The Effectiveness of Nursing Shift Handover Interventions Associated with the Incidence of Pressure Ulcers

Nursing shift handover is a process of transferring responsibility through communication and transfer of information for providing nursing care by accomplishing the continuity and safety of patient care.  Handover between shifts occurs between nurses who have finished carrying out care hours to nurses who will continue care hours. Communication of relevant task information across the shift changes process, thereby ensuring continuity of patient safety and effective working. The transfer of patient health care information about the patient's latest condition, the therapy that has been given, and the next action plan in examination are important points in delivering handovers.

Handover activities between shifts reduce the number of patient incidents and increase the quality of nursing services. SBAR method helps outgoing nurses and incoming nurses to communicate and ensure the right information about the patient's condition. SBAR is an acronym for Situation, Background, Assessment, and Recommendation. It provides essential information about patient status points to be conveyed. Bedside handover is beneficial for nurses, patients and family members in increasing the quality and effectiveness of medical care. Patients and the family members are directly involved and feel more cared for. This also increases patient autonomy over the therapy program. (Oxelmark, et al., 2020; Smeulers, Lucas, & Vermeulen, 2014).

Some of the barriers to handover implementation between nurses' shifts arise with nurses who have not consistently implemented the SBAR method. Nurses' tendencies to communicate things that do not contain the essence are related to the patient's condition as a whole. Hospital focused an effort on improving the quality of handover of individual patients by making a separate handover form. The purpose of this form is to help nurses stay focused on using SBAR in implementation. This form serves as a guide for nurses when doing handovers between shifts. The use of this form is expected to minimize incomplete data handover between nurses.

The important components in the inter-shift handover form include an assessment which is a summary of examination results completed by nurses throughout the nursing shift. The patients’ wound and the environmental conditions that affect the occurrence of the wound becomes a note that must be documented and handed over. 

Continuing nurses' handovers explores important information about the risks and conditions that allow the appearance of pressure ulcers. For example, there are areas of protruding bone, the appearance of areas of redness and decreased skin integrity.

Important information regarding pressure ulcers that are handed over will form the basis of continuous nursing interventions. If the initial phase of the risk of developing pressure ulcers gets detected and handled properly, it can be a preventive measure so that pressure ulcers do not turn into severe wounds. The nurse, as the most familiar care provider for the patient, must ensure that the patient does not experience an injury or illness beyond the main diagnosis and of course this is an indicator of quality service achievement features in the hospital.

A Standardized Shift Handover implementation must be mastered by nurses regarding the goal of communication which is security, safety and continuity of service to patients. A good handover helps the next shift to carry out care according to the treatment goals. The ongoing process is documentation form of care continuity, in this case related to a pressure ulcers incident.

“Handover activities between shifts reduce the number of patient incidents and increase the quality of nursing services.”

The consequence of poor handover between shifts leads to the possibility of missing information. Patients with pressure ulcers are in a deteriorating condition because the nursing care planning function is not going well. Other conditions that may occur are unavailability of nutritious food, the need for skin moisture and stimulation of circulation in the pressure sore area. This condition can exacerbate the ulcer pressure condition experienced by the patient.

The final part of this paper concludes that handover between shifts has high effectiveness on pressure ulcers management in hospitals. The management of the handover process which involves the supervisory role of the nursing manager enables the effectiveness of the process to run optimally. Handovers that are carried out precisely can also support the planning and management of pressure ulcers properly.