflected the staff mix in one acute-medical surgical unit were interviewed. A typical handover involves nurses of various grades and working experiences. Staff involved during a handover include Nurse Clinicians, Registered Nurses (RN), Enrolled Nurses (EN) and Patient Care Assistants, and this can vary from day to day depending on the skills mix required. Having the focus groups with nurses of different grades and experiences will help to stimulate discussions and build on each other’s responses.²³ The inclusion and exclusion criteria of the participants are presented in Table 1.

Table 1.

Inclusion and Exclusion Criteria.

Inclusion criteria	Exclusion criteria
RN or EN with at least one year of experience working as a nurse	Nurses who were not involved in bedside clinical handover
Nurses who were involved in bedside clinical handovers
Nurses who had participated in a bedside clinical handover for at least one month prior to the focus group interview

RN: registered nurse; EN: enrolled nurse.

Data collection

Ethical approval was obtained from the SingHealth Centralised Institutional Review Board and Human Research Ethics Committee of Curtin University. Written informed consent from all participants was obtained prior to the interviews.

A total of four focus groups were conducted with five nurses in each group. The nurses in each group (for example, all RNs or ENs) were homogeneous, to promote a good group dynamic.^24–26 The focus groups were conducted using semi-structured questions (refer to Table 2) to explore nurses’ perceptions of bedside clinical handover.^22,24,27 Another member from the research team acted as the moderator and sat in for all the interviews to assist in guiding the discussions. The focus groups took place in a private room to ensure privacy.

Table 2.

Focus group questions.

Item no.	Sample questions
1	What do you understand of a clinical handover?
2	What are your perceptions of the clinical handover?
3	What are your perceptions of the clinical handover conducted at patient’s bedside?
4	What are some of the good points of a bedside clinical handover?
5	What are some of the bad points of a bedside clinical handover?
6	What do you think of the structured acronym (RIMMS) used during the clinical handover?
7	What do you think of the information about the patient and their care that is handed over during the clinical handover?

RIMMS: Respect, Introduction, Medications, Management and Safety.

Each focus group took between 30 minutes and an hour. Non-verbal cues such as nurses’ body language and expressions were documented. The demographic data of the nurses including gender, grade and years of experience were also collected.

Data analysis

The interviews were audiotaped and transcribed verbatim. After each focus group interview, the researcher and moderator discussed the major themes that emerged. Pertinent themes were then used to inform the next focus group. The transcripts were read over and over to help gain an impression of the data and ensure accuracy. To ensure inter-coder reliability, another team member read and coded the transcripts. Researchers used the paper-based approach to analyze all the data collected. Data saturation was attained when there were no new information or codes emerging from the focus group interviews.

Thematic analysis was adopted to identify, analyze and report themes within the data. A theme was identified when the word or phrase from the data had a relation to the research question.²⁸ Data were coded manually by finding repetitive patterns and consistencies, as documented in the data. Codes helped identify a feature of the data that was interesting to the researcher and had relation to the research question.^28,29 After coding, themes were formed by finding patterns and variations in the data across all participants.^25,26,28 The common themes were identified through repeated reading of the transcripts and searching for meanings and patterns. A thematic map was formed by writing down the codes and themes on separate pieces of paper and organizing them accordingly. The relationship between the codes and themes was then identified.²⁸ Data saturation was deemed achieved when no new information could be found from the data collected. To ensure trustworthiness, an audit trail was used to allow the reader to follow the decision direction of the researcher and how the conclusion was reached.³⁰

Results

A total of 20 nurses participated in the focus group interviews. The majority of the participants were female (95%). Participants interviewed had an average working experience of 10 years. Table 3 summarizes the demographic data of the nurses.

Table 3.

Demographics of participants.

