Ineffective communication during nurse-to-nurse handoffs can jeopardize patient safety and continuity of care. The purpose of this pretest-posttest quasi-experimental study was to examine the effect of an electronic health record-prepopulated nurse handoff tool on communication, efficiency, and patient experience. Nurses' perceptions of information completeness, handoff duration, and overall experience were examined, followed by patients' satisfaction with nurse communication obtained from the Hospital Consumer Assessment of Healthcare Providers and Systems survey. Independent-sample and Welch t tests were used to evaluate changes in information completeness, handoff duration, and overall satisfaction. The results suggested the prepopulation of critical patient data likely reduced omissions and errors, contributing to perceived information completeness. The decrease in handoff time also suggests potential for workflow improvements, efficiency, and increased nurse satisfaction. Nurses reported significant improvements in capturing critical information, information clarity, timely completion, overall satisfaction, and reduced handoff time. Most notably, this intervention led to a substantial 20.10% increase in patient satisfaction with their nurses' ability to "always" explain things clearly, as measured on the Hospital Consumer Assessment of Healthcare Providers and Systems nurse communication domain question. Standardized electronic health record-prepopulated handoff reports hold promise for optimizing nurse handoff communication and efficiency.

Background: Nursing internship students often lack the necessary clinical decision-making skills, confidence, and experience due to limited competence. To ensure safe and high-quality care, nursing faculty must train graduates with the self-efficacy required to make effective decisions in complex, dynamic, and high-stress healthcare environments. The handover process involves the information that plays a critical role in clinical decision-making and care planning. One of the frameworks used in handover process is ISBAR (Identification, Situation, Background, Assessment, Recommendation). The clinical supervision model serves as an educational and supportive approach aimed at enhancing self-efficacy and skills, including the use of handover.

Objective: This study aimed to investigate the impact of an ISBAR-based Clinical Supervision Model (CSM) during handover on clinical decision-making and self-efficacy in nursing internship students.

Method: This quasi-experimental, two-group (pre-test and post-test) study was conducted in selected hospitals affiliated with Isfahan University of Medical Sciences, Iran, in 2024. Participants were selected through convenience sampling and then randomly allocated to either the intervention or control group. Data were collected using the ISBAR communication checklist, the Self-Efficacy in Clinical Performance (SECP) questionnaire, the Clinical Decision-Making questionnaire, and the Manchester Clinical Supervision Scale (MCSS). The clinical supervision model and routine supervision were administered over six sessions for the intervention and control groups, respectively. Data were analyzed using SPSS version 16. Independent t-tests and chi-square tests were used to assess baseline differences between groups. Paired t-tests evaluated within-group changes in clinical self-efficacy and clinical decision-making scores. ANCOVA was applied to compare ISBAR communication scores across six time points and post-intervention clinical self-efficacy and decision-making scores, controlling for pre-intervention values. Repeated measures ANOVA assessed within-group changes in mean ISBAR scores over time, while MANOVA examined multiple, interrelated ISBAR subscale scores. A significance level of p < 0.05 was set for all analyses.

Results: There were no significant differences in baseline characteristics between the intervention and control groups (p > 0.05). According to the within-group analysis, changes in the ISBAR communication scores over time were significant in both the intervention and control groups (p Time < 0.001), with a greater increase observed in the intervention group (p Intervention < 0.001). The intervention group demonstrated a significant improvement in clinical decision-making (p < 0.001) compared to the control group. Clinical self-efficacy showed significant improvement in both the control and intervention groups after the intervention (P < 0.05). However, between-group analysis showed that the increase was higher in the intervention group than in the control group (P < 0.001).) The mean score of the Manchester questionnaire in the intervention group in this study was 130.30, reflecting the high impact of implementing the clinical supervision model.

Conclusion: The findings revealed that the use of the clinical supervision model based on the ISBAR framework led to improvements in clinical self-efficacy and clinical decision-making, alongside the enhancement of handover skills in nursing internship students. Therefore, it is recommended that this model be utilized in the education of nursing students and newly graduated nurses to ensure safe and high-quality care.

Background: Effective nurse bedside reports are critical for patient safety, yet internal reviews have revealed issues that should have been addressed during these handoffs. A novel Reverse Report Simulation was designed to identify gaps in information gathering and enhance nurse prioritization of bedside assessments.

Method: This was a pre and post survey design surrounding a simulation. The simulation mimicked a patient room, requiring nurses to gather information from direct assessments and provide a verbal report. Preand postsimulation surveys ranked four information sources: the electronic health record (EHR), nurse verbal reports, patient and family input, and patient and environment assessment.

