Enhancing the verbal handover process for nurses in inpatient orthopedic wards: a best practice implementation project

OBJECTIVES: This evidence-based quality improvement project aimed to evaluate the effectiveness of a handover guide in improving handovers from registered nurses to enrolled nurses. INTRODUCTION: Nursing handover involves the transfer of the responsibility of care for a patient from one nurse to another. Handover techniques vary in different healthcare organizations. Non-standardized, incomplete handovers can lead to delays or errors in treatment, increased lengths of stay, and poor health outcomes. METHODS: This project was conducted in two orthopedic wards of a tertiary hospital, and occurred in four phases over 12 months. The project utilized the JBI Practical Application of Clinical Evidence System (PACES) and the Getting Research into Practice (GRiP) tools. RESULTS: The baseline audit in March 2017 revealed a poor compliance in handover of essential patient information. The post-intervention audit showed a significant increase (P < 0.001) in the compliance of handover of essential patient information. Registered nurses' handovers of patient information to enrolled nurses improved from 11% to 27% (P < 0.000). Verbal face-to-face handovers occurred throughout the implementation. Eighty-two per cent of the nurses felt that the handover guide had reduced the number of monitoring errors and delays in treatment. CONCLUSION: The project has successfully improved nurses' clinical handovers and contributed to safe patient care. Further audits are required to sustain the evidence-based practice change. Nursing leaders play a significant role in supporting the project and building a positive evidence-based practice environment.