OBJECTIVE: To develop a digital intelligent multimodal shift handover system for the intensive care unit (ICU) and evaluate its application effect in ICU shift handovers. METHODS: A research and development team was established, consisting of 1 department director, 1 head nurse, 3 information technology engineers, 3 nurses, and 2 doctors. Team members were assigned responsibilities including overall coordination and planning, platform design and maintenance, pre-application training, collection and organization of clinical feedback, and research investigation respectively. A digital intelligent multimodal shift handover system was developed for ICU based on the Shannon-Weaver linear transmission model. This innovative system integrated automated data collection, intelligent dynamic monitoring, multidimensional condition analysis and visual reporting functions. A cloud platform was used to gather data from multi-parameter vital signs monitors, infusion pumps, ventilators and other devices. Artificial intelligence algorithms were employed to standardize and analyze the data, providing personalized recommendations for healthcare professionals. A self-controlled before-after method was adopted. Before the application of the ICU digital intelligent multimodal shift handover system (from December 2023 to March 2024), the traditional verbal bedside handover was used; from June 2024 to March 2025, the ICU digital intelligent multimodal shift handover system was applied for shift handovers. Questionnaires before the application of the shift handover system were collected in April 2024, and those after the application were collected in April 2025. The shift handover time, handover quality (scored by the nursing handover evaluation scale), satisfaction with doctor-nurse communication (scored by the ICU doctor-nurse scale) before and after the application of the handover system were compared, and nurses' satisfaction with the shift handover system (scored by the clinical nursing information system effectiveness evaluation scale) was investigated. RESULTS: After the application of the ICU digital intelligent multimodal shift handover system, the shift handover time was significantly shorter than that before the application [minutes: 20 (15, 25) vs. 30 (22, 40)], the handover quality was significantly higher than that before the application [score: 84.0 (78.0, 88.5) vs. 71.0 (55.0, 79.0)], and the satisfaction with doctor-nurse communication was also significantly higher than that before the application (score: 84.58±6.79 vs. 74.50±11.30). All differences were statistically significant (all P < 0.05). In addition, the nurses' system effectiveness evaluation scale score was 102.30±10.56, which indicated that nurses had a very high level of satisfaction with the ICU digital intelligent multimodal shift handover system. CONCLUSIONS The application of the ICU digital intelligent multimodal shift handover system can shorten the shift handover time, improve the handover quality, and enhance the satisfaction with doctor-nurse communication. Nurses have a high level of satisfaction with this system.
Intensive Care Units ; Humans ; Patient Handoff ; Artificial Intelligence ; Algorithms

OBJECTIVE: This study investigated and compared the perspectives on emergency medicine (EM) professionalism competencies of medical students and EM residents. In addition, how they learned their EM professionalism was also investigated to develop the base of an educational program of professionalism in the field of EM. METHODS: Medical students in four medical colleges/schools and EM residents were recruited for the questionnaire. Regarding the importance and educational need for EM professionalism, 23 items for medical students and 59 items for EM residents were asked. The items were rated on a five point Likert scale. The perspectives of the two groups were compared. The learning methods for professionalism were investigated. RESULTS: A total of 198 medical students and 109 EM residents responded to the questionnaire. The residents responded with mean of 3.0 or more on all items, agreeing on the importance and educational need. On the other hand, the mean scale was less than 4.0 in communication and cooperation with society and social accountability. The students responded with a mean scale of 4.0 or more on all items and agreed on the importance and educational need. Of the 23 common items, there were differences between the two groups in 17 items, showing a higher mean value in the students. The most common methods of learning EM professionalism was bedside teaching during the clinical clerkship for students, and patient handover or board round for residents. CONCLUSION: EM residents tended to place more importance on medical care than social communication, cooperation, and ethical items. The most common learning method of EM professionalism was clinical practice-associated activities. The results of this study could help to develop a systematic and realistic educational program of EM professionalism in EM clerkship and resident training.
Clinical Clerkship ; Emergencies ; Emergency Medicine ; Hand ; Humans ; Learning ; Methods ; Patient Handoff ; Professionalism ; Social Responsibility ; Students, Medical