Results: Before the simulation, the EHR was the most valued information source, particularly among Generation Z nurses. After the simulation, 93% of participants of any generation shifted to ranking patient and environment assessments as the most valuable source. Nurse verbal reports remained the least valued source pre- and postsimulation.

Conclusion: The findings suggest that while nurses perform bedside reports, they may prioritize electronic records over direct patient assessment. This trend may be influenced by the increasing presence of technically savvy Generation Z nurses. The simulation highlighted the need for improved education regarding bedside report and understanding generational differences when providing education. [J Contin Educ Nurs. 2025;56(6):245-249.].

Objective: To uncover the factors that deteriorate the work environment during shift exchanges.

Method: This is a qualitative, descriptive-analytical study using the phenomenological method, based on Elton Mayo's human relations theory. The setting was a second-level hospital. A total of thirty-two participants were included. The social actors included were general nurses, specialists, and service managers. Data collection was carried out using interviews and non-participant observation techniques, conducted in September-October 2021. Data analysis was performed in three stages: epoché, description, and horizontalization. The chromatic technique was used for analysis.

Results: The main findings converge into three categories: workload, as it affects the quality of care; absenteeism, which increases handover time; and interpersonal relationships, which influence the handover process. Observations allowed for the creation of a shift exchange model represented by a flowchart and a patient reception instrument.

Final considerations: Workload and interpersonal relationships directly influence the work environment.

Background: Hospitalizations are common among people with substance use disorders (SUD). Transitioning to follow-up medical and SUD care after discharge is a complex process affected by numerous medical, environmental, and psychosocial factors. Little is known about the experiences of patients with SUD during post-hospitalization care transitions.

Objective: We sought to better understand the care transition experiences of people with SUD in the immediate post-hospitalization period.

Design: We conducted a qualitative study at a single academic hospital site.

Participants: We interviewed 25 recently hospitalized individuals with a SUD.

Approach: Participants were recruited during their hospitalization, and semi-structured interviews were completed via telephone 1-3 weeks after hospital discharge. Interviews were transcribed verbatim and coded. Thematic analysis was performed to inductively extract key themes from coded transcripts.

Key results: We identified six themes pertaining to post-hospitalization care transition experiences: (1) the timing and circumstances of hospital discharge were often unpredictable, which could be destabilizing for patients; (2) careful planning and thorough communication by hospital care teams at discharge were valued by patients but happened inconsistently; (3) substance use disorder treatment was desired and offered frequently via a spectrum of active and passive approaches; (4) patients faced multifarious challenges to following through with a care plan after discharge; (5) community supports and a sense of connection are key facilitators of SUD and medical care linkage after hospital discharge; and (6) proactive outreach, individualized care plans, and continuity of care are valued during post-hospitalization care transitions.

Conclusion: Our themes suggest several distinct and actionable steps to improve post-hospitalization care transitions based on the perspectives of people with SUD who were actively transitioning care. In the hospital, SUD treatment initiation, proactive planning around discharge, and predictability were valued. In the outpatient setting, a supportive community, assistance with basic amenities, and post-discharge outreach were valued.

Background: Effective patient handoffs are critical for maintaining patient safety and care continuity in healthcare settings. This quasi-experimental study aimed to assess the impact of an educational intervention on improving nursing handoffs in Katsina State Public Hospitals.

Methods: Conducted over 13 months, the study targeted registered nurses at General Hospital Katsina, comparing outcomes with those from General Hospital Funtua. A six-session educational program was implemented, and participants' perceptions were assessed before, immediately after, and during follow-up using the "Hospital Staff Views of Patient Handoffs" questionnaire.

Results: The facilitator-led intervention group, predominantly female (75.5%) and mostly aged 30-39 and married (86.7%), demonstrated a significant improvement in mean scores across three time points: pre-intervention (3.05 ± 0.32), immediately post-intervention (3.43 ± 0.45), and at follow-up (3.34 ± 0.40), with p < 0.001. Between-group analyses indicated a significant difference in outcomes (p < 0.001), with the facilitator-led intervention group consistently achieving higher scores than the self-directed education group. Post-hoc comparisons revealed significant mean differences between pre- and post-intervention assessments (-0.38, p < 0.001) and between pre-intervention and follow-up assessments (-0.29, p < 0.001). Despite a slight decline at follow-up, the positive impact of the educational intervention remained statistically significant.

