title: Information structure and organisation in change of shift reports: An observational study of nursing hand-offs in a Paediatric Intensive Care Unit.
abstract: Patient hand-offs involve the exchange of critical information. Ineffective hand-offs can result in reduced patient safety by leading to wrong treatment, delayed diagnoses or other outcomes that can negatively affect the healthcare system. The objectives of this study were to uncover the structure of the information conveyed during patient hand-offs and look for principles characterising the organisation of the information. With an observational study approach, data was gathered during the morning and evening nursing change of shift hand-offs in a Paediatric Intensive Care Unit. Content analysis identified a common meta-structure used for information transfer that contained categories with varying degrees of information integration and the repetition of high consequence information. Differences were found in the organisation of the hand-off structures, and these varied as a function of nursing experience. The findings are discussed in terms of the potential benefits of computerised tools which utilise standardised structure for information transfer and the implications for future education and critical care skill acquisition.
authors.affiliation: Carleton University, Ottawa, Ontario, Canada.
authors.forename: Tara
authors.initials: T
authors.lastname: Foster-Hunt
authors.affiliation: Carleton University, Ottawa, Ontario, Canada. Electronic address: avi_parush@carleton.ca.
authors.forename: Avi
authors.initials: A
authors.lastname: Parush
authors.affiliation: University of Ottawa, Ottawa, Ontario, Canada.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Ellis
authors.affiliation: Children's Hospital of Eastern Ontario, Canada.
authors.forename: Margot
authors.initials: M
authors.lastname: Thomas
authors.affiliation: Children's Hospital of Eastern Ontario, Canada.
authors.forename: Judy
authors.initials: J
authors.lastname: Rashotte
mesh_terms: D002648:Child; D002673:Child, Hospitalized; D002983:Clinical Competence; D003266:Continuity of Patient Care; D006801:Humans; D015278:Intensive Care Units, Pediatric; D009864:Ontario; D010371:Pediatric Nursing / Q000592:standards*; D010561:Personnel Staffing and Scheduling / Q000458:organization & administration*; D011795:Surveys and Questionnaires
keywords: Change of shift report; Information organisation; Nurses; Observational study