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Patients prefer clinical handover at the bedside; Nurses do not: Evidence from a Discrete Choice Experiment

Journal article
Authors Lena Oxelmark
Jennifer Whitty
Kerstin Ulin
Wendy Chaboyer
Ana Oliviera Goncales
Mona Ringdal
Published in International Journal of Nursing Studies
Volume 105
Issue May
ISSN 0020-7489
Publication year 2020
Published at Institute of Health and Care Sciences
Language en
Links https://doi.org/10.1016/j.ijnurstu....
Keywords Discrete choice experiment Bedside handover Nurses Patients Participation
Subject categories Nursing, Health Sciences

Abstract

Background Shift-to-shift bedside handover is advocated as a patient-centred approach, yet its enactment is challenging. Objectives To describe and compare the preferences of both patients and nurses in the implementation of bedside handover in a Swedish University Hospital. Design A discrete choice experiment (DCE) survey. Settings University setting, four medical wards in two hospitals. Participants Adult medical patients (n=218) and registered nurses (n=101) Methods The survey was administered by an electronic tablet-assisted face-to-face survey. Respondents made repeated choices between two hypothetical bedside handover alternatives and a third alternative of ‘handover away from the bedside’. Handover alternatives were described according to six attributes: invitation to participate, number of nurses present at the handover, family member, carer or trusted friend (of the patient) allowed to be present, level of (patient) involvement, what information related to your (patient) care is discussed. Choice data were analysed using a mixed logit model. Results A total of 1308 (patients) and 909 (nurses) choice observations were included in the preference models. Patients showed a strong preference for handover at the bedside compared to nurses. Nurses generally preferred handover away from the bedside. Patients perceived their level of involvement in handover as highly important, being able to speak, hear what was said being the most important characteristic, closely followed by being invited to participate and asked questions as well as being heard. Nurses considered patients being invited to participate most important, followed by level of involvement. Different options for handing over sensitive information were not perceived of importance by patients or nurses. There was substantial variation at the individual level across both patients and nurses for where and how handover is delivered. Conclusions In this study, patients strongly preferred handover at the bedside, while the nurses considered patients to be invited to participate to be the most important preference but generally preferred handover to take place away from the bedside, all else equal. When implementing bedside handover in a Swedish context this must be considered, although participation is a prerequisite for bedside handover. Differences between patients and nurses’ preferences could jeopardize future introduction of bedside handover in Swedish health care, and might explain why bedside handover is still not very common in hospital wards.

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