Measured and perceived handover effectiveness among nurse, paramedic and medical students
Objective: This study aimed to measure the effectiveness of student handovers in simulation and examine perceptions of handover effectiveness.
Methods: A mixed-methods crossover study involving interprofessional teams of nursing students (NS), paramedic students (PS) and medical students (MS). Students participated in two medical clinical simulations, which involved handovers, completion of self-reflection questionnaires (SRQ) and pre-post simulation questionnaires: Readiness for Interprofessional Learning Scale (RIPLS) and Attitudes Towards Health Care Teams Scale (ATHCT).
Results: 18 handovers were observed. Outbound simulation (n=9): 61% of all data items were transferred by the MS, 60% by NS, and 63% by PS. Inbound simulation (n=9): 80% of all data items were transferred by PS, 64% by NS and 50% by MS. Information handed over was most variable when broken down into categories. Data most likely to be handed over were patient demographics, clinical impression and treatment. Least likely to be handed over were additional background and response to treatment. The RIPLS questionnaire showed significant differences between student groups and a change in score between pre-post questionnaires, with NS and PS scoring higher than MS: 6.33 ± 3.51, 4.71 ± 4.37 and -2.67 ± 2.3, respectively (p < 0.05). No differences were noted between the pre- and post-ATHCT questionnaire. Comparison of actual and perceived data transferred showed the percentage of non-clinical data actually transferred to be higher than students’ perceived (p < 0.05).
Conclusion: In simulation, a significant amount of critical patient information was lost in subsequent handovers. The greatest loss of data occurred from additional background information and response to treatment. There was also an imbalance between students’ perceptions of, and actual, data transferred. Our results indicate that students require increased opportunities for handover practice and clarification on what constitutes an accurate handover. Amalgamation of current handover tools to a single tool that can be used in pre-hospital and hospital environments may be beneficial.
Article submitted: 8/11/2018
Article accepted: 6/12/2018
Publish date: 17/12/2018
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