Patients prefer clinical handover at the bedside; nurses do not: Evidence from a discrete choice experiment.


Journal

International journal of nursing studies
ISSN: 1873-491X
Titre abrégé: Int J Nurs Stud
Pays: England
ID NLM: 0400675

Informations de publication

Date de publication:
May 2020
Historique:
received: 06 05 2019
revised: 23 09 2019
accepted: 24 09 2019
pubmed: 23 3 2020
medline: 3 3 2021
entrez: 23 3 2020
Statut: ppublish

Résumé

Shift-to-shift bedside handover is advocated as a patient-centred approach, yet its enactment is challenging. To describe and compare the preferences of both patients and nurses in the implementation of bedside handover in a Swedish University Hospital. A discrete choice experiment (DCE) survey. University setting, four medical wards in two hospitals. Adult medical patients (n = 218) and registered nurses (n = 101) METHODS: The survey was administered by an electronic tablet-assisted face-to-face survey. Respondents made repeated choices between two hypothetical bedside handover alternatives and a third alternative of 'handover away from the bedside'. Handover alternatives were described according to six attributes: invitation to participate, number of nurses present at the handover, family member, carer or trusted friend (of the patient) allowed to be present, level of (patient) involvement, what information related to your (patient) care is discussed. Choice data were analyzed using a mixed logit model. A total of 1308 (patients) and 909 (nurses) choice observations were included in the preference models. Patients showed a strong preference for handover at the bedside compared to nurses. Nurses generally preferred handover away from the bedside. Patients perceived their level of involvement in handover as highly important, being able to speak, hear what was said being the most important characteristic, closely followed by being invited to participate and asked questions as well as being heard. Nurses considered patients being invited to participate most important, followed by level of involvement. Different options for handing over sensitive information were not perceived of importance by patients or nurses. There was substantial variation at the individual level across both patients and nurses for where and how handover is delivered. In this study, patients strongly preferred handover at the bedside, while the nurses considered patients to be invited to participate to be the most important preference but generally preferred handover to take place away from the bedside, all else equal. When implementing bedside handover in a Swedish context this must be considered, although participation is a prerequisite for bedside handover. Differences between patients and nurses' preferences could jeopardize future introduction of bedside handover in Swedish health care, and might explain why bedside handover is still not very common in hospital wards.

Sections du résumé

BACKGROUND BACKGROUND
Shift-to-shift bedside handover is advocated as a patient-centred approach, yet its enactment is challenging.
OBJECTIVES OBJECTIVE
To describe and compare the preferences of both patients and nurses in the implementation of bedside handover in a Swedish University Hospital.
DESIGN METHODS
A discrete choice experiment (DCE) survey.
SETTINGS METHODS
University setting, four medical wards in two hospitals.
PARTICIPANTS METHODS
Adult medical patients (n = 218) and registered nurses (n = 101) METHODS: The survey was administered by an electronic tablet-assisted face-to-face survey. Respondents made repeated choices between two hypothetical bedside handover alternatives and a third alternative of 'handover away from the bedside'. Handover alternatives were described according to six attributes: invitation to participate, number of nurses present at the handover, family member, carer or trusted friend (of the patient) allowed to be present, level of (patient) involvement, what information related to your (patient) care is discussed. Choice data were analyzed using a mixed logit model.
RESULTS RESULTS
A total of 1308 (patients) and 909 (nurses) choice observations were included in the preference models. Patients showed a strong preference for handover at the bedside compared to nurses. Nurses generally preferred handover away from the bedside. Patients perceived their level of involvement in handover as highly important, being able to speak, hear what was said being the most important characteristic, closely followed by being invited to participate and asked questions as well as being heard. Nurses considered patients being invited to participate most important, followed by level of involvement. Different options for handing over sensitive information were not perceived of importance by patients or nurses. There was substantial variation at the individual level across both patients and nurses for where and how handover is delivered.
CONCLUSIONS CONCLUSIONS
In this study, patients strongly preferred handover at the bedside, while the nurses considered patients to be invited to participate to be the most important preference but generally preferred handover to take place away from the bedside, all else equal. When implementing bedside handover in a Swedish context this must be considered, although participation is a prerequisite for bedside handover. Differences between patients and nurses' preferences could jeopardize future introduction of bedside handover in Swedish health care, and might explain why bedside handover is still not very common in hospital wards.

Identifiants

pubmed: 32200099
pii: S0020-7489(19)30251-2
doi: 10.1016/j.ijnurstu.2019.103444
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

103444

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2019. Published by Elsevier Ltd.

Auteurs

Lena Oxelmark (L)

Institute of Health and Care Sciences, the Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Department of Medicine, Gothenburg, Sweden. Electronic address: lena.oxelmark@gu.se.

Jennifer A Whitty (JA)

Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom; Collaboration for Leadership in Applied Health Research and Care (CLAHRC), East of England, United Kingdom. Electronic address: jennifer.whitty@uea.ac.uk.

Kerstin Ulin (K)

Institute of Health and Care Sciences, the Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Region Västra Götaland, Sahlgrenska University Hospital, Division Management Group 2, Gothenburg, Sweden. Electronic address: kerstin.ulin@gu.se.

Wendy Chaboyer (W)

Institute of Health and Care Sciences, the Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; School of Nursing and Midwifery, Patient Centred Health Services Group, Menzies Health Institute Queensland, Griffith University, Gold Coast campus, Queensland, Australia. Electronic address: w.chaboyer@griffith.edu.au.

Ana Sofia Oliveira Gonçalves (AS)

Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, Norfolk, United Kingdom. Electronic address: ana.goncalves@charite.de.

Mona Ringdal (M)

Institute of Health and Care Sciences, the Sahlgrenska Academy, Gothenburg University, Gothenburg, Sweden; Region Västra Götaland, Kungälvs Hospital, Department of Anaesthesiology and Intensive Care, Kungälv, Sweden. Electronic address: mona.ringdal@fhs.gu.se.

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