PATIENTS' Perceptions of Bedside Handoff: The Need for a Culture of Always" was read with particular interest due to the identification of the positive effects of patient involvement during clinical communication.1 Clinical communication plays a pivotal role in patient safety and care continuity.1,2 The process of handover is characterized by the transferability of patient information as well as patient treatment responsibility and accountability.1,3 However, communication breakdowns during patient handover can negatively impact patient safety and quality of care through delays in patient diagnosis and treatment, as well as a higher efficacy of adverse events.4
Involving a patient in clinical communication during bedside handover can positively affect patient safety and continuity of care.1 Findings published in the work of Ford et al1 conclude that the implementation of patient centeredness during handover improves patient safety through increased treatment error detection and correction, a greater understanding of treatment goals and plans, and an increase in overall patient and health care professional satisfaction.1 Furthermore, patient involvement during handover strengthens the professional relationship of the patient and the health care provider.1
Support for the research findings of Ford et al1 is evident in current literature.1,2,5 Jeffs et al5 found that patient involvement during clinical communication leads to increases in patient and staff satisfaction, detection and correction of inaccuracies in treatment, decreased falls, and an overall reduction in adverse events.5 McMurray et al2 also support these findings: they reported that the development of patient-centered care during clinical communication strengthens the patient and clinician therapeutic relationship, increasing the patient's sense of control, improving functional and clinical outcomes for patients, and reducing unwarranted diagnostic testing and occurrences of adverse events.1,2,5
Although the adoption of "a culture of always" can have positive effect on patient safety, patient-centered care approaches during handover may lead to a breach of confidentiality.6 In the research study conducted by Kerr et al,6 patients expressed concern that conversations of their health information might be overheard by other patients during bedside handover. McMurray et al2 suggest that a deeper therapeutic relationship is achieved with the application of patient-centered care approaches during handover due to the perceived empowerment of patients in the ability to be involved in their health care treatment.2
From an Australian perspective, two-thirds of sentinel events occurring in the Australian health care system are attributed solely to defects of communication at bedside handover.2 The Australian Commission in Safety and Quality in Health Care identifies that the development of patient-centered care leads to overall improvements in health care quality and safety, reduction in adverse events, cost-effectiveness, and satisfaction.7 The need for patient involvement during handover is outlined in Standard 6 of the Australian Health Care Systems National Safety and Quality Health Service Standards.7
-Elianna Johnson, MN (CCU), BN, RN
Critical Care Unit, Central Gippsland Health
Service, Sale, Victoria, Australia
[email protected]
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