Analysis of handover of complex hospitalised patients by nursing teams in Internal Medicine
Abstract
Introduction: Lack of standardization and tools to ensure continuity of care in information transfer during shift changes among healthcare professionals in patient hospitalizations remains an issue.
Objectives: To analyze the perceptions of nursing team professionals regarding the handover of complex chronic patients (CCPs) admitted to Internal Medicine units in the Region of Murcia.
Method: A multicenter, descriptive, observational, prospective, and cross-sectional study was conducted using a quantitative approach through an adapted questionnaire. Sociodemographic and work-related variables, as well as perceptions about information handover, were collected. Descriptive analysis and statistical significance tests (p < 0.05) were performed using SPSS 23.0.
Results: A total of 244 professionals participated. Even though 85% believe they perform handovers correctly, 84.83% think the process can be improved for more complex patients. The sample was predominantly female (88.11%), over 40 years old (68.4%), with half having ≤5 years of experience in Internal Medicine, and 12-hour shifts were the most common (82.4%). Significant associations were found between years of experience and adequacy of the handover location; between being a nurse (versus other roles) and forgetting information after a night shift; and between working 12-hour shifts or holding supervisory positions and the need to follow up due to information gaps, as well as receiving information from other involved professionals.
Conclusions: The nursing teams in Internal Medicine units of the Region of Murcia demonstrate a positive yet insufficient perception of the handover of complex patients. They consider it necessary to implement improvements and emphasize the importance of multidisciplinary team participation
Downloads
-
Abstract49
-
XML (Español (España))0
-
ESP_PDF (Español (España))26
-
ENG_PDF5
References
1. Corral MP, Borao JS, Atance AS. Análisis del cambio de turno y traspaso de información en equipos de enfermería de urgencias: Analysis of the shift change and transfer of information in emergency nursing teams. NURE Investig [Internet]. 14 de enero de 2020 [citado 20 de diciembre de 2024]; Disponible en:
https://www.nureinvestigacion.es/OJS/index.php/nure/article/view/1845
2. Smeulers M, Lucas C, Vermeulen H. Efectividad de diferentes estilos de traspaso de enfermería para asegurar la continuidad de la información en pacientes hospitalizados - Smeulers, M - 2014 | Cochrane Library. [citado 19 de diciembre de 2024]; Disponible en: https://www.cochranelibrary.com/es/cdsr/doi/10.1002/14651858.CD009979.pub2/full/es?highlightAbstract=handov%7Chandover
3. García DD. HERRAMIENTAS PARA LA SEGURIDAD DEL PACIENTE:
“BRIEFING” y DEBRIEFING. 2019 [citado 24 de enero de 2025];16(5):229-35. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S2254-28842017000500088
4. Abou Hashish EA, Asiri AA, Alnajjar YK. Shift handover quality in Saudi critical care units: determinants from nurses’ perspectives. BMC Nurs [Internet]. 31 de mayo de 2023 [citado 19 de diciembre de 2024];22(1):186. Disponible en: https://doi.org/10.1186/s12912-023-01348-z
5. Midega TD, Leite NCV, Nassar AP, Alencar RM, Capone A, Ferraz LJR, et al. Impact of intensive care unit admission during handover on mortality: propensity matched cohort study. Einstein São Paulo [Internet]. 10 de junio de 2021 [citado 18 de diciembre de 2024];19:eAO5748. Disponible en: https://journal.einstein.br/article/impact-of-intensive-careunit-admission-during-handover-on-mortality-propensity-matched-cohort-study/
6. Morán-Pozo C, Luna-Castaño P. Shift change handovers between nurses in CriticalCare Units. Enferm Intensiva. 2023;34(2):60-9.
