University Nursing Report: Bedside Handover Perception

This report examines the nursing professional's perception of bedside handover in clinical practice. It begins by establishing the importance of nurses in healthcare and the debate surrounding bedside handover, which involves sharing clinical information with patients. The report reviews existing literature, including studies that identify barriers to effective handover, such as communication issues, privacy concerns, and patient participation. The methodology involves a systematic review of literature from databases like PubMed Central, focusing on peer-reviewed articles published between 2013 and 2019. The review highlights the benefits of bedside handover, such as improved patient involvement and safety, while also acknowledging potential challenges. Key findings from the literature review include the preference for bedside handover by both patients and nurses, the importance of two-way communication, and the use of structured approaches like RIMMS. The report concludes by emphasizing the need for effective communication and patient-centered approaches to improve bedside handover practices.

Running head: BEDSIDE HANDOVER
Nursing Perception of Using Bedside Handover
Name of the Student
Name of the University
Author Note

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Introduction
Nursing professionals are critical part of the health care community, forming the
largest proportion of it. Providing health care services have primary objective of improving
patient’ s health outcome and safety and it is important the nurses, who have the largest
population amongst the health care professionals, take part in the decision making process of
care planning. One of the debatable topic in nursing care provision is the use and legality of
bedside handover in clinical practice. Sharing of clinical information between the nurse and
the patient at bedside is known as bedside handover. The information shared in such situation
may include current clinical condition and medical history of the patient, the patient’s
procedures or tests that have been scheduled, patient’s planning or expectation of discharge
from the clinic and patient’s need for assistance, such as toileting or showering (Malfait et al.
2018). Bedside handover has shown to ensure continuity in care by improving the
communication between the patients and nursing staffs, allowing the former to be an
important part of the discussion surrounding their care. This characteristic of care provision
has been an integral part of the nursing care for too long and it is important to get deeper
insights on the perception of the nurses in using bedside handover.
The following paper aims at finding out the nursing professional’s collective
perception of integrating bedside handover in their provision of care to the patient.
Background
As per Tobiano et al. (2017) it is important to carry out the handover in the bedside
for the proper visualization of the patient. In the paper the author has conducted a cross-
sectional survey in which each of the participant had an open-ended question that included
the barriers to the efficient bedside handover. The target or the sample population were the
nurses who used to work in acute medical wards. The total number of participants were 200
and 100 such surveys were completed. It is seen from the previous research that bedside

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handover also helps in the better participation of the patient along with enhancement of the
patient safety. However, according to the author there might be certain barriers in the
handover of the patient that can affect the rate of the patient safety and involvement. The
handover in the profession of nursing is the change of the shift of nurses and the handover of
the duties to the next nurse (Anderson et al. 2015). The most important part of handover is
communication among the nurses and should be done properly in order to facilitate smooth
relay of the patient information from one nurse to another. The author mentions a number of
barriers that have the potential to affect the handover of the patient information. The
identification of the barriers is necessary for the successful implementation of the
recommendations in the bedside handover. The barriers to the bedside handover might
include the complexities of the cultural differences, different evaluation processes and
different leadership goals (Malfait et al. 2019). The major barriers to the bedside handover
included censoring of the messages, problem in the flow of communication, and the
inhibiting features. Research has shown that there are a number of nurses who face difficulty
in sharing patient information aloud as they view the content as private and thus do not want
to share it loudly. This creates a major problem in the handover of the bedside information
among the nurses. The disruption in the flow of communication creates problems for a
majority of the nurses at the time of bedside handover (Malfait et al. 2018). This disruption
can be created by the external influences like the noise in the hospital that can disrupt the
flow of messages. There can be disruption in the flow of communication due to the questions
asked by the family members that are not related to the content of the handover (Tobiano et
al. 2017). This can distract the nurse at the time of bedside handover. Apart from this, there is
problem in the participation of the patient and the nurses might not get full support from them
due to their medical condition. Research has shown that due to the ineffective
communication, confidentiality problems, and hindrance in the patient and nurse participation

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creates disruption in the efficient bedside handover. This can be enhanced by the use of
certain frameworks for the effective handover in the bedside. The patient centered approach
and improving the effective communication of nurses will help in improving the bedside
handover.
Methodology
The study design to achieve the objectives of the research consists of systematic
review of literature relevant to the research topic. Databases including PubMed Central,
BioMed Central, and Cochrane Library were searched for articles relevant to the research
topic. Use of keywords including nursing perception, clinical handover, bedside handover,
therapeutic relationship, communication, nurse and patients were used to search for relevant
past conducted studies on the research topic. Boolean operators ‘AND’ & ‘OR’ were used in
the advanced search option in the databases, to refine the search results and ensure greater
relevancy of results with the research topic. The inclusion of only peer-reviewed articles
published between the years 2013 to 2019 was ensured. Only articles published in English
language were included in the study. The first review of search results included analysis of
the abstracts and the second round of review ensured reading of the complete content of the
study. Studies with high relevancy, no conflicts of interest and complete compliance to all
aspects of ethical considerations were approved for further analysis and reviewing.
Out of all the search results, 5 peer-reviewed journal articles were selected to be
included in the study. The use of CASP (Critical Appraisal Skills programme) checklist were
ensured to critically analyse the validity and reliability of the research findings from the
selected articles.
Review of Literature
As per Tobiano et al. (2017) it is important to carry out the handover in the bedside
for the proper visualization of the patient. In the paper the author has conducted a cross-