		Number of participants	Average years of working experience
Gender
	Female	19
	Male	1
Grade	Assistant Nurse Clinician	2	22
	Senior Staff Nurse	6	8
	Staff Nurse	7	2
	Principle Enrolled Nurse	2	18
	Senior Enrolled Nurse	1	5
	Enrolled Nurse	2	6

A total of 20 codes were derived and three major themes emerged from the focus group interviews: (1) Confidentiality can be compromised, (2) Disturbances during bedside clinical handover, and (3) Impact of bedside clinical handover on communication between nurse-nurse and nurse-patient. The subthemes are further illustrated in Table 4.

Table 4.

Themes and Subthemes.

Themes	Subthemes
Confidentiality can be compromised	Potential breach of patient confidentiality Request for secrecy Misinterpretation of information
Disturbances during bedside clinical handover	Interruptions and distractions Time taken to handover Companion
Impact of bedside clinical handover on communication between nurse–nurse and nurse–patient	Nurse–nurse Nurse–patient

Theme 1: confidentiality can be compromised

Bedside clinical handover required the outgoing nurse to handover to the incoming nurses at the patient’s bedside. The afternoon clinical handover at 1300 hours coincided with the visiting hours of the hospital, which is from 1200 hours to 1400 hours. As clinical handovers were conducted at patients’ bedsides, nurses spoke of several difficulties encountered when conducting clinical handover, especially during visiting hours, such as (1) potential breach of patient confidentiality, (2) request for secrecy and (3) misinterpretation of information.

Subtheme 1: potential breach of patient confidentiality

With bedside clinical handover, sensitive and confidential patient’s information was discussed in the presence of other patients and their family members, especially when handover took place in a shared cubicle. Other patients or relatives might hear their conversation, thus resulting in the potential breach of patient confidentiality. Nurses explained that patients or relatives do interact with other patients in the shared cubicle and may accidentally talk about the patient’s diagnosis aloud.

I have been through both, you handover at the bedside…if I’m the relative, I also want to listen to what you’re [nurses] talking about my mother or my relative…I think everybody is listening to it. (Assistant Nurse Clinician, Focus group 2)

It’s actually not really confidential because you know it’s like a bit open area…like four bedded…when you are talking about the patient then another relative they will listen. (Senior Staff Nurse, Focus group 4)

Subtheme 2: request for secrecy

Some patients or family members may request not to reveal certain information for various reasons; however, this was usually important information that had to be handed over to the incoming shift nurses. With bedside clinical handover, nurses shared that such information could be easily overheard during the handover:

You’re passing about Patient A, but Patient A might not want their friends to know about their condition…they [friends] are there [during bedside clinical handover] and they might be able to hear. (Assistant Nurse Clinician, Focus group 2)

Some patient wish their diagnosis not to be revealed or to be discussed…especially in those four-bedded room. (Assistant Nurse Clinician, Focus group 1)

Subtheme 3: misinterpretation of information

Nurses identified that other patients or family members who were present in the shared patient cubicle during the bedside clinical handover could listen to other patient’s confidential information. This may lead to an increase in unnecessary fear and anxiety due to poor understanding and misinterpretation of other patient’s information.

They were talking about patient A maybe…diagnosis of dengue fever. So (the patient) opposite of patient A …straight away very scared…I think very paranoid about whether the dengue fever will be passing over to him or not. (Enrolled Nurse, Focus group 3)

Theme 2: disturbances during bedside clinical handover

Clinical handovers conducted at the patients’ bedsides were depicted to be constantly interrupted by patients’ requests, family members asking for updates on the patient’s medical condition and their treatment plans, healthcare personnel and even the environment itself, such as the medical equipment.

Subtheme 1: interruptions and distractions

Bedside clinical handover was described as challenging and disruptive, as nurses were often interrupted by patients’ requests, answering family members’ enquiries or even by their own colleagues. Nurses felt obliged to attend to the patients’ needs when being called. In addition, the nurses found that family members tended to approach nurses during bedside clinical handover requesting to be updated on the patient’s condition and their treatment plans as the nurses were all available and seen in the room.

