Handover is a common nursing responsibility. Nurses use this to transfer accountability and responsibility to the one on the next shift.

In Malaysia, one form of handover that is prevalent in the majority of clinical settings is the bedside handover. However, with medical technology, the importance of bedside care has been significantly reduced, as computerised systems are now used for the handover process.

Pros of bedside handovers

1.Knowing what to expect and continuity of care

Over the years, bedside handover is known as a patient-centered strategy to transform care. During this process, the patient will be the centre of activities within two-way communication amongst nurses.

In doing so, nurses can update the patient’s health progress, ensure that they understand their condition and know where to go for assistance and information. Overall, this form of handover promotes consistency and continuity of care.

In a given scenario of older patients who are at risk of hypernatremia following surgery, the outgoing nurses need to notify the incoming nurses about the patient’s condition of volume depletion. Generally, the patient will appear thirsty, tachycardic, and lethargic. Oncoming nurses need to be alert on the patient’s status and be prepared for other possible side effects such as disorientation, irritability, and muscle twitching since their cells will become more dehydrated.

The patient’s urine output is likely to be low as the body tries to compensate by holding onto water. Ultimately, the continuity of care is promoted when the outgoing nurse points out the nursing interventions and what has been done about it.

For instance, following the hypernatremic patient, the serum sodium and osmolality are monitored and fluid or electrolytes are administered. The oncoming nurses need to notify those in nursing care and also carefully monitor the patients’ intake and output.

2. Encourages patients to participate actively in their care plan 

Encouraging patients to participate in their plan of care promotes active engagement. Additionally, in allowing patients to clear their doubts and uncertainties, patients will be assured that the care delivered is proper and safe. 

It will also facilitate effective group cooperation as the handover will bring a group of nurses in one place at one time.

Cons of bedside handovers

1. Redundant

On the flipside, bedside handovers can be a redundant procedure when incoming nurses only need to go over the things that they are already aware of. Nurses who are passing over the report should determine the necessary parts that oncoming nurses need to be notified on. For instance, there are certain points that they will be able to find on their own, such as lab values and orders, so skip those unless it is relevant.

2. May breach patients’ privacy and confidentiality

Breaking patients’ privacy and confidentiality are other controversial issues in handovers. Many times, handovers are conducted within non-privacy areas such as a hall, where others may be able to hear about the patient’s particulars. To overcome such barriers, nurses who are involved in the handover can use written information, lower their voices, and appraise sensitive information away from the bedside.

3. Inescapable medical jargon usage

At times, the presence of many nurses at the patient’s bedside and the use of medical jargon during the handover may impede the patient from actively participating in their care. It is inevitable for nurses to use medical jargon, but what they can do is to limit their use of it and openly communicate with patients to allow them to ask for anything that they want to know.

Are bedside handovers still necessary?

Based on the points above, the pros are outweighing the cons. Thus, the bedside handover which has been present for decades should not be dismissed entirely. Factors that may be recognised as barriers in implementing effective bedside handovers should be addressed. Moreover, the handover process should be short and clear so that concise information is successfully conveyed and received.

To conclude, bedside handovers are indeed still applicable in clinical care settings. Bedside handovers act as the quality improvement strategy that allows nurses to know what to expect, ensure continuity of care and encourages patients to take part in their own care.

The cons in bedside handovers should also be considered and addressed. Possible measures include modifying how the handover is delivered, limiting the use of medical jargon and avoiding the privacy issues that may exist in this common practice. MIMS

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