Research on nursing handoffs for medical and surgical settings: an integrative review

Aims: To synthesize outcomes from research on handoffs to guide future computerization of the process on medical and surgical units.

Background: Handoffs can create important information gaps, omissions and errors in patient care. Authors call for the computerization of handoffs; however, a synthesis of the literature is not yet available that might guide computerization.

Data sources: PubMed, CINAHL, Cochrane, PsycINFO, Scopus and a handoff database from Cohen and Hilligoss.

Design: Integrative literature review.

Review methods: This integrative review included studies from 1980-March 2011 in peer-reviewed journals. Exclusions were studies outside medical and surgical units, handoff education and nurses' perceptions.

Results: The search strategy yielded a total of 247 references; 81 were retrieved, read and rated for relevance and research quality. A set of 30 articles met relevance criteria.

Conclusion: Studies about handoff functions and rituals are saturated topics. Verbal handoffs serve important functions beyond information transfer and should be retained. Greater consideration is needed on analysing handoffs from a patient-centred perspective. Handoff methods should be highly tailored to nurses and their contextual needs. The current preference for bedside handoffs is not supported by available evidence. The specific handoff structure for all units may be less important than having a structure for contextually based handoffs. Research on pertinent information content for contextually based handoffs is an urgent need. Without it, handoff computerization is not likely to be successful. Researchers need to use more sophisticated experimental research designs, control for individual and unit differences and improve sampling frames.