They [caregivers] miss the doctors’ round right, then only when passing report that time…that’s the only perfect time when they can catch us and ask about their family members about the patient’s condition. (Staff Nurse, Focus group 4)

They [patients] will ask you for convenience sake because you were there. They will ask you err can you pour me a glass of water? Nurse what is this thing for? Nurse could you help me draw the curtain? All these kind of small things and make the handing over being interrupted very frequently. (Assistant Nurse Clinician, Focus group 1)

Besides human factors, the physical environment also added to the interruptions and distractions during a bedside handover. Nurses revealed that it could get very noisy in the room during visiting hours or they had to attend to medical equipment which emitted a “beeping alarm”.

When we are passing inside the room so at times we have…like four to five nurses taking over report and when we are passing over, it’s still visiting hours. So when there are a lot of visitors in the four bedded room and we pass report, it can become very noisy… because we are like trying to compete with each other to talk louder. (Staff Nurse, Focus group 1)

Nurses also expressed that with the frequent interruptions and distractions, critical patient information was missed out during the handover. Nurses suggested to have protected time to conduct a proper clinical handover without compromising the patient’s needs and with no disturbances from family members, visitors or healthcare personnel. They felt that with no interruptions and distractions from the patients and surroundings, the clinical handover would be holistic.

Information tends to be skipped…you might not remember where you exactly stopped and then sometimes…at the back of the mind you might have wanted to say something and that’s also disrupted. (Staff Nurse, Focus group 1)

Nurses perceived that patients’ rests were disrupted when they handover at the patient’s bedside. Nurses spoke of bedside clinical handover being too noisy and disruptive to the patients’ rest time. Nurses also felt that they were being watched all the time by other patients and family members during the bedside clinical handover, causing them to feel uneasy most of the time.

So when there are a lot of visiting visitors in the four bedded room and we passing report can become very noisy. So let’s say for a patient who has got no visitors or who wants to rest can’t manage to sleep because it’s so noisy it’s like almost like a market kind of setting. (Staff Nurse, Focus Group 1)

Subtheme 2: time taken to handover

With bedside clinical handover, patients’ involvement, interruptions and distractions were inevitable. Nurses found that bedside clinical handover was more time consuming and caused delay in rendering care and treatment to the patients.

It’s quite comprehensive…sometimes when we want to achieve this comprehensive of the whole information about the same patient you spent a lot of time. I found it quite time consuming. (Assistant Nurse Clinician, Focus group 1)

Theme 3: impact of bedside clinical handover on communication between nurse–nurse and nurse–patient

Bedside clinical handover is not only a platform for communication between nurses, but also with the patients and their family members. Nurses spoke of the advantages and disadvantages of handover by the patients’ bedside.

Subtheme 1: nurse–nurse

Bedside clinical handover was believed to be a good platform for nurses to communicate with each other to ensure the continuity of care for patients, clarify doubts and to allow a visual reference of the patient during handover. With the presence of a patient and/or their family members during the bedside clinical handover, the outgoing nurses were reminded of important details and information to handover to the incoming nurses. The incoming nurses were also able to visualize and clarify when unsure of the information being handed over.

Patient is practically there so if like a drip we are passing over we can just take a look at one glance…we know that is it already halfway there or finishing or it’s not running at all…rectify it there and then. (Staff Nurse, Focus group 1)

However, nurses perceived that they were viewed as “unprofessional” by patients, family members and/or visitors when conducting bedside clinical handover. Nurses felt that they were viewed as making small talk amongst themselves, instead of conducting a clinical handover. Some nurses mentioned that they tend to giggle and laugh during the bedside clinical handover. They felt as if they were exposing themselves to the patients and their family members and were susceptible to negative impressions from the patients and their family members.

