Patient handover: time for a change?

Abstract

Background: Receiving a patient handover from an ambulance crew occurs many times during the day across the country. Handover has major implications for subsequent patient care but there has been little investigation of the handover process between ambulance and emergency department staff.

Methods: Four emergency departments and one ambulance service were included within one geographical area in the UK. The research was based on a quantitative approach using a descriptive, non-experimental cross-sectional survey. A questionnaire was distributed to a convenience sample of ambulance paramedics and emergency department nurses and doctors. The questionnaire was constructed using mainly closed questions with some qualitative date collected through open questions. Data was analysed using SPSS version 11.5.

Results: Of the 101 questionnaires distributed, a total of 80 (68%) participants contributed towards the study. The results indicated emergency department staff need to appreciate that a lack of active listening skills can lead to frustration for ambulance staff. Ambulance staff must expect to repeat their handover, especially for patients in the resuscitation room. Handovers for critically ill patients should be delivered in two phases, with essential information given immediately and again thereafter to give further information when initial treatment has been undertaken.

Recommendations: Suggestions are made for improving handovers by developing national guidelines and by incorporating handover in emergency department education.