Features of recording practices and communication during nursing handover: a cluster analysis

Rikos, Nikos; Linardakis, Manolis; Rovithis, Michael; Philalithis, Anastas

doi:10.1590/S1980-220X2018006203401

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Original Article • Rev. esc. enferm. USP 52 • 2018 • https://doi.org/10.1590/S1980-220X2018006203401 copy

Features of recording practices and communication during nursing handover: a cluster analysis^* * Extracted from thesis: “The assessment of the information of Nursing Handover in a hospital in Greece”, University of Crete, Faculty of Medicine, Department of Social Medicine, 2016.

Características da gravação de práticas e comunicação durante a troca de turno de enfermagem: uma análise de grupo

Características de la grabación de prácticas y comunicación durante el cambio de turno de enfermería: un análisis de grupo

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective:

To record and identify the characteristics of nursing handovers in a tertiary hospital.

Method:

Observational study. Twenty-two nurses participated in 11 nursing handovers in 2015/16, using a recorded audio system and an unstructured observation form. Hierarchical cluster analysis was performed.

Results:

Thirty characteristics were identified. The nursing handovers were based on the clinical status of patients, and all nurses obtained specialized scientific knowledge specific to the clinical environment. The information used was not based on nursing diagnoses and not in accordance with best nursing clinical practice. The following four clusters emerged among the 30 characteristics: 1) the use of evidence-based nursing practice, 2) the nonuse of evidence-based nursing practice and its correlation with strained psychological environment, 3) patient management and the clinical skills/knowledge of nurses, and 4) handover content, quality of information transferred and specialization.

Conclusion:

Multiple characteristics were observed. The majority of characteristics were grouped based on common features, and 4 main clusters emerged. The investigation and understanding of structural relations between these characteristics and their respective clusters may lead to an improvement in the quality of nursing health care services.

DESCRIPTORS
Patient Handoff; Nursing Care; Nursing Audits; Nursing Services

		N	%
Gender	males	3	13.6
	females	19	86.4
Age, years	up to 30	4	18.2
	31-40	8	36.4
	41 +	10	45.5
mean ± standard deviation (min-max)			39.3±8.2 (27-53)
Profession	registered nurse	17	77.3
	staff or head nurse	5	22.7
Departments	Pediatric General (3 clinics)	6	27.3
	Surgical (3 clinics)	6	27.3
	Internal Medicine (5 clinics)	10	45.4
Occupation status, years	mean ± standard deviation (min-max)		18.7±6.9 (5-30)
	20+ years	10	45.5

Characteristics	n	%
1. Based on the patient's clinical status	11	100.0
2. The handover is simply and scientifically approached without the evidence-based nursing documentation	8	72.7
3. Nurses act with special skills and comments	8	72.7
4. All nursing levels participate	9	81.8
5. Key management by nurses	8	72.7
6. Participation in the interdisciplinary management of the patients	8	72.7
7. Further information from other health professionals	11	100.0
8. Substantial biopsychosocial approach	8	72.7
9. Strong emotional bonding with the patients	5	45.5
10. Not based upon nursing diagnoses	9	81.8
11. Not acting according to the Best Nursing Clinical Practice	9	81.8
12. Handle with Nursing Diagnoses	2	18.2
13. Management according to the Best Nursing Clinical Practice	2	18.2
14. Starting from the first day of hospitalization up to that time	7	63.6
15. Special scientific knowledge specializing in the clinical environment	11	100.0
16. Considerably detailed handover	9	81.8
17. Strained working environment	9	81.8
18. Strained psychological environment	7	63.6
19. It is noticed that nurses perform and act independently, regardless of their instructions	5	45.5
20. Act auxiliary to other health professionals	10	90.9
21. Patient education or training	10	90.9
22. Use of scientific terminology	9	81.8
23. Satisfactory general scientific knowledge beyond the Nursing Science	6	54.5
24. Use of empirical skills	11	100.0
25. Implementation of specialized skills and interventions	6	54.5
26. Based only on the scientific data with evidence-based documentation character	2	18.2
27. Implementation of Nursing clinical examination	1	9.1
28. Use of electronic recording system & Nursing folders	6	54.5
29. Use of Nursing folders only, in a hardcopy form	1	9.1
30. Use of Nursing folders in a hardcopy form and notes	4	36.4

