Handoffs During Nursing Shift Changes in Acute Care

Abstract

Handoffs during the nursing shift change were directly observed on two acute care wards each of a private and public hospital, for a total of 236 patient updates by 49 nurses during 14 shift changes. Data from the three wards which conducted audio-taped updates were transcribed. The transcriptions and field notes were analyzed for the existence and frequency of 21 strategies used in high reliability organizations. In addition, we iteratively categorized the interruptions, questions, and statements made during the updates. Finally, we iteratively categorized stances towards decisions communicated during the updates. Implications of the findings are discussed.