The effectiveness of bedside handovers: A multilevel, longitudinal study of effects on nurses and patients. (27th February 2019)

• Record Type: Journal Article
• Authors: Malfait, Simon; Eeckloo, Kristof; Van Biesen, Wim; Van Hecke, Ann
• Is Part Of: Journal of advanced nursing. Volume 75:Number 8(2019)
• Page Start: 1690
• Page End: 1701
• Publication Date: 2019-02-27
• Subjects: bedside handovers -- individualized care -- longitudinal -- multicentred -- nursing -- patient participation -- quantitative research; Nursing -- Periodicals; 610.7305
• DOI: 10.1111/jan.13954
• Languages: English
• ISSNs: 0309-2402

Abstract

Abstract: Aims: To investigate the effectiveness of bedside handovers. For nurses, effects on nurse–patient communication, individualized care, coordination of the care process, job satisfaction, intention to leave, patient participation and work interruptions were measured. For patients, effects on patient activation, individualized care and quality of care were measured. Design: This is a longitudinal, controlled, multicentred study on 13 nursing wards in five hospitals. The seven interventional wards consisted of two medical rehabilitation, two geriatric and three surgical/medical wards. Methods: A questionnaire for patients and nurses at baseline (May–June 2016), 3 (July–August 2017) and 9 months (December 2017–January 2018) after implementation was completed by 799 patients and 165 nurses. Per protocol analysis was used in combination with linear mixed models analysis. Results: With exception for work interruptions and patient participation for nurses, no overall effects could be found for both patients and nurses. For nurses, patient participation increased, and work interruptions decreased in the intervention group. Individualized care remained stable in the intervention group, whereas it decreased in the control group. Conclusion: The results indicate that bedside handover can be regarded as superior to more commonly used handover models as it enhances patient participation and decreases work interruptions. However, the positive image of bedside handovers, mostly based on observational, short‐term and single‐centred experiences, cannot be confirmed as there were no effects on any of the other measured parameters. As bedside handovers put patient participation on the agenda and negative effects are absent, implementing bedside handovers should be considered a mean for more patient‐centeredness instead of a goal itself. Abstract : 目的: 在于探讨床边移交的有效性。对于护士, 测量了护患沟通、个性化护理、护理过程协调、工作满意度、离职意向、患者参与和工作中断方面的影响。对于患者, 测量了患者活化、个性化护理和护理质量方面的影响。 设计: 这是一项对五所医院13个护理病房的纵向、对照、多中心研究。七个介入病房包括两个医疗康复病房、两个老年病房和三个外科/内科病房。 方法: 在在基线状态下(2016年5月至6月)、实施后3个月(2017年7月至8月)和9个月(2017年12月至2018年1月)对799名患者和165名护士进行了问卷调查。结合使用了按方案分析法 与线性混合模型分析法。 结果: 除了护士的工作中断和病人参与外, 都没有发现病人和护士的综合影响。对于护士来说, 在干预组中, 病人参与增加, 工作中断减少。在干预组中, 个体化护理保持稳定, 而在对照组中, 个体化护理则有所下降。 结论: 调查结果表明, 床边移交可以被视为优于更常用的交接模式, 鉴于它提高了患者参与度, 减少了工作中断。然而, 床边移交的正面形象, 主要基于观察性、短期性和单一集中性经验, 无法得到证实, 鉴于对任何其他测量参数都没有影响。由于床边移交将患者参与列入了议程, 并且没有负面影响, 所以应将实施床边移交视为更以患者为中心的手段, 而不是目标本身。