Sometimes we like giggle you know when we pass report … or maybe the body posture, the way we stand also can affect how they see us. (Senior Staff Nurse, Focus group 1)

Subtheme 2: nurse–patient

Bedside clinical handover was a platform for patients to communicate with nurses. Patients were able to inform nurses of their preferences and feedback to the team of nurses regarding the result of their treatments. Similarly, nurses were able to update patients about their plan of care and conduct patient education during the bedside clinical handover.

This is also a platform for the patient to communicate with healthcare worker or communicate with nurses what they need or what they understand of their care and management. (Assistant Nurse Clinician, Focus group 1)

However, nurses verbalized that not all patients wanted to be involved in the bedside clinical handover, as handover was perceived as a job for the professionals. A nurse described her encounter with a patient who preferred not to be involved in the bedside clinical handover: “The patient said you [the nurse] don’t need to involve me and I got my own schedule” (Assistant Nurse Clinician, Focus group 1).

Discussion

Nurses in this study conveyed that bedside clinical handover can cause a potential breach of patient information when handed over in the presence of other patients and family members. This study was conducted in a general ward, where not all patients were in a single room. Hence, nurses had to handover sensitive information outside the cubicle so that other patients, family members or visitors could not hear their conversation. A recent review showed that nurses were more concerned about patient confidentiality issues than the patients themselves.³¹ Other researchers have also presented similar findings where a patient’s confidential information was handed over to the incoming shift nurses away from the patient area.^1,32 Another descriptive qualitative study conducted in medical and surgical wards also showed that the nurses and midwives were concerned about patients’ confidential information being disclosed during a bedside clinical handover. The nurses in that study shared that they protect patient confidentiality and privacy by pointing at important patient information in the patient’s notes, speaking softly when handing over vital confidential information, asking visitors to leave the room and disclosing sensitive information outside the patient’s room.⁶

Then again, Manias et al.³³ reported that healthcare professionals were able to deliver an effective handover when conducted at the patient’s bedside as compared to a non-bedside handover. With patient and family members’ involvement in the bedside handover, the healthcare professionals were able to better understand the patient’s perspective.³³ Likewise, Bradley and Mott³⁴ found that both patients and staff perceived the bedside clinical handover to be a patient-centered-care approach towards handover. Patients preferred the bedside clinical handover over the closed-door office handover approach as it let them know who the healthcare providers looking after them were, and patients felt included in the handover when discussing matters that were related to their care.³⁴

The nurses in this study stated that interruptions from other patients, family members and healthcare personnel, as well as the presence of “beeping” equipment, were the main sources of disruptions and distractions during bedside clinical handover. These issues were mentioned in other research studies as a concern, but researchers argued that patient safety was not compromised when clinical handovers took place at the patient’s bedside.^35,36 Tobiano et al. found that bedside clinical handovers allowed caregivers to have better interactions with the nurses, understand the patients’ situation better, and better prepare patients for their discharge from the hospital.³⁷ In addition, the outgoing nurse would be reminded of the important information to handover, as the presence of the patient would prompt them on the key information. Clarifications can also be made immediately during the bedside clinical handover, which helps to prevent potential adverse events. The distractions from equipment, such as the beeping equipment, allowed nurses to check if the equipment was faulty. Hence, this could prevent any potential medication errors as well.

Nurses from this study also felt that with the constant interruptions and distractions, bedside clinical handover became very time consuming, thus causing a delay in the delivery of care.³⁸ Similarly, another observational study on bedside clinical handover in the ICU showed that colleagues and alarming intravenous pumps were the most frequent interruptions during the bedside handovers. These interruptions and distractions that occurred during the bedside clinical handover were also perceived to cause the loss of vital information and led to adverse patient events.³⁹ Despite that, other researchers found that some nurses viewed bedside clinical handovers to be more time-effective.^1,40 An observational study which timed the handover conducted at the patient’s bedside and compared it to the time taken for handover in the office concluded that bedside clinical handovers were prompt and right on point as compared to those conducted in the office, as nurses tended to create small conversations amongst them.¹

Besides being time consuming, nurses in this study felt that they were viewed as behaving unprofessionally during bedside clinical handover. One study that looked at patients’ perceptions of bedside clinical handover also suggested that nurses were often viewed as unprofessional during bedside clinical handover.⁴¹. To avoid such comments, nurses need to portray a professional image; not only in their physical appearance, but also through their knowledge of the patient’s condition and the treatment plans, involving the patient and/or their family members during the bedside clinical handover.

