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Interruptions During Senior Nurse Handover in the Intensive Care Unit

A Quality Improvement Study

Spooner, Amy J., BN, Grad Dip ICU, RN; Chaboyer, Wendy, PhD, MN, BSc (Nurs) Honours, RN, FAAN; Aitken, Leanne M., PhD, B HSc (Nurs) Hons, Grad Dip Sc Med (Clin Epi), Grad Cert Mgt, IC Cert, FAAN, FACN

doi: 10.1097/NCQ.0000000000000345

Background: Interruptions during handover may compromise continuity of care and patient safety.

Local Problem: Interruptions occur frequently during handovers in the intensive care unit.

Methods: A quality improvement study was undertaken to improve nursing team leader handover processes. The frequency, source, and reason interruptions occurred were recorded before and after a handover intervention.

Interventions: The intervention involved relocating handover from the desk to bedside and using a printed version of an evidence-based electronic minimum data set. These strategies were supported by education, champions, reminders, and audit and feedback.

Results: Forty handovers were audiotaped before, and 49 were observed 3 months following the intervention. Sixty-four interruptions occurred before and 52 after the intervention, but this difference was not statistically significant. Team leaders were frequently interrupted by nurses discussing personal or work-specific matters before and after the intervention.

Conclusions: Further work is required to reduce interruptions that do not benefit patient care.

Adult Intensive Care Services, The Prince Charles Hospital, Chermside, Brisbane, Queensland, Australia (Ms Spooner); School of Nursing and Midwifery, Griffith University, Queensland, Australia (Ms Spooner and Drs Chaboyer and Aitken); Menzies Health Institute Queensland, Gold Coast, Queensland, Australia (Drs Chaboyer and Aitken); and School of Health Sciences, City, University of London, London, United Kingdom (Dr Aitken).

Correspondence: Amy J. Spooner, BN, Grad Dip ICU, RN, Queensland University of Technology, Centre for Clinical Nursing, Building 34, level 5, Cnr Butterfield St and Bowen Bridge Rd, Herston, Royal Brisbane and Women's Hospital. QLD, 4029, Australia (

Ms Spooner was partially supported by the Babe Norman PhD Scholarship awarded by the Nurses Memorial Centre.

The authors declare no conflicts of interest.

Accepted for publication: May 16, 2018

Published ahead of print: June 18, 2018

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