Ghent University Hospital, Belgium.
Faculty of Medicine and Health Sciences, Department of Public Health, University Center for Nursing and Midwifery, Ghent University, Belgium.
Worldviews Evid Based Nurs. 2018 Dec;15(6):432-439. doi: 10.1111/wvn.12330. Epub 2018 Oct 15.
Bedside handover is increasingly used and studied in nursing due to the method's acclaimed positive effects on patient safety, patient participation, communication, and efficiency. Still, reported results about its impact on handover duration are ambiguous. Revealing the root cause of these ambiguous effects is important, as increased duration could lead to overtime, lower job satisfaction, and failure in implementation. In contrast, decreased handover duration could lead to more efficient nursing care and facilitate implementation.
To explore the effects of bedside handovers on the handover duration by comparing wards before and after the implementation of bedside handovers.
As part of a multicentered longitudinal study, observations (N = 638) with time measurement were performed. Approximately 22% of the observations were performed by two researchers to check reliability. These time measurements were compared to the handover duration before the implementation of bedside handover, determined through interviews (n = 105), unstructured observations (n = 40), and a review of time schedules (n = 12). A descriptive, comparative research design was used.
On average, a bedside handover takes 146 s for one patient (83 s-204 s). Depending on the previously used handover model, the number of patients allocated to each nurse, and the use of a structured handover content, time gain or loss as a result of introducing the bedside handover can be expected.
The effect on time depends on the organizational changes necessary for the implementation of bedside handovers, most importantly the use of a decentralized handover model and structured handover content. Implementing bedside handover will therefore not always lead to a decrease in time use. A matrix for estimating the effects of bedside handover on time use is presented. While using bedside handovers will not always lead to decreased handover time, it will increase direct patient contact, increasing the possibilities for patient participation and enhancing patient safety.
由于床边交接对患者安全、患者参与、沟通和效率的积极影响，床边交接在护理中越来越多地被使用和研究。然而，关于其对接时间影响的报告结果并不明确。揭示这些模糊效果的根本原因很重要，因为延长交接时间可能会导致加班、降低工作满意度和实施失败。相反，减少交接时间可以使护理工作更有效率，并便于实施。
通过比较实施床边交接前后的病房，探讨床边交接对接时间的影响。
作为一项多中心纵向研究的一部分，进行了带有时间测量的观察（N=638）。大约 22%的观察由两名研究人员进行，以检查可靠性。这些时间测量与实施床边交接前通过访谈（n=105）、非结构化观察（n=40）和时间安排审查（n=12）确定的交接时间进行比较。使用描述性、比较性研究设计。
平均而言，一次床边交接需要 146 秒完成一个患者（83 秒至 204 秒）。根据之前使用的交接模式、分配给每位护士的患者数量以及使用结构化交接内容，引入床边交接可能会导致时间的增加或减少。
时间的影响取决于实施床边交接所需的组织变革，最重要的是使用分散式交接模式和结构化交接内容。因此，实施床边交接并不总是会导致时间使用减少。本文提出了一个用于估计床边交接对时间使用影响的矩阵。虽然使用床边交接并不总是会导致交接时间缩短，但它会增加与患者的直接接触，增加患者参与的可能性，并提高患者安全性。
