Inter Shift Handover Report

The authors’ involvement and wide range of existing research on inter-shift handover reveals that there are many different ways to hand over a client at the end of the nursing shift. This so-called “ritual” is central to good practice development and aids a nurse to gain essential caseload knowledge at the beginning of the shift. However, current inter-shift handover practice in psychiatric setting founded by outdated medical model. This model ignores nurses’ needs and clients’ wishes of being involved in the care process as advised by the “A Vision for Change” report (DoH 2006). In the beginning of each shift a nurse is allocated to a specific area (say for example Kilkenny), therefore, the client’s she is responsible to deliver nursing care
Present inter-shift nursing handover in acute psychiatric setting takes place in well-lit, spacious nursing office, with doors that closed for the duration of the handover to help minimise disturbances. Yet, this simple fact could be seen as a barrier for client’s involvement in their care provision (DoH 2006). Furthermore, in spite of this precaution, this process is usually interrupted by client’s knocks and shouts at the door, or latecomer/late-leaving nurse’s walking in or out respectfully. In advance of inter-shift handover each nurse formulates a short written handover note for each of the clients. The content of such notes usually includes: client’s name, changes in care-plan (usually medicine changes), reviews (medical assessments, multidisciplinary review), daily observations and test results (psychological observations and voiced complaints of any nature). Because these notes do not have pre-set data requirements regulations or policy, at times it is unclear which data is worthy to go into these handover
Unstructured handover leads to loss of time by the arriving nurse as she/he forced to multitask in hope of recovery of needed information from vast range of the nursing documentation which could lead to stress, fatigue, waste of time and inefficient nursing care delivery, thus has a negative impact not only on the quality of care but well-being of the nurse in question (Leonard et al. 2004, Denham 2008). Furthermore, in some cases passed on information could be labelled as useless and irrelevant making it retrospective in regards of continuity of care. For example some notes may state that “there was no change in presentation”, one may wonder if the presentation they meant was from the initial assessment or from last nursing notes which are probably said same thing in a different manner. This conclusion supported by research conducted by Webster (1999) and Sexton et al. (2004). They found that information passed during handover may be biased and not informing (Webster 1999, Sexton et al. 2004) Current inter-shift handover is predominantly verbal. Two pilot studies by Pothier et al. (2005) and Bhabra et al. (2007), compared dependability of verbal, verbal with records-keeping and printed handout with relevant data set approaches. These studies have demonstrated that solely verbal handover was a poor style that led to an absolute loss of information after three consecutive handovers (Pothier et