Conclusion: This study highlights the enduring positive effects of educational interventions on nursing handoffs and patient safety perceptions. It underscores the importance of ongoing education in cultivating a culture of safety within hospitals, emphasizing the need for sustained efforts to enhance patient handoff practices and improve overall patient care.

Background: Risk assessment tools are intended to support nurses' decision-making in the continuous Nursing Process of comprehensive assessment, planning, implementation and evaluation for each patient in their care. While patient distress is common during periods of ill-health, tools to formally assess distress are not routinely used by nurses.

Aim: The purpose of this study was to explore the utility of the distress thermometer by nurses for general medical and surgical inpatients.

Methods: An audit of 2370 electronic medical records was used to extract data on risk assessment completion for adult patients admitted across three wards from December 2020 to March 2021. An online survey using the System Usability Scale and free-text comments collected data on nurses' perceptions of the Distress Thermometer.

Results: Only 33% of patients had the Distress Thermometer tool completed by nurses during patient risk assessment on their admission to the hospital ward (393/2370). Only 12.86% of nurses reported scores indicating acceptable usability of the Distress Thermometer in electronic medical records (greater than 68). Distress Thermometer completion was significant between wards (chi-square analysis X² (2, N = 2,370) = 84.902, p = <.001). Factors contributing to low usability included unnecessary addition to their workload and tool perceived as not useful to care planning.

Discussion: Nurses reported the Distress Thermometer was an unnecessary addition to their workload and not perceived to add any value to patient assessment in general medical and surgical inpatients.

Conclusion: Nursing risk assessments in electronic medical records carry a high workload burden. The perceived usability, usefulness and suitability for specific patient groups are important considerations for uptake and implementation of any additional tools.

Background: A nurse's clinical handover is an important and complex form of communication in healthcare organizations that involves the exchange of patient-related information during shift change. Nurse-to-nurse clinical handover is frequently implemented at inpatient and emergency units, with an increased risk of information loss. Ineffective clinical handover is responsible for about 80% of the causes of serious, preventable adverse health events. However, the evidence is unknown in Ethiopia, particularly in the study setting. Therefore, this study aimed to explore the lived experience of clinical handover among nurses working in the Jimma Medical Center in South Western Ethiopia in 2022.

Method: This study employed a descriptive phenomenological approach to explore the lived experiences of nurses in medical, surgical, and emergency outpatient departments. Data collection occurred between July 1st and August 31st, 2022. Nine nurses, purposively selected for their diverse experiences, participated in individual, semi-structured, in-depth interviews. To provide additional context, five key informants were also interviewed. Additionally, twenty non-participatory observations were conducted. Interview recordings and field notes were transcribed verbatim and analyzed using Colaizzi's seven-step method, facilitated by Atlas.ti 8 software. Rigor was ensured through adherence to Lincoln and Guba's criteria for trustworthiness. Findings are presented through thematic narratives supported by direct participant quotations.

Result: Analysis of the data revealed three emerged core themes of the clinical handover experience: i) "Inconsistent, non-standardized handover processes and content"- with subthemes:"communication styles","location of handover","time of handover", "the content of handover","patient involvement", and"handover responsibility." ii) "Obstacles to consistent handover", with subthemes such as" healthcare system-related factors", "care provider-related factors", and "patient's health status-related factors". iii) "Negative impacts on patients from inconsistency in handover." All participants reported that ineffective clinical handover was harming the holistic quality of nursing care.

Conclusion: This study found that consistent and standardized clinical handover practice has a significant deficit, which was affected by obstacles related to nurses, the organizational healthcare system and the patient's health status. Therefore, tailored intervention is needed to improve the clinical handover in nursing practice.

Interdisciplinary communication is a critical component of quality patient care. On emergency medical services (EMS) arrival to the emergency department (ED), the pre-existing opportunity-based reporting (OBR) handoff paradigm may result in disjointed, repetitive and incomplete transition of patient care to the ED, adversely impacting patient care. This quality improvement study was conducted at a tertiary care, academic university hospital ED and evaluated the impact of team-based reporting (TBR) during EMS patient handoff in the ED on several markers of clinical efficiency (CE). The standard OBR handoff protocol was compared with the TBR protocol, which brings the patient's ED care team to bedside shortly after patient arrival, allowing EMS to give a single, synchronous handoff. The use of TBR during prehospital-ED handoffs was associated with statistically and clinically significant improvement across multiple CE quality indicators. A team-based handoff strategy is a low-cost policy intervention that provides meaningful improvements related to CE and quality care.

