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Quality in Postoperative Patient Handover

Different Perceptions of Quality Between Transferring and Receiving Nurses

Reine, Elizabeth, RN, MNSc; Ræder, Johan, MD, PhD; Manser, Tanja, PhD; Småstuen, Milada C., PhD; Rust⊘en, Tone, PhD, RN

doi: 10.1097/NCQ.0000000000000318

Background: A safe and efficient patient handover is important to ensure high-quality patient care and reduce the risk of patient harm. Few studies have explored handover activities beyond information transfer.

Purpose: The aims were to assess overall postoperative handover quality and relate quality assessments to handover circumstances, conduct, and teamwork and to compare transferring and receiving nurses' evaluations of handover quality.

Method: This was a cross-sectional study using the Norwegian Handover Quality Rating Form (N-HQRF). In addition, data were collected on nurses' evaluations of the patient condition, handover preparation, and participating nurses' clinical experience.

Results: Although total perceived handover quality was high in a large majority of cases, there were significant differences between transferring and receiving nurses' evaluations of the same handover. Lower-quality handovers had a higher frequency of time pressure, uncertainty, and patient-related problems.

Conclusion: The findings point to the need to assess handover quality in a wider perspective. Handover circumstances might impact handover quality and should be considered when procedures for handover quality are designed and implemented.

Departments of Nurse Anesthesia (Ms Reine), Anesthesiology (Dr Ræder), and Research and Development (Drs Småstuen and Rust⊘en), Division of Emergencies and Critical Care, Oslo University Hospital, Norway; Department of Nursing Science, Institute of Health and Society (Ms Reine and Dr Rust⊘en), and Institute of Clinical Medicine (Dr Ræder), Faculty of Medicine, University of Oslo, Norway; Institute for Patient Safety, University Hospital Bonn, Germany, and Department of Health Studies, University of Stavanger, Norway (Dr Manser); and Faculty of Health Sciences, Oslo, and Akershus University College of Applied Sciences, Norway (Dr Småstuen).

Correspondence: Elizabeth Reine, RN, MNSc, Department of Nurse Anesthesia, Division of Emergencies and Critical Care, Postboks 4950 Nydalen, 0424 Oslo, Norway (

The authors declare no conflicts of interest.

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Accepted for publication: November 27, 2017

Published ahead of print: January 16, 2018

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