7. Cowan S, Murphy P, Kim M, Mador B, Chang E, Kabaroff A, et al. Paramedic to trauma team verbal handover optimization — a complex interaction. Can J Surg [Internet]. 24 de mayo de 2023 [citado 20 de diciembre de 2024];66(3): E290-7. Disponible en: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10228662/
8. Prieto-Molina A, Aranda-Gallardo M, Moya-Suárez AB, Rivas-Ruiz F, Peláez-
Cherino J, Canca-Sánchez JC. Patient transfers from emergency departments to other inhospital areas: a failure mode and effects analysis. (“456-462_4158_ARTICULO ESPECIAL_Prieto_INGLES.indd”) Emerg Rev Soc Espanola Med Emerg.diciembre de 2023;35(6):456-62.
9. Roldán Valcárcel MD, Beteta Fernández D, Iniesta Alcázar J, Navarro Egea AP, Pérez Luján R. Gestión de casos: Análisis de costo eficiencia en continuidad de cuidados de
Pacientes crónicos complejos. Enferm Glob [Internet]. 1 de octubre de 2023 [citado 19 de diciembre de 2024];22(4):77-103. Disponible en:
https://revistas.um.es/eglobal/article/view/561651
10. García Sainz L, Guillén Chalezquer MÁ, Juandeaburre Pedroarena B, Urbiola García A, Arraztoa Alcasena MT, Martín Pérez S, et al. Comunicación intraprofesional durante el
cambio de turno a pie de cama. Percepciones del paciente. "Enferm En Cardiol Rev Científica E Inf Asoc Esp Enferm En Cardiol [Internet]." (“Papel de enfermería en la atención a pacientes con sistemas de ...”) 2020 [citado 19 de diciembre de 2024];(81):47-53. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7845228
11. Caro Rodríguez I, Ojeda Ramírez D, Casuso Jiménez L, Fernández Valenzuela R, Rodríguez Puertas JF, García Hita S, et al. Briefing. Herramienta para garantizar la seguridad del paciente. Enferm Nefrológica [Internet]. 2017 [citado 20 de diciembre de 2024]; 20:88-88. Disponible en: https://scielo.isciii.es/scielo.php?script=sci_abstract&pid=S2254-28842017000500088&lng=es&nrm=iso&tlng=es
12. Curtis K, Elphick TL, Eyles M, Ruperto K. Identifying facilitators and barriers to develop implementation strategy for an-ED to, Ward handover tool using behaviour change theory (EDWHAT). Implement Sci Commun [Internet]. 2020 [citado 19 de diciembre de 2024];1(1). Disponible en: http://dx.doi.org/10.1186/s43058-020-00045-1
13. Santos GRDSD, Barros FDM, Silva RCD. Handover communication in intensive therapy: nursing team meanings and practices. Rev Gaúcha Enferm [Internet]. 2020 [citado 18 de diciembre de 2024];41: e20180436. Disponible en:
http://www.scielo.br/scielo.php?script=sci_arttext&pid=S198314472020000100400&tlng=en
14. Figueiredo ARE, Ferreira dos Santos Potra TM, Lucas PRMB. Transição de cuidados de enfermagem: ISBAR na promoção da segurança dos doentes – revisão scoping. Ambitos Rev Int Comun [Internet]. 2020 [citado 19 de diciembre de 2024];(49):32-48. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=7548160
15. Felipe TRL, Spiri WC, Juliani CMCM, Mutro MEG. Nursing staff’s instrument for change-of-shift reporting - SBAR (Situation-Background-Assessment-Recommendation): validation and application. Rev Bras Enferm [Internet]. 22 de agosto de 2022 [citado 19 de diciembre de 2024];75: e20210608. Disponible en:
https://www.scielo.br/j/reben/a/rK7G6VycSgQjmGQV77VfHPK/?lang=en
16. Emergencias EPMU y. IDEAS y SBAR. Métodos estandarizados de traspaso de información [Internet]. Urgencias y emergencias®. 2016 [citado 20 de diciembre de 2024]. Disponible en: https://www.urgenciasyemergen.com/ideas-y-sbar-metodos-estandarizados-de/
17. Alves C, Veiga Branco MA. Effective communication in the handover in the
emergency department: nurses’ perception. Millenium [Internet]. 2024 [citado 19 de diciembre de 2024];(Extra-14):15. Disponible en: https://dialnet.unirioja.es/servlet/articulo?codigo=9408430
18. Kim JH, Lim JM, Kim EM. Patient handover education programme based on situated learning theory for nursing students in clinical practice. (“Development of Handoff Education Program using SBAR for Nursing ...”) Int J Nurs Pract. febrero de 2022;28(1):e13005.
