title: Need for a hands-on approach to hand-offs: A study of nursing handovers in an Indian Neurosciences Center.
abstract: BACKGROUND
  Standardized nursing handovers have been known to improve outcome, reduce error, and enhance communication. Few, if any, studies on nursing handovers have been conducted in the India.
  
  
  OBJECTIVE
  The aim was to study nursing handover practices in a Neurosciences Center in India.
  
  
  METHODS
  This study was conducted in a 200 bedded public sector Neurosciences Center in New Delhi, to assess nursing handover practices across five wards, all shifts, weekdays, and weekends using a pretested checklist. Ten elements were observed under the categories of time, duration, process, nurse interaction, and patient communication.
  
  
  METHODS
  Analysis of variance, Z-test, and Spearman's correlation coefficient.
  
  
  RESULTS
  Totally, 525 nursing handovers revealed varying compliance levels among (63%) time, place (76%), process (82%), staff interaction (53%), and patient communication (44%) related elements. Poorer compliance was seen in morning shifts and weekends; the difference being statistically significant. Bedside handovers were more frequent during weekends and night shifts and were positively correlated with increased staff interaction and patient communication and negatively related to handover duration. Though nurses showed better adherence to process related elements, background patient information, and assessment was explained less frequently. Differences between wards were insignificant except in categories of nurse interaction and patient communication which was better in the neurosurgery than neurology wards.
  
  
  CONCLUSIONS
  Study revealed a need for a system change and standardization of handovers. Greater administrative commitment, use of technology, training, and leadership development will aid in continuity of care, promote patient safety, and ensure better outcomes.
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Parmeshwar
authors.initials: P
authors.lastname: Kumar
authors.affiliation: Army Medical Corps, Ministry of Defence, Government of India, India.
authors.forename: Vishwanathan
authors.initials: V
authors.lastname: Jithesh
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Aarti
authors.initials: A
authors.lastname: Vij
authors.affiliation: Department of Hospital Administration, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Shakti Kumar
authors.initials: SK
authors.lastname: Gupta
keywords: Neurosciences Center; nursing handover; weekend shifts