Aims: To capture inter-shift handoff changes over a 6-year interval and to verify whether the handoff supporting system and aids (e.g., guidelines, training, and protocols) and environment really affect handoff performance.
Design: A non-experimental cross-sectional research design. Data from the 2017 and 2011 surveys were used for comparisons.
Methods: A questionnaire survey was conducted among nursing staff in 31 general hospitals in 2017 and 4,282 staff responses were collected from inpatient wards such as internal medicine and surgery, the intensive care unit, emergency department and operating room. These were compared with the 1,182 responses collected in the previous 2011 survey.
Results: Changes in the 6-year interval included the introduction of handoff guidelines and increased provision of training. The handoff approach changed significantly and relied more on electronic systems, especially in inpatient wards. However, there was no significant improvement in interruptions. Information transfer improvement was limited and only observed in the surgery wards. Significant correlations verified that in hospitals where nursing staff more positively evaluated the effectiveness of the guidelines, faced fewer interruptions and had more time, handoff performance was better overall, and a higher frequency of sufficient information transfer was evident.
Conclusion: Although the inter-shift handoff supporting system had great changes, improvement of information transfer occurred only in the surgery wards and was limited. It was verified that more effective handoff guidelines and a better handoff environment contributed significantly to improving inter-shift handoff performance.
Impact: This study addressed the question as to whether inter-shift handoffs have really improved. The answer is yes, but in a limited way. Based on the survey results and handoff practices in Japanese hospitals, a mixed approach (verbal, written, technological) is suggested for inter-shift handoffs. In addition, it is important to improve the current handoff procedures, guidelines and training.
目的: 观察6年内的轮班交接变化,并验证交接支持系统、辅助工具(如指南、培训和协议)以及环境是否会真正影响交接性能。 设计: 非实验性横断面研究设计。比较2017年和2011年的调查数据。 方法: 2017年,对31家综合性医院的护理人员进行问卷调查,涉及内外科、重症监护室、急诊科、手术室等住院病房,共收集4,282名员工的答复。将这些员工的答复与2011年调查收集的1182份答复进行对比。 结果: 过去6年内,发生了一系列变化,包括引入交接指南和增加培训。交接方式发生显著变化,更多地依赖于电子系统,特别是住院病房。然而,中断未明显改善。信息传递改善,但改善程度有限,仅可在外科病房观察。相关分析结果显示,如果护理人员对指导方针的有效性评价更高,中断次数更少或任职时间更长,则表示,整体交接性能更好,信息传输更充分,频率更高。 结论: 尽管轮班交接支持系统发生了很大变化,但仅外科病房的信息传递有所改善,且改善效果有限。结果表明,如果需要提高提高交接性能,则需要更有效的交接准则和更好的交接环境。 影响: 本研究旨在探讨轮班交接是否真的得到改善。答案是肯定的,但在某种程度上,这种改善是极为有限。根据调查结果和日本医院的交接实践,建议采用口头、书面、技术等多种方法进行轮班交接。此外,应该对现有的交接程序、准则和培训做出改进,这一点至关重要。.
Keywords: guidelines; handoff approach; handoff performance; information transfer; inter-shift handoff; nursing handoff; patient safety; training.
© 2020 John Wiley & Sons Ltd.