Ryan Jessica M, Biesty Linda, Simiceva Anastasija, Devane Declan, Eppich Walter, Kavanagh Dara O, Taneri Petek Eylul, McNamara Deborah A
Department of Surgical Affairs, Royal College of Surgeons in Ireland, Dublin, Ireland
The Bon Secours Hospital, Glasnevin, Dublin, Ireland.
BMJ Open. 2025 Aug 8;15(8):e100883. doi: 10.1136/bmjopen-2025-100883.
High quality handover is critical for patient safety and care continuity. Existing practice is based on a weak evidence base in which the patient voice is poorly captured. The aim of this study was to identify outcomes of importance to patients, families and carers regarding interventions to improve in-hospital handover between healthcare practitioners.
A rapid systematic review of qualitative literature was carried out after prospective registration with PROSPERO and was reported in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses and Enhancing Transparency in Reporting the Synthesis of Qualitative Research guidelines.
The Ovid MEDLINE database was searched.
Qualitative or mixed-methods studies reporting patient, family or caregiver perspectives on in-hospital handovers were eligible for inclusion.
Synthesis was informed by the best-fit framework approach using a published taxonomy of handover-related outcomes and the Core Outcome Measures in Effectiveness Trials taxonomy. Outcomes were reported according to two distinct types of handover: bedside (patient-involved) and provider-focused (patient-uninvolved).
A total of 34 studies, including 1262 participants across a range of specialties and predominantly high-income settings, were analysed. 53 bedside and 31 provider-focused handover outcomes were identified according to four domains; adverse events, quality of patient care, quality of handover and patient/caregiver satisfaction. Bedside handover studies frequently reported outcomes relating to patient engagement and communication with healthcare staff. One study was carried out in a low income country; however, outcomes identified were broadly similar.
These findings expand the known outcomes for evaluating handover interventions and highlight the importance of prioritising the patient and public perspective in research. This work will contribute to developing a core outcome set for trials in surgical handover but can also be applied to handover practices for any other discipline within the hospital environment.
CRD42023493367.
高质量的交接班对于患者安全和护理连续性至关重要。现有做法的证据基础薄弱,患者的声音未得到充分体现。本研究的目的是确定对于患者、家属和护理人员而言,与改善医护人员之间住院期间交接班的干预措施相关的重要结果。
在向国际前瞻性系统评价注册库(PROSPERO)进行前瞻性注册后,对定性文献进行了快速系统评价,并按照系统评价和Meta分析的首选报告项目以及增强定性研究综合报告透明度指南进行报告。
检索了Ovid MEDLINE数据库。
报告患者、家属或护理人员对住院期间交接班看法的定性或混合方法研究符合纳入条件。
采用最佳拟合框架方法进行综合,使用已发表的与交接班相关结果的分类法和有效性试验核心结局指标分类法。根据两种不同类型的交接班报告结果:床边(患者参与)和以提供者为中心(患者未参与)。
共分析了34项研究,包括来自一系列专科且主要为高收入环境的1262名参与者。根据四个领域确定了53项床边交接班和31项以提供者为中心的交接班结果;不良事件、患者护理质量、交接班质量以及患者/护理人员满意度。床边交接班研究经常报告与患者参与及与医护人员沟通相关的结果。一项研究在低收入国家进行;然而,确定的结果大致相似。
这些发现扩展了用于评估交接班干预措施的已知结果,并强调了在研究中优先考虑患者和公众观点的重要性。这项工作将有助于制定手术交接班试验的核心结局指标集,但也可应用于医院环境中任何其他学科的交接班实践。
国际前瞻性系统评价注册库(PROSPERO)注册号:CRD42023493367。