Patient Participation in Change-of-Shift Procedures. The Implementation of the Bedside Handover for the Improvement of Nursing Quality in an Italian Hospice

In the Italian health system, the most common handover model is that of a meeting between nurses at the shift change in the nurses’ staff room. The information dealt with at the handover tends to cover patients’ medical diagnoses, physical symptoms, and clinical events. Information tends to be omitted however, relating to patients’ needs and their care plan, all elements that might benefit from involvement of the patient. This research, using Lewin’s 3-Step Model for Change, tracks the change at an Italian hospice from verbal reporting in an isolated room to bedside handover with the patient present. An assessment of the hospice bedside handover was made by means of a questionnaire in collaboration with management and training staff. One questionnaire was drawn up for patients and family members and another for nurses and healthcare assistants. The universally positive reaction of patients, appreciating the handover model proposed and obtaining benefit from it, confirmed that bedside handovers represent an increase in quality for patients. The bedside handover can help to humanize relations and indeed, as at the hospice, to humanize dying itself. This result is consistent with findings of other research confirming increases in patients’ sense of safety.