Factors Affecting Nurses’ Experiences Related to Current Handover Process between Emergency Department and In-patient Units

For nursing students

Study summary

This article, titled 'Factors Affecting Nurses’ Experiences Related to Current Handover Process between Emergency Department and In-patient Units,' explores a critical aspect of nursing practice: the handover process. The study was conducted at Tanta University Emergency Hospital in Egypt by Shereen Dorgahm and Heba Obied. It is an open-access journal article published in the 'Tanta Scientific Nursing Journal' on May 1, 2021.

The research focuses on understanding how nurses experience the handover process when patients are transferred from the Emergency Department (ED) to in-patient units. Handovers are crucial for patient safety because they ensure that all relevant information about a patient is accurately communicated between healthcare providers. The authors frame this as a nursing problem by highlighting communication failures as a major source of medical errors or sentinel events, which can have serious consequences for patients.

The study used a cross-sectional, correlational design to assess factors affecting nurses' experiences with the current handover process. A sample of 60 nurses from Tanta University Emergency Hospital participated in the research. The authors utilized one structured questionnaire that consisted of three parts: Nursing Satisfaction with Handover, Current Handover Process Quality, and Information Inventory Provided in Current Handover Process.

The findings revealed several important insights into how nurses experience handovers: 1. A significant portion (33.3%) of the nurses reported they rarely had an opportunity to ask questions or clarify information during the handover process. This suggests that communication may not always be open and transparent, potentially leading to misunderstandings. 2. An even larger majority (77%) of the participating nurses expressed dissatisfaction with the current handover process. This indicates a widespread perception among these nurses that the existing system is flawed or ineffective in meeting their needs for clear patient information transfer. 3. A concerning number, specifically 30%, reported experiencing errors during the handover process due to ineffective communication. This directly links poor handover practices to potential risks of medical mistakes. 4. When asked about what would improve the handover process, a substantial majority (45%) viewed providing accurate and honest information as important, while another significant group (31%) emphasized the need for a structured standardized process. These findings highlight key areas where improvements could be made to enhance both safety and satisfaction. 5. Furthermore, nearly half of the nurses surveyed (49.9%) admitted that they did not provide total information during handover processes themselves. This finding is particularly important as it points towards systemic issues or individual practices within the nursing staff regarding thoroughness in communication.

When appraising this study, students should consider several aspects: * **Source and Rights:** The paper is available through DOAJ (Directory of Open Access Journals) with a high confidence score for its source information. It's important to note that while it provides valuable insights into nursing practice at Tanta University Emergency Hospital in Egypt, the findings might not be universally generalizable without further research. * **Research Design:** The cross-sectional design means data was collected once from participants; this can provide a snapshot of experiences but may not capture changes over time or establish causality. However, for assessing current experiences and satisfaction levels, it is appropriate. * **Sample Size and Setting:** The study involved 60 nurses from one specific hospital in Egypt. While this provides meaningful data about that particular setting, the results should be interpreted with caution if applied to other contexts without further validation.

As a nurse, reasoning from this evidence would involve recognizing the clear need for improvement in handover processes at Tanta University Emergency Hospital and potentially similar settings. The high rates of dissatisfaction (77%) and reported errors due to ineffective communication (30%) are strong indicators that current practices fall short of ensuring optimal patient safety and care continuity. Nurses should advocate for changes such as implementing standardized tools tailored to the ED context and each inpatient unit, which could help optimize handover quality. Additionally, conducting training programs aimed at enhancing nurses' satisfaction by equipping them with knowledge and skills to manage these intricate processes more effectively would be a logical next step based on the study's recommendations.

In summary, this research underscores that while handovers are fundamental for patient safety, there are significant challenges in their current implementation. The experiences of nurses surveyed highlight issues related to communication opportunities, overall satisfaction with existing procedures, error rates linked directly to poor communication, and a lack of complete information sharing during these critical transitions between care settings.

For educators

Teaching and appraisal notes

This article by Dorgahm and Obied (2021) investigates factors influencing nurses' experiences with the handover process when patients are transferred from an Emergency Department (ED) to in-patient units at Tanta University Emergency Hospital, Egypt. Employing a cross-sectional, correlational design, 60 nurses completed a structured questionnaire assessing their satisfaction with handovers, perceptions of current process quality, and information inventory during these transitions.

The study's key findings reveal significant concerns within the ED-to-inpatient unit handover system: 1. A substantial proportion (33.3%) of nurses reported rarely having opportunities to ask questions or clarify information during handovers, indicating potential gaps in interactive communication. 2. An overwhelming majority (77%) expressed dissatisfaction with the current handover process itself, suggesting widespread perceptions that existing methods are inadequate for ensuring effective patient care transitions. 3. A concerning 30% of nurses reported experiencing errors attributable to ineffective communication during these handovers, directly linking poor practices to potential risks for patients. 4. When queried about improvements, a large segment (45%) emphasized the importance of providing accurate and honest information, while another significant group (31%) highlighted the need for structured standardized processes as crucial elements for enhancement. 5. Nearly half of the nurses surveyed (49.9%) admitted they did not provide total information during handover processes themselves; this finding is critical as it points to systemic or individual shortcomings in thoroughness that can compromise patient safety and continuity of care.

These findings underscore a clear need for intervention at Tanta University Emergency Hospital. The high rates of dissatisfaction (77%) and reported errors due to ineffective communication (30%) are particularly alarming, indicating that current practices may not be meeting the standards required for safe and effective patient handovers. The authors' recommendations—establishing standardized tools tailored to specific ED contexts and inpatient units, coupled with targeted training programs designed to enhance nurses' satisfaction and equip them with better strategies for managing these complex interactions—are well-grounded in their evidence.

For faculty, this study serves as a valuable resource for teaching about patient safety, communication skills, and quality improvement initiatives in nursing education. It provides concrete examples of how research can identify specific areas within clinical practice that require attention and change. The methodology is appropriate for its aims (assessing current experiences), but instructors should guide students to critically evaluate the generalizability of these findings from a single Egyptian hospital setting. Furthermore, it highlights the importance of fostering environments where nurses feel empowered to ask questions during handovers and are supported in providing complete information.