Policy Research Unit on Health and Social Care Workforce, The Policy Institute at King's, King's College London, London, UK.
Int J Older People Nurs. 2020 Dec;15(4):e12339. doi: 10.1111/opn.12339. Epub 2020 Aug 27.
It is widely acknowledged that inadequate handovers are associated with putting patients at risk in clinical settings; however, handover practices have received little attention in other 24-hr settings such as long-stay residential care facilities.
This study aimed to explore the perceived purpose and organisational processes involved in the handover of information between shifts of staff caring for older residents in five care homes in England.
The study took an ethnographic approach to fieldwork, undertaken between February and June 2016. It consisted of observations of handovers (n = 12) and interviews with managers, Registered Nurses (RNs) and care assistants (n = 27) working day and night shifts. Interview transcripts and observation notes were analysed within NVivo using a matrix approach.
Handovers were highly variable in all five care homes in relation to their timings, locations, content and participants. Managers and RNs highlighted handovers as an opportunity for risk assurance, supervision, team building, staff education and monitoring of residents' clinical status. In comparison, care assistants considered the purpose of handovers to be prepared for the responsibilities of working a shift. The discussion addresses implications of these findings, particularly consideration of how best use can be made of RN skills and knowledge in handovers.
Research is needed to identify whether care home resident safety can be linked to handover practices and how the presence of RNs in handovers in care homes affects this.
Care home managers, RNs and care workers may find this research useful in practice when considering how best to organise handovers and deploy staff in care homes for older people.
人们普遍认为，临床环境中交接不充分会使患者面临风险；然而，在其他 24 小时工作场所，如长期居住的养老院，交接工作并没有受到太多关注。
本研究旨在探讨英格兰五家养老院中夜班工作人员在交接老年居民信息时，交接的目的和组织流程。
该研究采用民族志方法进行实地调查，时间为 2016 年 2 月至 6 月。它包括对 12 次交接班的观察以及对夜班和白班工作的经理、注册护士（RN）和护理助理（CA）的 27 次访谈。使用 NVivo 内的矩阵方法对访谈记录和观察笔记进行分析。
在所有五家养老院中，交接班在时间、地点、内容和参与者方面都存在很大的差异。经理和 RN 强调交接班是风险保证、监督、团队建设、员工教育和监测居民临床状况的机会。相比之下，护理助理认为交接班的目的是为轮班工作做好准备。讨论部分探讨了这些发现的影响，特别是考虑如何在交接班中最好地利用 RN 的技能和知识。
需要研究交接实践是否与养老院居民的安全相关，以及养老院交接中 RN 的存在如何影响这一点。
养老院经理、RN 和护理人员在考虑如何最好地组织交接班和在养老院部署工作人员时，可能会发现这项研究在实践中有用。
