Christiana Care Health System, Newark, Delaware, USA.
Am J Nurs. 2010 Apr;110(4):24-34; quiz 35-6. doi: 10.1097/01.NAJ.0000370154.79857.09.
Handoffs of patient care from one nurse to another are an integral part of nursing practice; but there is abundant evidence that poor communication and variable procedures result in inadequate handoffs. We sought to conduct a systematic review of articles that focused on nursing handoffs, conduct a qualitative review of barriers to and strategies for effective handoffs, and identify features of structured handoffs that have been effective.
We conducted a systematic review of English-language articles, published between January 1, 1987, and August 4, 2008, that focused on nursing handoffs in the United States. The search strategy yielded 2,649 articles. After title review, 460 of these were obtained for further review by trained abstractors.
Ninety-five articles met the inclusion criteria; of these, 55 (58%) were published between January 1, 2006 and August 4, 2008. Content analysis yielded identification of barriers to effective handoffs in eight major categories and strategies for effective handoffs in seven major categories. Twenty articles involved research on nursing handoffs. Quality assessment scores for the research studies ranged from 2 to 12 (possible range, 1 to 16). The majority of the research studies on nursing handoffs (17 studies; 85%) received quality scores at or below 8 and only three achieved scores above 10. Ten (50%) of the studies included measures of handoff effectiveness.
Despite the well-known negative consequences of inadequate nursing handoffs, very little research has been done to identify best practices. There is remarkable consistency in the anecdotally suggested strategies; but there is a paucity of evidence to support them. We call for high-quality studies of handoff outcomes that focus on systems factors, human performance, and the effectiveness of structured protocols and interventions.
护士之间的患者交接是护理实践的一个组成部分；但有大量证据表明，沟通不畅和程序多变导致交接不充分。我们试图对专注于护理交接的文章进行系统评价，对有效交接的障碍和策略进行定性评价，并确定结构交接的特征，这些特征是有效的。
我们对 1987 年 1 月 1 日至 2008 年 8 月 4 日期间在美国发表的专注于护理交接的英文文章进行了系统评价。搜索策略产生了 2649 篇文章。经过标题审查，其中 460 篇由经过培训的摘要作者进一步审查。
95 篇文章符合纳入标准；其中，55 篇（58%）发表于 2006 年 1 月 1 日至 2008 年 8 月 4 日期间。内容分析确定了有效交接的八个主要障碍类别和七个主要策略类别。20 篇文章涉及护理交接的研究。研究的质量评估分数范围为 2 至 12（可能范围为 1 至 16）。护理交接的大多数研究（17 项研究；85%）的质量评分在 8 或以下，只有 3 项评分超过 10。10 项（50%）研究包括交接有效性的测量。
尽管交接不足会产生众所周知的负面影响，但很少有研究致力于确定最佳实践。在口口相传的建议策略中存在显著的一致性；但支持这些策略的证据很少。我们呼吁对交接结果进行高质量的研究，重点关注系统因素、人为因素以及结构化协议和干预措施的有效性。
