Document Type : Original Article

Authors

Abstract

BACKGROUND: The patient handover process is in fact a valuable and essential part of the care
processes in the hospitals. This can be a factor in increasing the quality and effectiveness of medical
care. Incorrect and incomplete handover can increase the percentage of errors and cause serious
problems for patients. The aim of this study was to identify the handover challenges concerning
safety and quality of health services.
MATERIALS AND METHODS: A systematic review was conducted according to the Preferred
Reporting Item for Systematic Reviews and Meta‑analyses guideline. The key words “challenges
of patient handover” or “challenges of patient handoff” were used in combination with the Boolean
operators OR and AND. The ProQuest, Ovid, Doaj, Magiran, SID, Scopus, Science Direct, PubMed,
and ISI were searched.
RESULTS: A total of 263 articles were extracted, and 20 articles were selected for final review.
The results of selected articles indicated that there are various challenges such as communication,
noncoordination, nonuse of checklist, poor management, time management, and other things. These
studies reported that communication was the main challenge of handover process.
CONCLUSIONS: Hospitals try to provide a lot of services to the patients and other customers in a
safe and healthy environment. Lack of communication among the incoming and outgoing nurses in
handover process is one of the main causes of reduced safety and quality of services and patient
dissatisfaction.

Keywords

  1. Hemmati MP, Sheikh B, Mehri B. The relationship between
    nurse‑patient communication skills and patients’ safety status
    in special sectors. Clin Nurs Midwifery J 2014; 3:77‑84. URL:
    http://jcnm.skums.ac.ir/article‑1‑72‑fa.html [Last accessed on
    2018 Feb 2].
    2. Mohseni M, Raeisi AR, Azami‑Aghdash S, Moosavi A,
    Mousavi SM. Hospital services quality from patients’ perspective
    in Iran: A systematic review and meta‑analysis. Evid Based Health
    Policy Manage Econ 2017; 1:261‑9. URL: http://jebhpme.ssu.
    ac.ir/article‑1‑116‑en.html [Last accessed 2018 Feb 2].
    3. Hemmati MP, Sheikh B, Mehri B. The relationship between
    nurse‑patient communication skills and patients’ safety status in
    special sectors. Clin Nurs Midwifery J 2014; 3:77‑84. URL: http://
    jcnm.skums.ac.ir/article‑1‑72‑fa.html [Last accessed on 2018 Feb
    2].
    4. Till A, Sall H, Wilkinson J. Safe handover: Safe patients – The
    electronic handover system. BMJ Qual Improv Rep 2014;2. pii:
    u202926.w1359.
    5. Etezadi Gam TectamMalekzadeh Javad, Mazlum Reza, Taseiri
    Alireza. Nursing shift counseling guide: A way to ensure the safe
    operation of nurses in intensive care units . Evid Based Q J 2012;
    2:7‑18. http://osub.mums.ac.ir/osub/nilfr/nmjournal/index.
    php. [Last accessed on 2018 Feb 2].
    6. Allen DE, Vitale‑Nolen RA. Patient care delivery model improves
    nurse job satisfaction. J Contin Educ Nurs 2005; 36:277‑82.
    7. Gier, Kathleen, “The Effects of a Care Delivery Model Change on
    Nursing Staff and Patient Satisfaction” (2013). Nursing Theses and
    Capstone Projects. 61. https://digitalcommons.gardner‑webb.
    edu/nursing_etd/61. [Last accessed on 2018 Feb 2].
    8. Australian Medical Association. Safe Handover: safe Patients.
    Guidance on Clinical Handover for Clinicians and Managers.
    Australian Medical Association; 2006. Available from: https://
    www.ama.com.au/sites/default/files/documents/Clinical_
    Handover_0.pdf. [Last accessed on 2018 Feb2].
    9. MeyerRM, Wang S, LiX, ThomsonD, O’Brien‑Pallas L. Evaluation
    of a patient care delivery model: Patient outcomes in acute cardiac
    care. J Nurs Scholarsh 2009; 41:399‑410.
  2. 10. Sheikhbardsiri H, Yarmohammadian MH, Khankeh HR,
    Nekoei‑Moghadam M, Raeisi AR. Meta‑evaluation of published
    studies on evaluation of health disaster preparedness exercises
    through a systematic review. J Educ Health Promot 2018; 7:15.
    11. Yang XJ, Park T, Siah TH, Ang BL, Donchin Y. One size fits all?
    Challenges faced by physicians during shift handovers in a hospital
    with high sender/recipient ratio. Singapore Med J 2015; 56:109‑15.
    12. Thomson H, Tourangeau A, Jeffs L, Puts M. Factors affecting
    quality of nurse shift handover in the emergency department.
    J Adv Nurs 2018; 74:876‑86.