Our nurses alluded to bedside clinical handover being a good platform of communication amongst nurses and between nurses and patients and/or family members. Bedside clinical handover allowed nurses to check on their patients and clarify any doubts to ensure the continuity of care.¹⁴ Previous researchers agree that bedside clinical handover allows nurses to handover in a structured manner as nurses are able to see the patient, thus reminding them of the important patient information to handover to the incoming nurses.^13,42 Moreover, bedside clinical handover was reported to promote both nurse and patient satisfaction, with better communication during the process.⁴³

However, not all patients wanted to participate in the bedside clinical handover.^41,44 To some patients, clinical handover was perceived as a job for the professionals and there was no need for them to be involved. Nurses in this study described that some patients verbalized their request not to be involved in the clinical handovers conducted at the patient’s bedside, as they would prefer to do other thing such as rest or attend to visitors and/or family members. Lu et al.⁴⁵ explained that patients were not keen to listen in on clinical handovers, mainly because they did not want to hear about other patients’ health information, as the individual patient might feel uncomfortable after knowing the other patients’ diagnosis. However, patient involvement was reported to be one of the important components in a clinical handover in addition to the quality of information exchanged, the interaction and support from the nurses, and the efficiency of the clinical handover. In the same study, the nurses surveyed also agreed that that patient involvement was an important component to ensure a good and effective clinical handover.⁴⁶ To avoid patients declining to participate in the bedside clinical handover, nurses should explain to patients and their family members the importance of the clinical handover, in order to attain agreement from patients and/or family members to be involved in bedside clinical handover.^45,47

Limitations

Participants in this study were recruited from one ward of an acute tertiary hospital, and may only reflect the perceptions of that clinical area. This unit mainly received patients with a higher socio-economic background, and, hence, patient’s expectations with regards to participation in clinical handover and nursing care may differ from patients in other units. Findings from this qualitative study may be not generalized to other settings.

Conclusion

This study provided insights into nurses’ perceptions of bedside clinical handover and the challenges faced by the nurses during the bedside clinical handover. Nurses in this study identified both the advantages and disadvantages of bedside clinical handover from the nurses’ perspective. Research into the nurses’ perceptions of bedside clinical handover, in general, had differing views and a field of enquiry that was not fully developed. This was illustrated by the lack of consistency in the nurses’ perceptions of bedside clinical handover of the participants in this study compared to some of the studies that were reviewed. Future studies should look into the three major themes that were determined from the interviews in this study, and help the nursing community to improve practices in bedside clinical handover.

Footnotes

Acknowledgements

The authors thank Dr Ruth McConigley, Ms Jo Zhou and Senior Nurse Manager Ang Shin Yuh for their support and guidance.

Declaration of conflicting interests

None declared.

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

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Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study

Abstract

Background:

Aim:

Methodology:

Results:

Conclusion:

Keywords

Introduction

Method

Design

Participants

Data collection

Data analysis

Results

Theme 1: confidentiality can be compromised

Subtheme 1: potential breach of patient confidentiality

Subtheme 2: request for secrecy

Subtheme 3: misinterpretation of information

Theme 2: disturbances during bedside clinical handover

Subtheme 1: interruptions and distractions

Subtheme 2: time taken to handover

Theme 3: impact of bedside clinical handover on communication between nurse–nurse and nurse–patient

Subtheme 1: nurse–nurse

Subtheme 2: nurse–patient

Discussion

Limitations

Conclusion

Footnotes

Acknowledgements

Declaration of conflicting interests

Funding

References