Impact of a modified nursing handover model for improving nursing care and documentation in the emergency department: A pre- and post-implementation study

The aim of this study was to evaluate whether implementation of a new nursing handover model led to improved completion of nursing care activities and documentation. A pre- and post-implementation study, using a survey and document audit, was conducted in a hospital ED in Melbourne. A convenience sample of nurses completed the survey at baseline (n=67) and post-intervention (n=59), and the audit was completed at both time points. Results showed significant improvements in several processes: handover in front of the patient (P<0.001), patients contributed and/or listened to handover discussions (P<0.001), and provision of adequate information about all patients in the department (P<0.001). Nurses also reported a reduction in omission of vital signs (P=0.022) during handover. Three hundred sixty-eight medical records were audited in the two study periods: 173 (pre-intervention) and 195 (post-intervention). Statistically significant improvements in the completion of two nursing care tasks and three documentation items were identified. The findings suggest that implementation of a new handover model improved completion of nursing care activities and documentation, and transfer of important information to nurses on oncoming shifts.