title: Medication communication during handover interactions in specialty practice settings.
abstract: OBJECTIVE
  To investigate what and how medication information is communicated during handover interactions in specialty hospital settings.
  
  
  BACKGROUND
  Effective communication about patients' medications between health professionals and nurses at handover is vital for the delivery of safe continuity of care.
  
  
  METHODS
  An exploratory qualitative design and observational study.
  
  
  METHODS
  Participant observation was undertaken at a metropolitan Australian public hospital in four specialty settings: cardiothoracic care, intensive care, emergency care and oncology care. A medication communication model was applied to the data and thematic analysis was performed.
  
  
  RESULTS
  Over 130 hours of observational data were collected. In total, 185 (predominately nursing) handovers were observed across the four specialty settings involving 37 nurse participants. Health professionals communicated partial details of patients' medication regimens, by focusing on auditing the medication administration record, and through the handover approach employed. Gaps in medication information at handover were evident as shown by lack of communication about detailed and specific medication content. Incoming nurses rarely posed questions about medications at handover.
  
  
  CONCLUSIONS
  Handover interactions contained restricted and incomplete medication information. Improving the transparency, completeness and accuracy of medication communication is vital for optimising patient safety and quality of care in specialty practice settings.
  
  
  CONCLUSIONS
  For nurses to make informed and rapid decisions regarding appropriate patient care, information about all types of prescribed medications is essential, which is communicated in an explicit and clear way. Jargon and assumptions related to medication details should be minimised to reduce the risk of misunderstandings. Disclosure of structured medication information supports nurses to perform accurate patient assessments, make knowledgeable decisions about the appropriateness of medications and their doses, and anticipate possible adverse events associated with medications. In addition, benefits of patient and family member contributions in communicating about medications at handover should also be considered.
authors.affiliation: Department of Nursing, Faculty of Medicine, Dentistry and Health Sciences, The University of Melbourne, Parkville, Vic., Australia.
authors.forename: Sandra
authors.initials: S
authors.lastname: Braaf
authors.affiliation: Faculty of Medicine, Dentistry and Health Sciences, Melbourne School of Health Sciences, The University of Melbourne, Parkville, Vic., Australia.
authors.forename: Sascha
authors.initials: S
authors.lastname: Rixon
authors.affiliation: Monash Nursing Academy, Monash University, Clayton, Vic., Australia.
authors.forename: Allison
authors.initials: A
authors.lastname: Williams
authors.affiliation: Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Vic., Australia.
authors.forename: Danny
authors.initials: D
authors.lastname: Liew
authors.affiliation: Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Parkville, Vic., Australia.|School of Nursing and Midwifery, Deakin University, Burwood, Vic., Australia.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Manias
mesh_terms: D000328:Adult; D001315:Australia; D003142:Communication; D005260:Female; D006779:Hospitals, Public; D006801:Humans; D007400:Interprofessional Relations; D008297:Male; D008508:Medication Errors / Q000451:nursing / Q000517:prevention & control*; D062209:Patient Handoff
keywords: communication; handover; health care; medication; observation; participant; qualitative research; research