Perceptions, Practices and Barriers of Clinical Handover among Nurses at Colombo South Teaching Hospital, Sri Lanka.

Abstract

Background: Effective clinical handover is crucial for ensuring safe and seamless patient care during nursing shift transitions. Previous studies have shown deficiencies in the clinical handover process. Objective: To describe perceptions, practices and barriers to effective clinical handover among nurses in a selected teaching hospital

Methods: A descriptive cross-sectional study was conducted among a convenience sample of 256 nurses in Colombo South Teaching Hospital during May-June 2023. A pre-tested, self administered questionnaire was used to collect data and overall mean perception score was considered as the cut-off for levels of perception. Descriptive statistics and Chi-square test were used to analyse data using the SPSS version 26.0.

Results: The majority of the participants were female (96.5%, n=247), and 72.3% (n=185) were in 20-35 years age group. The majority (64.5%, n=165) had positive perceptions related to clinical handover process particularly in the areas of; the way of delivering information (97.7%, n=250), having opportunity to ask questions (91%, n=233) and the availability of records to clarify information (93.4%, n=239). Majority (77.7%, n=199) reported handing over patients always at the end of each shift, provide information verbally (90.2%, n=231) and bedside handover (74.2%, n=190) were commonly practiced. Patient and family involvement in handover was not widely reported. The main barriers identified included; workload (88.7%, n=227), lack of guidelines (77%, n=197), punctuality (27%, n=69) and interest among fellow nurses (17.6%, n=45). Level of perception of clinical handover is significantly associated with highest education level (p=0.014), experience in current workplace (p=0.042) and previous training on clinical handover (p=0.006).

Conclusions: Nurses had positive perceptions regarding clinical handover, and they generally practice end of shift handover at bedside using verbal communication. However, several barriers were evident. The study highlights the need for standardized guidelines, training programs, and improved information systems to enhance clinical handover practices of nurses.