Clinical handover practices in maternity services in Ireland: A qualitative descriptive study

Abstract

Objective: the objective was to examine and describe clinical handover practices in Irish maternity services.

Design: the study design incorporated interviews and focus group discussions with a purposive sample of healthcare practitioners working in Irish maternity services.

Setting: five maternity hospitals and fourteen co-located maternity units.

Participants: midwives, obstetricians and other healthcare professionals, specifically physiotherapists and radiologists, midwifery students and health care assistants working in maternity services.

Findings: the study participants provided nuanced and differentiated accounts of clinical handover practices, which indicated a general absence of formal policy and training on clinical handover and the practice of midwifery and medical teams holding separate clinical handovers based on their separate, respective needs for transferring information and clinical responsibility. Participants spoke of barriers to effective clinical handover, including unsuitable environments, lack of dedicated time and fatigue during duty shift clinical handover, lack of supportive information technology (IT) infrastructure, and resistance of some staff to the adoption of new technologies to support clinical handover.

Key conclusions: whether internal and external to clinical handover events, the barriers to effective clinical handover represent threats to patient safety and quality of care, since effective clinical handover is essential to the provision of safe quality care.

Implications for practice: clear and effective communication between collaborating professionals within maternity teams is essential.

Keywords: Care; Clinical; Focus group; Handover; Interview; Ireland; Maternity; Practice.