19. Abo Seada AI, Abo Habieb ETE, Salameh BS, El-Wkeel NS, Abdelkader Reshia FA. "Developing Nursing Standards for Maintaining Shift Handover in the Intensive Care Unit: A Methodological and Cross-Sectional Study." (“Developing Nursing Standards for Maintaining Shift Handover in the ...”) Inq J Health Care Organ Provis Financ [Internet]. 1 de enero de 2022 [citado 19 de diciembre de 2024]; 59:00469580221144078. Disponible en:
https://doi.org/10.1177/00469580221144078
20. Lee H, Cumin D, Devcich DA, Boyd M. Expressing concern and writing it down: an experimental study investigating transfer of information at nursing handover. J Adv Nurs. enero de 2015;71(1):160-8.
21. Pun J. Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context. BMC Nurs [Internet]. 11 de junio de 2021 [citado 19 de diciembre de 2024];20(1):95. Disponible en: https://doi.org/10.1186/s12912-021-00624-0
22. Kazemi S, Hashemi S, Rahmani A, Mahmoudi H. Investigating the impact of nursing shift change audit on the safety of emergency department patients. (“The effect of using SBAR model in shift handover on patient and nurse ...”) Int Emerg Nurs. 2025; 78:101551. doi: 10.1016/j.ienj.2024.101551.
23. Handayani R, Rachmawaty R, Erika KAE. Estrategias para involucrar al paciente y a la familia en la mejora de los objetivos de Seguridad del Paciente en el hospital: una revisión del alcance. Enfermería Global. 2025;24(75): e636521. doi:10.6018/eglobal.636521.
24. de Lange S, Heyns T, Filmalter C. A concept analysis of person-centred handover practices: The meaning in emergency departments. Int Emerg Nurs. 2024 Jun; 74:101446. doi: 10.1016/j.ienj.2024.101446.
25. Cáceres E, Lagos Z, Cabrera P. Efectividad de las intervenciones de transición en el cuidado del paciente crítico adulto: una revisión de la literatura. Rev Iberoam Educ Investig Enferm. 2023;13(2): 36-50. Doi: https://doi.org/10.56104/Aladafe.0000.13.1021000407.
26. González-López JR, García-González J, García-González J, González-López JR. Efectividad de las intervenciones de transición en el cuidado del paciente crítico adulto: una revisión de la literatura. Enferm Intensiva. 2023;34(4):183–91.
27. Gilabert Clairol M, Villamor Ordozgoiti A, Olmo Lugo D, Castells Maspoch E, Monereo Font M, Estragués Oliva. M. Evaluación del traspaso de información (Hand Off) en equipos de enfermería de urgencias. Rev. cuba. enferm. [Internet]. 13 de octubre de 2017 [citado 28 de Abril de 2025];33(3). Disponible en: https://revenfermeria.sld.cu/index.php/enf/article/view/1539
28. Carmona-Torres JM, Requena-García C, Rivera-Picón C, Sáez-Abad C. Percepción de la muerte en estudiantes de enfermería: un estudio cualitativo. Enfermería Universitaria [Internet]. 2019 [citado 2025 Abril 28];16(3):313–20. Disponible en: https://www.scielo.org.mx/pdf/eu/v16n3/2395-8421-eu-16-03-313.pdf
Copyright (c) 2026 Global Nursing
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.