    13. Showell C, Thomas M, Wong MC, Yee KC, Miller S, Pirone C,
    et al. Patient safety and sociotechnical considerations for electronic
    handover tools in an Australian eHealth landscape. Stud Health
    Technol Inform 2010; 157:193‑8.
    14. Herrigel DJ, Carroll M, Fanning C, Steinberg MB, Parikh A,
    Usher M, et al. Interhospital transfer handoff practices among
    US tertiary care centers: A descriptive survey. J Hosp Med 2016;
    11:413‑7.
    15. Din N, Ghaderi S, O’Connell R, Johnson T. Strengthening surgical
    handover: Developing and evaluating the effectiveness of a
    handover tool to improve patient safety. BMJ Qual Improv Rep
    2012;1. pii: u492.w164.
    16. Goldsmith D, Boomhower M, Lancaster DR, Antonelli M,
    Kenyon MA, Benoit A, et al. Development of a nursing handoff
    tool: A web‑based application to enhance patient safety. AMIA
    Annu Symp Proc 2010; 2010:256‑60.
    17. Sujan MA, Chessum P, Rudd M, Fitton L, Inada‑Kim M,
    Cooke MW, et al. Managing competing organizational priorities
    in clinical handover across organizational boundaries. J Health
    Serv Res Policy 2015; 20:17‑25.
    18. Zakrison TL, Rosenbloom B, McFarlan A, Jovicic A, Soklaridis S,
    Allen C, et al. Lost information during the handover of critically
    injured trauma patients: A mixed‑methods study. BMJ Qual Saf
    2016; 25:929‑36.
    19. Meisel ZF, Shea JA, Peacock NJ, Dickinson ET, Paciotti B, Bhatia R,
    et al. Optimizing the patient handoff between emergency medical
    services and the emergency department. Ann Emerg Med 2015;
    65:310‑70.
    20. Evans SM, Murray A, Patrick I, Fitzgerald M, Smith S,
    Andrianopoulos N, et al. Assessing clinical handover between
    paramedics and the trauma team. Injury 2010; 41:460‑4. https://
    doi.org/10.1016/j.injury. 2009.07.065.
    21. Breuer KR, Taicher B, Turner DA. Standardizing postoperative
    PICU handovers improves handover metrics and patient
    outcomes. Qual Saf 2015; 16:256‑62. https://doi.org/10.1097/
    PCC.0000000000000343. [Last accessed on 2018 Feb 2].
    22. Stelfox HT, Leigh JP, Dodek PM, Turgeon AF, Forster AJ,
    Lamontagne F, et al. A multi‑center prospective cohort study of
    patient transfers from the intensive care unit to the hospital ward.
    Intensive Care Med 2017; 43:1485‑94.
    23. Balka E, Tolar M, Coates S, Whitehouse S. Socio‑technical issues
    and challenges in implementing safe patient handovers: Insights
    from ethnographic case studies. Int J Med Inform 2013;82: e345‑57.
    24. Carroll JS, Williams M, Gallivan TM. The ins and outs of change
    of shift handoffs between nurses: A communication challenge.
    BMJ Qual Saf 2012; 21:586‑93.
    25. Hilligoss B, Cohen MD. The unappreciated challenges of
    between‑unit handoffs: Negotiating and coordinating across
    boundaries. Ann Emerg Med 2013; 61:155‑60.
    26. Nakhshab M, Vosughi E. The Condition of Neonatal Transport
    to NICU in Mazandaran. J Mazandaran Univ Med Sci. 2010;
    20 (78):50‑57. URL: http://jmums.mazums.ac.ir/article‑1‑623‑en.
    html. [Last accessed on 2018 Feb 2].
    27. Habibzadeh F, Imanipour M, Mohammad Aliha J, Mehran A.
    Effect of applying checklist on quality of intra‑hospital transport
    of intensive care patients. 2014; 3 (3):30‑37. URL: http://journal.
    icns.org.ir/article‑1‑257‑en.html. [Last accessed on 2018 Feb 2].
    28. Sabet Sarvestani R, Moattari M, Nasrabadi AN, Momennasab M,
    Yektatalab S. Challenges of nursing handover: A qualitative study.
    Clin Nurs Res 2015; 24:234‑52.
    29. Kostelec P, Emanuele Garbelli P, Emanuele Garbelli P.
    Introduction of a Microsoft excel‑based unified electronic
    weekend handover document in acute and general medicine in
    a DGH: Aims, outcomes and challenges. BMJ Qual Improv Rep
    2017;6. pii: u212152.w5721.
    30. Møller TP, MadsenMD, FuhrmannL, Østergaard D. Postoperative
    handover: Characteristics and considerations on improvement:
    A systematic review. Eur J Anaesthesiol 2013; 30:229‑42.
    31. Anthony MK, Preuss G. Models of care: The influence of nurse
    communication on patient safety. Nurs Econ 2002; 20:209‑15, 248.
    32. Cheung DS, Kelly JJ, Beach C, Berkeley RP, Bitterman RA,
    Broida RI, et al. Improving handoffs in the emergency
    department. Ann Emerg Med 2010; 55:171‑80. doi: 10.1016/j.
    annemergmed.2009.07.016. Epub 2009 Oct 2.