Aims and objectives. To identify factors influencing change in two hospitals that moved from taped and verbal nursing handover to bedside handover. Background. Bedside handover is based on...

Aims and objectives. To identify factors influencing change in two hospitals that moved from taped and verbal nursing handover
to bedside handover.
Background. Bedside handover is based on patient-centred care, where patients participate in communicating relevant and
timely information for care planning. Patient input reduces care fragmentation, miscommunication-related adverse events,
readmissions, duplication of services and enhances satisfaction and continuity of care.
Design. Analysing change management was a component of a study aimed at developing a standard operating protocol for
bedside handover communication. The research was undertaken in two regional acute care hospitals in two different states of
Australia.
Method. Data collection included 532 semi-structured observations in six wards in the two hospitals and 34 in-depth interviews
conducted with a purposive sample of nursing staff involved in the handovers. Observation and interview data were analysed
separately then combined to generate thematic analysis of factors influencing the change process in the transition to bedside
handover.
Results and conclusion. Themes included embedding the change as part of the big picture, the need to link the project to
standardisation initiatives, providing reassurance on safety and quality, smoothing out logistical difficulties and learning to
listen. We conclude that change is more likely to be successful when it is part of a broader initiative such as a quality
improvement strategy.
Relevance to clinical practice. Nurses are generally supportive of quality improvement initiatives, particularly those aimed at
standardising care. For successful implementation, change managers should be mindful of clinicians’ attitudes, motivation and
concerns and their need for reassurance when changing their practice. This is particularly important when change is dramatic, as
in moving from verbal handover, conducted in the safety of the nursing office, to bedside handover where there is greater
transparency and accountability for the accuracy and appropriateness of communication content and processes.
Key words: interpersonal communication, nursing handover, patient-centred care, patient information, patient participation,
quality of care