Background: In the context of patient handovers, there is a consensus on the importance of utilizing standardized forms, yet comprehensive evidence on the effectiveness of complex nursing interventions in post-use evaluations is lacking, especially regarding their impact on short-term, long-term and patient outcomes.

Objective: This study aims to assess the feasibility, implementation and impact of interventions designed to enhance the effectiveness of patient handovers among nurses.

Methods: This quasi-experimental, complex nursing intervention development study investigated patient handover practices in general surgery intensive care units, internal medicine and general surgery clinics. The study utilized the Handoff CEX, standard patient handover form to categorize effectiveness, Newcastle Satisfaction with Nursing Care Scale and Trust in Nurses Scale.

Results: Analysis of the Handoff CEX total and Newcastle Nursing Care Satisfaction Scale and the Trust in Nurses Scale mean scores, showed a statistically significant increase.

Conclusion: Nurses and educators can adopt complex nursing intervention practices for patient handovers in both current practice and future research. Standardizing patient handovers will contribute to increased patient safety and satisfaction.

Implications for the profession and/or patient care: From a professional standpoint, this study emphasizes how crucial it is to use standardized interventions during patient handovers since they've the ability to improve patient outcomes, nursing practices and serve as guidelines for future research.

Impact: It is widely acknowledged that the establishment of standardization is crucial for attaining improvement in patient handover. The results of this study revealed that non-standardized handovers lead to limited transfer of information. The research findings show the use of intricate nursing interventions during patient turnover can augment the efficacy of permanent handover, so causing better patient outcomes.

Reporting method: The guidance for CReDECI 2 was followed throughout this study.

Patient or public contribution: While nurses work in the clinics where the research was conducted, patients receive treatment and care at the same places. Patients and nurses who have the inclusion criteria were included in the study.

Trial registration: NCT06468631.

Background: In-hospital handover of patient care is an essential but high-risk professional activity that often lacks transparency for patients. The purpose of this survey was to gain insight into surgical patients' perceptions of handover communications between doctors, incorporating patient and public involvement to enhance accessibility and understanding.

Methods: A cross-sectional, mixed-methods survey was developed with patient and public involvement and distributed to general surgery patients in two University Teaching Hospitals between 24 October 2023 and 21 July 2024. Comparative analyses of quantitative data were performed using McNemar's test for paired nominal data and Wilcoxon rank-sum test for continuous data. Free-text responses underwent thematic analysis to validate and expand on quantitative findings. Patient and public involvement partners contributed to study design, methodology, and the final manuscript.

Results: In total, 208 responses were received (52.3%). Significantly more patients reported having prior knowledge of nursing handovers (73.1%) compared to doctors' handovers (63.9%; x² = 14.53, p = 0.0002). Patient perceptions of the handover process were generally positive; although satisfaction declined significantly with weekend handovers (p < 0.05). Thematic analysis identified four themes: (1) the impact of poor inter-professional communication, (2) the importance of teamwork, (3) external factors influencing handover effectiveness, and (4) patient nonchalance about their care. The use of patient and public involvement in this study improved survey accessibility and understanding of the concept and importance of handover.

Conclusions: This study shows limited prior awareness of handover between doctors among surgical patients, especially the potential hazards that can arise if performed poorly. Patient and public involvement improved accessibility and understanding of the topic; however, challenges such as adequate training for meaningful engagement remain.

Background: Handoffs are a weak link in the chain of clinical care of inpatients. Within-unit handoffs are increasing in frequency due to changes in duty hours. There are strong rationales for standardising the reporting of critical information between providers, and such practices have been adopted by other industries.

Objectives: As part of Making Healthcare Safer IV we reviewed the evidence from the last 10 years that the use of structured handoff protocols influences patient safety outcomes within acute care hospital units.

Methods: We searched four databases for systematic reviews and original research studies of any design that assessed structured handoff protocols and reported patient safety outcomes. Screening and eligibility were done in duplicate, while data extraction was done by one reviewer and checked by a second reviewer. The synthesis of results is narrative. Certainty of evidence was based on the Grading of Recommendations Assessment, Development and Evaluation framework as modified for Making Healthcare Safer IV.

Results: We searched for evidence on 12 handoff tools. Two systematic reviews of Situation, Background, Assessment, Recommendation (SBAR) (including 11 and 28 original research studies; 5 and 15 were about the use in handoffs) and two newer original research studies provided low certainty evidence that the SBAR tool improves patient safety outcomes. Ten original research studies (about nine implementations) provided moderate certainty evidence that the I-PASS tool (Illness severity, Patient summary, Action list, Situation awareness, Synthesis to receiver) reduces medical errors and adverse events. No other structured handoff tool was assessed in more than one study or one setting.

