An ethnography of the nursing handover : a thesis submitted in partial fulfillment of the requirements for the degree of Master of Arts in Nursing at Massey University

Abstract

The purpose of this study was to enable nurses to recognise the significance of their role in delivering the nursing handover, and the impact this has on direct patient care. The aims of the study were: To identify how prepared nurses perceived they were for the next shift at the end of the nursing handover; to describe what nurses identify as important to handover to the nurse on the next shift; and to examine the processes by which nurses deliver the nursing handover. The research question was: Does the nursing handover adequately prepare the nurse for the next shift? This qualitative study using an ethnonursing approach investigated the nursing handover in a large base hospital in New Zealand between the morning and afternoon shifts. Research data were collected during 5 non-participant observations of the nursing handovers between morning and afternoon shifts, and 10 nurses were interviewed using a semi-structured interview schedule. The interview questions emerged from the non-participant observations. The data was analysed using Leininger's 4 phases of ethnonursing. The findings identified that the nurses in the study perceived they were not always adequately prepared during the nursing handover for the next shift. They frequently needed to access further information from a variety of other sources to ensure the provision of safe care to their patients. My observations showed, that the majority of these nurses when handing over recited the list of tasks and procedures they had completed during their shift, rather than prospectively providing the information required by the incoming nurses. The findings also indicated that the nursing handover is still a key component of nursing practice, and serves purposes other than just handing over patient care. It is important for the communication, education and socialisation of nurses.