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JANE CURRIE outlines the results of a study into A&E handovers
Handover is an important nursing ritual, essential for continuity of care (Kennedy 1999), and as nurses we should be aiming to improve the efficiency of handover in the environment we work in. This piece of research was invited by the A&E clinical manager at Selly Oak Hospital, Birmingham, following the author's audit on handover on a surgical ward (Currie 2000). The aim of the research was to identify which topics of handover should receive the highest priority when working in an A&E environment.
At the time of writing there appeared to be no available research on handover in the emergency department environment. However, there is a wealth of literature on nursing handover on wards. Topics ranging from its contents (Hesse 1983), its length (Matthews 1986, Sherlock 1995, Thurgood 1995), the methods of handover, including bedside (McMahon 1990, Howell 1994) tape recorded (Mosher and Bontomasi 1996) and nonverbal (Kennedy 1999) to patient confidentiality during handover are described (Howell 1994).
The literature shares one common feature; being that handover influences the delivery of care for the following shift (Thurgood 1995). Hesse (1983) argued that a successful handover should be guided by nursing and medical documentation and it should include the patient's diagnosis, vital signs, diagnostic tests and restrictions. Including these topics may ensure that handover is accurate. Modern nursing is extremely fluid, there is a high turnover of both staff and patients so the accuracy of handover becomes ever more important.
RESEARCH DESIGN
To obtain a large amount of information in a swift time frame, the author selected a questionnaire design (Table 4). The questionnaire design was based on the 'Content checklist', which was used in the previous audit (Currie 2000), this encompassed the topics listed by Hesse (1983). The research assistant verified the questionnaire.
The study was piloted on the emergency admissions assessment unit, and this acute environment made an excellent training ground for this research. The pilot study highlighted two areas requiring modification. First, the researcher added one topic to the questionnaire. Second, when analysing the data from question 13, many nurses gave more than one response. The method of analysis for this data was modified so that the data was...