4BEDSIDE HANDOVER
sectional survey in which each of the participant had an open-ended question that included
the barriers to the efficient bedside handover. The target or the sample population were the
nurses who used to work in acute medical wards. The total number of participants were 200
and 100 such surveys were completed. It is seen from the previous research that bedside
handover also helps in the better participation of the patient along with enhancement of the
patient safety. However, according to the author there might be certain barriers in the
handover of the patient that can affect the rate of the patient safety and involvement. The
handover in the profession of nursing is the change of the shift of nurses and the handover of
the duties to the next nurse (Anderson et al. 2015). The author mentions a number of barriers
that have the potential to affect the handover of the patient information. The barriers to the
bedside handover might include the complexities of the cultural differences, different
evaluation processes and different leadership goals (Malfait et al. 2019). The major barriers
to the bedside handover included censoring of the messages, problem in the flow of
communication, and the inhibiting features. Research has shown that there are a number of
nurses who face difficulty in sharing patient information aloud as they view the content as
private and thus do not want to share it loudly. This creates a major problem in the handover
of the bedside information among the nurses. There can be disruption in the flow of
communication due to the questions asked by the family members that are not related to the
content of the handover (Tobiano et al. 2017). This can distract the nurse at the time of
bedside handover. Apart from this, there is problem in the participation of the patient and the
nurses might not get full support from them due to their medical condition. Research has
shown that due to the ineffective communication, confidentiality problems, and hindrance in
the patient and nurse participation creates disruption in the efficient bedside handover. This
can be enhanced by the use of certain frameworks for the effective handover in the bedside.

5BEDSIDE HANDOVER
The patient centered approach and improving the effective communication of nurses will help
in improving the bedside handover.
According to Whitty et al. (2017), one of the most frequent adverse events that take
place in a hospital setting is due to miscommunication that had been a topic of discussion
over the past decade. The most viewed high-risk process is considered to be clinical handover
because of the fact that it might be incomplete, inaccurate, or information may be misleading
in nature. The study aims to understand as well as equate the opinions of patients and nurses
with respect to the implementation of the bedside handover procedure. The use of a discrete
choice experiment was conducted that involve six critical characteristics of handover in two
Australian hospitals. The sample size chosen for this study included 401 adult patients and
200 nurses who were recruited in the medical wards. The use of mixed multinomial logit
regression analysis was utilised for obtaining and estimating the mean importance scores for
the characteristics of handover. From the result, it was inferred that both patients and nurses
favoured handover at the bedside instead of any other areas in the hospital. It can be stated
that the presence of two nurses instead of the entire nursing team is more appropriate for the
safety and efficacy of patients (Mardis et al. 2017). In addition, the participation of patient
facilitating two-way communication is preferred by nurses and stated to be critical. On the
contrary, the nurses do not prefer the presence of family, friend or carer as it is thought to be
misguiding or interfering in nature. The outcome indicates that there is a weak preference for
sensitive information handed at bedside quietly, on the contrary, the nurses are of the opinion
that there is a reasonably strong preference toward handover of critical information on a
verbal mode away from the bedside. Therefore, the transfer at the bedside is strongly
supported by all the participants; however, the difference exists between the preference of
patient and nurses in various aspects. Moreover, the study indicated the importance of two-

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way communication that allowed the patients to conserve and resolve their queries in relation
to the care process.
An interpretive descriptive study was conducted by Roslan and Lim (2017) to
determine the perception of the nurses in using bedside handover in clinical practice in a
medical-surgical unit. According to the authors, effective clinical bedside handover is
determined by continuity of care and transition of critical information from patient to the
health care professionals and the nursing staffs play a critical role in contributing to patient’s
safety and care by making use of bedside clinical handover. The authors state that with the
help of clinical bedside handover, the nurses are able to effectively manage their workload by
prioritizing the patient care and planning it carefully according to patient’s specific need. A
typical structured approach of bedside clinical handover can be identified with the use of
RIMMS- Respect, Introduction, Medications, Management and Safety. The previous forms of
handover included the exchange of critical information outside the patient’s cubicles,
intended to prevent pass of inaccurate information and reduce interruptions. However, the
current practice of handover at patient’s bedside is deemed to be more appropriate as it
encourages the patient to be actively involved in critical decisions and care planning. Even
though bedside handover has proven its beneficence in the present time, it is still not widely
practiced by health care professionals in care settings and hospitals.
To achieve the objective of the study, the authors use qualitative research study design
for data collection and analysis. The research approach adopted by the researchers was
qualitative, descriptive and interpretive, all of which essentially helps to gain deeper insights
into perception of the nurses of using bedside handover in clinical practice. Semi-structured
interviews were conducted with focus groups that included 20 nurses from an acute-care
hospital in Singapore. Thematic analysis was applied to the data collected via transcribed
verbatim and interviews that were audiotaped. The first theme that was assessed by the

