I-PASS-Structured Bedside Nursing Handovers: A Type-1 Effectiveness—Implementation Hybrid Pilot Study

Abstract

Aims

The aim of this study was to evaluate the feasibility, acceptability and preliminary effectiveness of I-PASS-structured (Identification—Patient—Action—Situation—Synthesis) bedside nursing handovers on the handover global quality and the patients trust in nurses.

Background

Oral end-of-shift nursing handovers can become moments of patient vulnerability. Moving handovers from nurses' offices to patients' bedsides is a means of improving them; however, implementing this remains a challenge.

Design

This was a Type-1 effectiveness–implementation hybrid study.

Methods

We measured the effectiveness using a simple interrupted time series with three measurement points before and after the introduction of I-PASS-structured bedside nursing handovers between August and November 2022. Implementation was explored using multi-method measurements of quantitative and qualitative data. As an implementation strategy, we developed a specific training session, including simulations.

Results

Bedside nursing handovers were introduced into one surgery and one medicine ward, with the 831 handovers evaluated showing significant improvements in handover quality compared to before implementation, although handover duration increased. Patient outcomes validated this change in nursing practice. However, examining nurses' perspectives of the implementation process revealed several obstacles to using bedside nursing handovers that training alone was not strong enough to overcome.

Conclusions

Given the findings of the present project, the use of bedside nursing handovers should be extended to other units by developing strategies that will make the practice sustainable.

Relevance to Clinical Practice

Bedside nursing handovers improved handover quality and created a true partnership with the patient: nurses feel more confident about seeing the patient quickly. Patients felt more taken into consideration and safer.

Patient or Public Contribution

For feasibility reasons, patients and the public were not involved in the design, conduct, reporting or dissemination plans of this research. The trial was prospectively registered before the first participant was recruited under the ISRCTN # 81701569.