Characteristics	Departments
Characteristics	Pediatric General	Surgical	Internal Medicine
1. Based on the patient's clinical status	100.0	100.0	100.0
2. The handover is simply and scientifically approached without the evidence based nursing documentation	100.0	100.0	40.0
3. Nurses act with special skills and comments	100.0	33.3	80.0
4. All nursing levels are participating	66.7	100.0	80.0
5. Key management by nurses	66.7	100.0	60.0
6. Participation in the interdisciplinary management of the patients	66.7	100.0	60.0
7. Further information from other health professionals	100.0	100.0	100.0
8. Substantial biopsychosocial approach	100.0	33.3	80.0
9. Strong emotional bonding with the patients	100.0	0.0	40.0
10. Not based upon nursing diagnoses	100.0	100.0	60.0
11. Not acting according to the Best Nursing Clinical Practice	100.0	100.0	60.0
12. Handle with Nursing Diagnoses	0.0	0.0	40.0
13. Management according to the Best Nursing Clinical Practice	0.0	0.0	40.0
14. Starting from the first day of hospitalization up to that time	100.0	33.3	60.0
15. Special scientific knowledge specializing in the clinical environment	100.0	100.0	100.0
16. Considerably detailed handover	100.0	66.7	80.0
17. Strained working environment	100.0	66.7	80.0
18. Strained psychological environment	100.0	0.0	80.0
19. It is noticed that nurses perform and act independently, regardless of 33.3		66.7	40.0
20. Act auxiliary to other health professionals	100.0	100.0	80.0
21. Patient education or training	100.0	66.7	100.0
22. Use of scientific terminology	66.7	100.0	80.0
23. Satisfactory general scientific knowledge beyond the Nursing Science	0.0	66.7	80.0
24. Use of empirical skills	100.0	100.0	100.0
25. Implementation of specialized skills and interventions	33.3	66.7	60.0
26. Based only on the scientific data with evidence-based documentation character	0.0	0.0	40.0
27. Implementation of Nursing clinical examination	0.0	0.0	20.0
28. Use of electronic recording system & Nursing folders	66.7	66.7	40.0
29. Use of Nursing folders only, in a hardcopy form	0.0	33.3	0.0
30. Use of Nursing folders in a hardcopy form and notes	33.3	0.0	60.0

Universidade de São Paulo, Escola de Enfermagem Av. Dr. Enéas de Carvalho Aguiar, 419 , 05403-000 São Paulo - SP/ Brasil, Tel./Fax: (55 11) 3061-7553, - São Paulo - SP - Brazil
E-mail: reeusp@usp.br

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[1] Corresponding author: Nikos Rikos, 36 N. Xilouri St., PO Box 71307 Heraklion, Crete, Greece rikosn@gmail.com

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Features of recording practices and communication during nursing handover: a cluster analysis* * Extracted from thesis: “The assessment of the information of Nursing Handover in a hospital in Greece”, University of Crete, Faculty of Medicine, Department of Social Medicine, 2016.

Características da gravação de práticas e comunicação durante a troca de turno de enfermagem: uma análise de grupo

Características de la grabación de prácticas y comunicación durante el cambio de turno de enfermería: un análisis de grupo

ABSTRACT

Objective:

Method:

Results:

Conclusion:

Features of recording practices and communication during nursing handover: a cluster analysis^* * Extracted from thesis: “The assessment of the information of Nursing Handover in a hospital in Greece”, University of Crete, Faculty of Medicine, Department of Social Medicine, 2016.