7BEDSIDE HANDOVER
researchers was the confidentiality of the patient. This theme highlighted the three major
perception of the nurses, which were potential breach of confidentiality of the patient’s
critical information, misinterpretation of information and request for secrecy by the patients.
The family members and other nursing staffs present during the bedside handover might
overhear patient’s confidential information and poor understanding of such critical
information could lead to unnecessary anxiety and fear among all stakeholders of the
particular situation. In addition to this, the research findings also suggest that majority of the
nurses perceive that bedside handover might lead to increased disturbances, caused patient’s
interrupted requests and updates asked by family members. Bedside clinical handover is
perceived to be increasing the distractions and the time taken for handover is quite extended
after such disruptions, which reduces the feasibility of using bedside handover in clinical
practice. However, a common perception of majority of the nursing professionals is that
bedside handover serves as a good platform of communication, be it between patients and the
nurses or nurse to nurse interaction. It has a critical advantage of transition of critical
information between the major stakeholder, however, the nurses worry that nurse-to-nurse
interaction via bedside handover is perceived negatively by the patients and their family
members, who think the nurses are having small talks and are being unprofessional. The
authors conclude that nurses have a common positive perception regarding use of bedside
handover in clinical perception, but necessary improvements need to be made into the
handover process to eliminate present discrepancies.
The authors Khuan and Juni (2017) conducted a qualitative study aiming to determine
the opinion of the nurses on the involvement of nurses in planning patient-centered care with
the help of bedside handover. The purpose of this study was to view the problem of affected
quality of patient care due to the involvement of patient during the bedside handover from the
perspective of Malaysian nurses. The background of the problem is that there are studies

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evidencing that the involvement of patients, their respective families and various caregivers
provide a better patient centered care (PCC) (Rathert, Wyrwich & Boren 2013). The type of
data used for this study was qualitative data collection method. The method that were used in
this study was Focus Group Discussion (FGD) method. Six male nurses and 14 female nurses
participated in this who were asked three questions (Khuan & Juni 2017). The result of the
study reflected the unwillingness of the nurses in case of involving the patients during the
bedside handover process. The nurses were reluctant with involving the patients in the
handover process (Khuan & Juni, 2017). The participant nurses also did not have a clear view
on the concept of PCC. There are a few major components of PCC, which can be enlisted as
concordance, continuity of care and communication (Constand et al. 2014).. The reason
behind this feeling of the nurses was their lack of knowledge about the concept of PCC and
their own stressed mentality. The future recommendation from this study was that the nurse
leaders must promote the concept of PCC in the nurses in order to change their opinion on
involving the patients in the bedside handover process.
As per the study conducted by Oxelmark et al. (2019), the provision of shift-to-shift
handover is considered to be an approach related to patient-centred care; however, the
depiction of the approach is challenging in nature. The perception of confidentiality of the
nurses is found to have threatened the process of bedside handover, which is one of the care
processes that increase the safety and participation of patients. The limitation of information
is found to be due to the difference in knowledge among patients and nurse’s preferences that
need to be enhanced. As commented by Tobiano et al. (2015), the traditional form of
handover is found to be less effective in term of communication among the members, thus,
affecting the aspect of patient safety. It employed 1308 medical patients and 909 registered
nurses and an electronic tablet-assisted face-to-face survey was administered in describing six
attributes of handover alternatives. It was observed that patients had shown a strong

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preference toward the handover at the bedside area instead of other location in comparison to
the preferences of nurses. Therefore, it can be seen that there is a strong preference of bedside
handover among patients; however; this is not the case for the nurses. The preferred attributes
that had been found to prefer by both the parties mostly were the patients being asked to
participate as well as the level of involvement (Vines et al. 2014). The prospect of sensitive
information provided during the handover process was stated to have minimal importance
within the study. Therefore, it can be noted that the preference of both nurses and patients
need to be considered because it may affect the future implementation and outlook of
handover beside the bed of the patient.
Conclusion
Nursing professionals play a critical role in deciding the care plan for the patients, as
they are the first instance of interaction with the patients. To derive better patient-centered
care plan, it is important that the patients are encourage to participate in the decision-making
process and voice opinions. A crucial platform to ensure this is to make use of bedside
handover in the clinical practice. The above sections of the paper reviewed five articles that
focused on analyzing the perception of the nursing professionals in integrating bedside
handover process in their clinical practice. The common perception of majority of the nurses
was that bedside handover provided a platform to support the transition of critical
information that can be used to derive better care plans for the patient. However, it can be
concluded from the above analysis that handover at bedside requires a major changes to
eliminate the small discrepancies, which include confidentiality and misinterpretation of
information.

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