Exploring the experiences and perceptions of the utilisation of structured clinical handover frameworks by nurses working in acute care settings: A scoping review

Background & Aim (s): Inconsistencies in utilising the structured clinical-handover frameworks exist despite evidence that these frameworks improve communication for safe high-quality patient-centred care. The scoping review’s aims were to explore, synthesize and map current existing evidence in relation to the experiences and perceptions of utilising structured clinical handover frameworks by nurses working in acute care settings while also identifying any knowledge gaps in relation to this topic area.


Methods:
The Joanna Briggs Institute guideline for scoping reviews guided this review. Studies included were limited to those meeting the predetermined Population-Concept-Context-framework, peer-reviewed primary research published in English and from year 2000 - 2022. Five databases (CINHAL, MEDLINE, PROQUEST, EMCARE and Web of Science) were searched. 301-studies were imported into COVIDENCE™ for screening; 75-duplicates removed. 226-studies remained and were screened against the inclusion/exclusion criteria resulting in 23-studies meeting the eligibility-criteria. 23-studies were evaluated for relevance and quality of research using the QualSyst-tool. All authors independently undertook all screening- processes. Data was extracted, collated, appraised, summarised from the 23-studies resulting in the narrative account of the findings established.

Results/Expected outcomes:
The review provides evidence that implementing structured clinical-handover- frameworks improves the nurses ‘experiences of handover processes while also increasing patient safety. Evidence also suggests that practice gaps in enacting these frameworks exist due to limited training, limited interdisciplinary awareness, lack of leadership support, limited patient engagement and other institutional barriers.

Challenges:
The exclusion of the studies from non-English backgrounds limits generalisability of this study. Most studies were quantitative in nature and as such there were limited augmentations from qualitative studies which means that the explored context, complexity, and diversity of the nurse’s experiences in utilising the structured clinical handover frameworks may be limited thereby signifying a gap in literature.

Implications/Conclusion/Take home message: Further research is needed to establish why inconsistencies in utilising structured clinical-handover frameworks exist and determine mitigating factors to reduce the inconsistencies for improved clinical-handover practices, safety and patient health outcomes. The perceived associations to patient outcomes need to be explored.