title: Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge.
abstract: OBJECTIVE
  To systematically review and evaluate the effectiveness of interventions in order to improve the safety and efficiency of patient handover between intensive care unit (ICU) and general ward healthcare professionals at ICU discharge.
  
  
  METHODS
  PubMed, CINAHL, PsycINFO, EMBASE, Web of Science, and the Cochrane Library were searched for intervention studies with the aim to improve clinical handover between ICU and general ward healthcare professionals that had been published up to and including June 2013. The methods for article inclusion and data analysis were pre-specified and aligned with recommendations outlined in the PRISMA guideline. Two reviewers independently extracted data (study purpose, setting, population, method of sampling, sample size, intervention characteristics, outcome, and implementation activities) and assessed the quality of the included studies.
  
  
  RESULTS
  From the 6,591 citations initially extracted from the six databases, we included 11 studies in this review. Of these, six (55 %) reported statistically significant effects. Effective interventions included liaison nurses to improve communication and coordination of care and forms to facilitate timely, complete and accurate handover information. Effective interventions resulted in improved continuity of care (e.g., reduced discharge delay) and in reduced adverse events. Inconsistent effects were observed for use of care, namely, reduction of length of stay versus increase of readmissions to higher care. No statistically significant effects were found in the reduction of mortality. The overall methodological quality of the 11 studies reviewed was relatively low, with an average score of 4.5 out of 11 points.
  
  
  CONCLUSIONS
  This review shows that liaison nurses and handover forms are promising interventions to improve the quality of patient handover between the ICU and general ward. More robust evidence is needed on the effectiveness of interventions aiming to improve ICU handover and supportive implementation strategies.
authors: IQ healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, 9101, 6500 HB, Nijmegen, The Netherlands, nelleke.vansluisveld@radboudumc.nl.
authors: Nelleke
authors: N
authors: van Sluisveld
authors: Gijs
authors: G
authors: Hesselink
authors: Johannes Gerardus
authors: JG
authors: van der Hoeven
authors: Gert
authors: G
authors: Westert
authors: Hub
authors: H
authors: Wollersheim
authors: Marieke
authors: M
authors: Zegers
mesh_terms: D003142:Communication; D003422:Critical Care / Q000592:standards; D006282:Health Personnel; D006757:Hospital Units / Q000458:organization & administration*; D006801:Humans; D007362:Intensive Care Units / Q000458:organization & administration*; D024802:Nurse's Role; D010360:Patient Transfer / Q000592:standards*; D000078329:Workforce