Conclusion: The SBAR and I-PASS structured tools for within-unit handoffs probably improve patient safety, with I-PASS having a stronger certainty of evidence. Other published tools lack sufficient evidence to draw conclusions.

Prospero registration number: CRD42024576324.

Objective: To design and evaluate the model combining ISOBAR communication tool with case teaching method, and to explore its influence on the nursing handover level, clinical work ability, nursing teaching quality and nurses' satisfaction of pediatric resident nurses.

Methods: A total of 84 pediatric resident nurses were selected by random sampling and divided into the experimental group (n = 40) and the control group (n = 44). The experimental group implemented the ISOBAR combined with case teaching method, while the control group adopted the traditional lecture method combined with case teaching method. After 2 months of pediatric standardized training, the nursing handover level was evaluated by the Nursing Assessment of Shift Report (NASR) scale, the clinical nursing ability was evaluated by the pediatric and hospital-wide standardized training assessment results, the teaching satisfaction and willingness to continue in nursing work were evaluated by a 10-point satisfaction questionnaire, and the incidence of nursing adverse events in the two groups was recorded.

Results: The experimental group was significantly better than the control group in dimensions (including patient safety assurance, patient participation promotion, enhancement of nurses' supervision, cooperation and responsibility) and the total score of the NASR scale (P < 0.05). The experimental group also had significantly higher scores in the pediatric and hospital-wide standardized training assessment results and willingness to continue in nursing work (P < 0.05). However, there was no significant difference in the incidence of nursing adverse events and teaching satisfaction between the two groups.

Conclusion: The combination of ISOBAR and case teaching method effectively improves the nursing handover level and clinical nursing ability of resident nurses, and increases their willingness to continue in nursing work. Simple to implement, this model is well worth further promotion.

Clinical trial registration number: Not applicable, as the study is not a trial.

This study assessed patient handover practices and associated factors among inpatient nurses at South Wollo Zone hospitals in Ethiopia (2022). A hospital-based cross-sectional study using a structured questionnaire and observational checklist was conducted with 389 of which 369 of them responded the self-administered questionnaire inpatient nurses. The overall handover practice level was 43.6%. Positive associations were found with technology use and the availability of protocols, while fatigue and intrusions negatively impacted practice. The study highlights the need to improve handover practices through technological enhancements, the development of effective protocols, and improved nurse staffing to mitigate fatigue.

Recent studies on handover communication highlight the role of the incoming physician in preventing misunderstandings that contribute to medical errors. However, existing research often only provides abstract recommendations for increasing their participation, without specifying where and how this should occur. This paper applies discourse theory and methods to identify where the incoming physician's active involvement is interactionally appropriate and can be integrated naturally and effectively. Twelve handovers between six pairs of resident physicians were recorded in a simulated ICU setting at a teaching hospital and analyzed using a combination of genre theory and conversation analysis. By first identifying the "moves" that constitute the handover genre, we pinpointed places where active participation by the incoming physician is expected and facilitates effective communication. While the tasks and focus points and the questions and consultation moves clearly invite such participation, the clinical situation move requires more negotiation, as the outgoing physician maintains control over the conversational floor, making it less immediately accessible for the incoming physician to contribute. The four remaining moves exhibit a more monologic pattern, where both participants display interactional behavior signaling that active input from the incoming physician is not anticipated. Our findings suggest that medical professionals share an implicit understanding of when participation is appropriate, shaped by conventions of the handover genre itself. By reconstructing these tacit rules through genre theory and conversation analysis, we provide insights that can inform training methods, ensuring that recommendations for active participation by the incoming physician align with the structured expectations of clinical practice.

Background: Discharging patients from intensive care units (ICUs) poses significant risks for adverse events (AEs), contributing to hospital morbidity and mortality. To mitigate premature transitioning, an ICU discharge readiness checklist (ICU-DRC) was developed. Enhanced patient safety culture (PSC) is crucial for reducing AEs and improving outcomes. Given the pressing need to enhance PSC in ICUs, this study evaluates the impact of ICU-DRC implementation on PSC, aiming to address a critical gap in quality improvement. Methods: A prospective quasi-experimental study assessed PSC before and after a year-long ICU-DRC intervention at Merkur Clinical Hospital in Zagreb, Croatia. Healthcare providers from two distinct ICUs participated voluntarily in the Hospital Survey on Patient Safety Culture. The surgical ICU, where the intervention was applied, employed 106 providers, while the medical ICU, which did not implement the intervention, had 42 providers. Results: Initial response rates were 58% for the intervention group and 45% for the control group, with post-intervention rates of 53% and 48%, respectively. The ICU-DRC was utilized with a fidelity of 65.7%. Due to the non-normal distribution found for most variables, non-parametric analytical procedures were applied. In baseline measurements, the control group outperformed the intervention group in three out of fourteen PSC dimensions. Post-intervention, PSC scores in the intervention group significantly improved in one dimension, whereas three dimensions in the control group showed significant declines, resulting in superior PSC outcomes for four dimensions in the intervention group during the second measurement. Conclusions: Applying the ICU-DRC as an isolated safety intervention aimed at optimizing ICU patient throughput resulted in observable patterns of improvement in several PSC dimensions, with statistically significant changes in specific areas.

Background The I-PASS bundle is a standardized care handoff associated with improved outcomes that is widely used in residency training. Sustainable use of I-PASS bundle components among attending hospital medicine providers merits further study. After we implemented a handoffs pilot process including written handoffs and Epic chat message (surrogate for verbal handoff) based on the I-PASS protocol, providers reported high levels of satisfaction. However, the pilot tool was utilized infrequently, and use ceased after the pilot. Methodology We utilized qualitative methods to assess attending physicians' and Advanced Practice Providers' perceptions to understand discrepancies between perceived utility and actual use. From February to March 2022, we interviewed 13 attending hospitalist physicians (n = 11) and Advanced Practice Providers (n = 2) individually or in homogenous focus groups; we transcribed recordings for qualitative coding (interrater agreement was κ = 0.82). We coded and analyzed the textual data via the specific concerns participants shared in the interviews and focus groups. Results Participants felt that while the I-PASS-based tool was suboptimal, the pilot raised overall awareness and use of handoff processes. They recommended that feasible handoff processes provide necessary information quickly for cross-cover providers, but do not require similar details for stable patients. Most participants reported that existing electronic medical record chat functions along with notes were adequate and more efficient. They also recommended standardizing format and processes; obtaining buy-in from all patient care providers; education on efficient use of tools; and formal, explicit expectations that providers complete handoffs. Conclusions Handoffs are an important component of patient safety measures. While they perceived the I-PASS-based tool to be suboptimal in several aspects, participants felt that the handoff quality improvement pilot raised overall awareness and use of handoff processes, which they felt was important for patient safety. Implementation of I-PASS bundle components may require contextual adaptation.

Aims and objectives: To evaluate the impact of implementing a prototype of simulation-based educational technology on raising awareness among ICU nurses, improving communication in nursing handover, and promoting patient safety.

Design: Qualitative study based on the conceptual framework of patient safety. The COREQ tool guided the presentation of the research report.

Methods: The research was conducted with 18 nurses from the ICU of a public hospital in Rio de Janeiro, Brazil, who worked directly in nursing handover. The technology implemented was developed based on communication failures identified in a previous stage of the macro research project. This evidence supported the development of a simulated scenario of a nursing handover of a critical patient, which was recorded in audio and video. The video addressed content (absence, incompleteness and lack of ordering of information) and behavioural errors (interruptions, distractions, noise and lack of clarity) during communication between intensive care nurses. The video was implemented with nurses through the use of telesimulation with debriefing. Finally, the nurses were subjected to a semi-structured interview to evaluate the potential of the technology, whose data underwent thematic analysis with an inductive model.

Results: The nurses recognised the communication failures portrayed as part of their daily practice, reflected on their mistakes, and on actions to be adopted to change behaviour during the handover.

Conclusions: The simulation-based technology prototype has the potential to promote self-reflection and raise nurses' awareness of the need to change behaviours during the handover.

Relevance to clinical practice: The simulation-based technology prototype can be applied as an educational strategy to improve communication safety in nursing handover.

Patient or public contribution: No patient or public contribution.

Objectives: Effective communication during handoffs between emergency medical services (EMS) and emergency department (ED) personnel is a critical step in out-of-hospital cardiac arrest (OHCA) care. No handoff tool has been specifically designed for OHCA, in which timely and accurate transfer of information can substantially affect patient care. This study aimed to develop a standardized checklist for OHCA handoffs based on expert consensus using a modified Delphi approach.

Methods: A panel of experts from EMS and the ED were recruited to rate the importance of 17 preidentified communication items derived from video reviews of OHCA handoffs. Experts completed 2 rounds of identical surveys, followed by participation in a focus group. Participants were asked to rate the importance of each item from 1 to 10 and the timing of when items should be communicated (ie, first, second, or third part of the handoff). The focus group further refined the checklist, finalizing the key elements to be included during a 90-minute virtual session via unanimous consensus.

Results: Eleven experts were approached, 10 completed surveys, and 7 participated in the focus group. The expert panel developed a 13-item checklist (patient age, location/cause of arrest, witnessed arrest, estimated downtime, bystander cardiopulmonary resuscitation, initial rhythm, most recent rhythm, episodes of return of spontaneous circulation, defibrillation attempts, airway type, vascular access, medications administered, and code status). Witnessed arrest, bystander cardiopulmonary resuscitation, and estimated downtime were prioritized for the first part of handoff communication.

Conclusion: This study developed a concise, expert-driven checklist for OHCA handoffs to improve communication between EMS and ED.

Objectives: Communication errors are the main cause of adverse events in emergency medicine, underscoring the importance of patient handover conversations. This study aims to assess the impact of implementing the ISOBAR handover protocol for patient transfer between emergency medical services and emergency department (ED) personnel.

Methods: We conducted a single-center implementation trial to evaluate the ISOBAR handover protocol efficacy in a German university hospital ED. We observed and analyzed 651 handover conversations involving adult patients, comparing those using the ISOBAR protocol to those following standard procedure without the protocol. Direct observation of handover processes was employed during alternating interventional periods across 6 trial phases. Primary outcome measure was the "Key Information Transfer Efficiency" score (KITE), a higher score indicating a more efficient patient handover conversation. Secondary outcome measure was the retention of key information by ED personnel, indicating successfully conveyed information.

Results: The KITE score was significantly higher in the ISOBAR group (difference 0.12, 95% CI 0.02-0.22), showing a notable increase from baseline without ISOBAR to the final trial phase using ISOBAR (difference 0.16, 95% CI 0.02-0.34). Key information retention increased significantly: +18% for physicians (95% CI 9-28) and +19% (95% CI 10-28) for nurses. The number of questions asked after handover decreased by 29% (95% CI 5.81-41.46). The adherence to ISOBAR had no notable effect on outcome measures.

Conclusion: The implementation of ISOBAR can enhance information transfer during handover. However, adherence to ISOBAR was not crucial, highlighting the importance of focusing on quality of communication during patient handover.

Background/Objectives: Patient and family involvement in bedside handover is a requirement of the national standards on patient safety and quality in Australia. To ensure patient-and-family-centred care, it is essential to understand how patients and families perceive their involvement in nursing bedside handover and what difficulties they face when participating. This study aimed to explore patient and family perceptions of their involvement in nursing bedside handover. Methods: We employed a qualitative descriptive study design with in-depth and semi-structured interviews. Using purposive and convenience sampling, 24 patients and family members were recruited from two adult hospitals in Western Australia between November 2021 and February 2022. The data were thematically analysed. Results: Participants had mixed experiences that overlapped with their individual perceptions, needs, and experiences. Their responses were grouped into three major themes with sub-themes: (1) discovering new nursing care approaches; (2) seeing the value of involvement in bedside handover; and (3) barriers hindering patient and family involvement in bedside handover. The findings revealed that patients and families valued their involvement in nursing bedside handover. However, several factors challenged their participation, including a lack of awareness about their right to participate, the timing of handovers, the nurse's approach, and fear of asking questions. Conclusions: The findings serve as a guide for evidence-based practice and may significantly influence policy and practice in nursing bedside handover, potentially enhancing patient-and-family-centred care. While considered best practice, the consistent involvement of patients and their families in nursing bedside handover is not routinely achieved and is implemented to varying extents.

Background: In Australia, aligned to safety and quality standards, the health system implements standardised practices that include patient involvement in nursing bedside handover. Despite this mandate, it remains unclear whether patients are genuinely participating in nursing bedside handovers and whether their perspectives are being considered.

Aim: To explore patient perceptions of their involvement in nursing bedside handovers.

Methods: A cross-sectional survey study was conducted in two acute metropolitan hospitals in Western Australia from July 2021 to March 2022. The survey administered to patients, comprised three sections: demographic information; involvement in bedside handover; and perceptions of bedside handovers; utilising close-ended and Likert scale questions. Open-ended questions further explored participation in bedside handovers. Descriptive statistics and comparative analyses were performed and responses to open-ended questions underwent summative deductive content analysis.

Results: Of the 390 participants, over half reported five or more bedside handovers (n = 197, 50.7%). Most perceived the importance of (n = 334, 79.0%), and expressed their satisfaction with (n = 327, 89.6%), involvement in bedside handover. Perceptions of handover were mostly positive. There were a few significant differences throughout based on type of hospital, gender and age-group. Open ended responses shared perceptions on the perceived benefits, challenges and barriers and ways to enhance involvement in bedside handover. Patients expressed several challenges, including lack of awareness of their right to participate, the approach of nurses and the timing of handovers as hindering their participation in bedside handovers.

Conclusion: Patients perceived the importance of, were mostly satisfied with, and had positive perceptions of bedside handover. However, several challenges hindered effective patient participation. Further research is needed into bedside handover as it is essential to enhance patient-centred quality care that aligns with national safety and quality healthcare standards.

Impacts: Understanding the significance of patient involvement in bedside handovers motivates patients to actively share information about their care, leading to increased patient satisfaction and the promotion of patient-centred care. Addressing challenges through targeted strategies can enhance patient participation, communication, increased patient satisfaction and foster a more patient-centred approach to care.

Patient or public contribution: The conduct of this study was supported by the consumer advisory group in the participating hospitals who also reviewed the survey questionnaires and conducted face validity of the survey.

Background: Effective handover communication by nurses is essential to ensuring care continuity, care quality and patient safety and minimizing the risk of adverse events. Notably, the increasing globalization of the nursing profession and the resulting rise of multicultural workplaces in health care can affect handover communication. However, no tools have yet been developed to evaluate the current practices and factors contributing to effective handover in multicultural care settings, even though such instruments are deemed necessary to identify communication challenges and opportunities for improvement.

Aims: This paper describes the protocol that will be used in a proposed study that aims to adapt and validate an existing instrument for measuring handover quality-namely the Handover Evaluation Scale. The proposed study will also examine the factors contributing to effective handovers in a multicultural critical care context using a sequential exploratory mixed-method and will involve a qualitative and a quantitative phase.

Study design: The first phase will explore Saudi Arabian ICU nurses' perceptions of effective shift handovers and the factors influencing handover quality. Data will be collected by recruiting 20 nurses through purposive sampling for semi-structured interviews. Interpretive description will be used to analyse the data to identify items useful for modifying the tool. Next, the tool will be modified based on the qualitative findings. Lastly, a quantitative study will be conducted based on the results of the first phase to assess the instrument's reliability and content validity and determine its internal dimensional structure.

Results: This paper describes the study protocol that will be applied to adapt and validate an existing tool to measure the quality of handover in multicultural ICUs, using an exploratory sequential mixed-methods design.

Relevance to clinical practice: The protocol described in this paper provides a framework for an adaptation of the Handover Evaluation Scale to measure handover effectiveness and to identify current challenges and factors affecting handover effectiveness in the multicultural critical care context. This version of the scale can be applied in clinical practice to determine best practices for improving handover.

Purpose: Effective patient handovers in healthcare settings are critical for ensuring patient safety and care quality. Handover tools have gained prominence as potential aids in improving these transitions. This systematic review seeks to answer the question if the use of validated handover protocols leads to better treatment outcomes in polytrauma patients compared to no use of validated handover protocols.

Methods: We searched PubMed, Cochrane Central Register of Controlled Trials and Web of Science to identify relevant studies from inception of each database to June 15, 2022. We intended to include systematic reviews and randomized controlled trials comparing the use of validated handover tools to no use of such tools in adult polytrauma patients.

Results: Despite the absence of systematic reviews and RCTs meeting our criteria, we included 26 initially excluded studies to glean insights into handover tool usage. This broader inclusion facilitated the identification of two categories of tools: standardized tools and customized tools. Among studies employing customized tools, positive outcomes were reported in various aspects, including enhanced information quality, improved staff communication, and reduced risks and treatment errors. In contrast, studies utilizing well-established standardized tools documented improvements in communication, documentation, and overall satisfaction among medical professionals, signaling a reduction in communication errors and lost information.

Conclusion: Heterogeneity of the studies and no trials meeting our eligibility criteria present challenges for conducting a traditional systematic review. In the lack of evidence from RCTs and systematic reviews, our analysis of the available studies sheds light on the complexities of assessing handover tools' utility, especially in diverse clinical settings. It highlights the need for more standardized methodologies and further investigation into the effectiveness of custom-designed tools. It emphasizes the importance of understanding the role of handover tools in healthcare. While some studies suggest positive outcomes, further research is necessary to elucidate the design and implementation of these tools to enhance care and support healthcare professionals in their roles.