PURPOSE: This study was conducted to develop a handoff education program for nursing students and examine the effects of it on nursing students'self-efficacy, communication ability, and clinical performance ability. METHODS: A quasi-experimental design was used with a nonequivalent control group pretest-posttest method. The experimental group (n=31) received handoff education using SBAR; the control group (n=31) received non-SBAR handoff education. Self-efficacy, communication ability, clinical performance ability were measured to evaluate the effects of the program. RESULTS: The experimental group showed significant improvements in self-efficacy (p<.001), and communication ability (p=.025) compared to the control group. However, there was no significant difference in the clinical performance ability between the groups (p=.618). CONCLUSION: The results indicate that the handoff education program using SBAR is effective in improving nursing students'self-efficacy and communication ability.
Communication ; Education ; Humans ; Methods ; Nursing ; Patient Handoff ; Self Efficacy ; Students, Nursing

PURPOSE: This study aimed to investigate the performance of patient engagement nursing services perceived by nurses and necessity in Korea. METHODS: This study was a descriptive research. A total of 205 nurses participated in the study. The Smart Patient Engagement Assessment Checklist was developed by the investigators to assess patient engagement nursing services performance and necessity. The data were collected using online survey. Descriptive analysis and χ² analysis were performed using SPSS 25.0 program. RESULTS: The mean age of participants was 36.6±8.5 years and the mean working experience was 12.92±9.23 years. Seventy eight percent of participants reported that patients and family participated in care as advisors through customer's suggestion or patient satisfaction assessment. The rate of patients' and family's engagement in care as advisors was significantly higher in tertiary hospitals (χ²=28.54, p<.001). About 89% of participants communicated with patients and family to make clinical decisions with a multidisciplinary approach. The rate of communication for multidisciplinary decision making was significantly higher in tertiary hospitals (χ²=6.30, p=.012). With regards to nurses' bedside patient handoff, 22.0% of participants reported that they were performing bedside patient handoff, and there was no significant difference between type of hospitals. About discharge planning, 72.2% of participants reported utilizing discharge checklist. CONCLUSION: Currently, patient engagement nursing services are applied partially in Korea. It seems that care protocols to be applied for patient engagement nursing services are insufficient. Therefore, patient engagement care protocols need to be developed to improve patient's health outcome and safety.
Checklist ; Decision Making ; Humans ; Korea ; Needs Assessment ; Nursing Services ; Nursing ; Patient Discharge ; Patient Handoff ; Patient Participation ; Patient Satisfaction ; Research Personnel ; Tertiary Care Centers

PURPOSE: This study develop a Video Recording-Based Standardized Handoff (VRSH) program at shift change for ward nurses.METHOD: The study was conducted in five medical, three surgical, and one comprehensive nursing care service wards affiliated with a secondary general hospital. In this methodological study, the VRSH program was developed between April and December, 2017. It is noted that 65 nurses who were involved in the VRSH program participated in this study.RESULTS: In line with the modified Situation, Background, Assessment, Recommendation tool, the VRSH program consisted of three phases. In the VRSH program, the average time for handoff duration was 3–5 minutes per patient. More than 90% of the ward nurses were satisfied with the VRSH program since it benefited them by reducing overtime work and improving the performance, as well as effective communication, of nurses. The content analysis of nurses' VRSH program experience, revealed three categories and eight sub-categories.CONCLUSION: This study provides evidence that the VRSH program improves effective nursing performance and, the handoff communication and relationships between nurses. Future studies on large sample sizes and multiple settings are required to substantially evaluate the impact of the VRSH program on clinical outcomes.
Feasibility Studies ; Hospitals, General ; Humans ; Methods ; Nursing ; Nursing Care ; Patient Handoff ; Pilot Projects ; Sample Size ; Video Recording

PURPOSE: The purpose of this study was to develop a model for handoff education for nursing students based on simulation using video and to identify educational effects of a simulated situation in pediatric care units. METHODS: Data were collected from May 1 to 30, 2016. Participants were 84 senior nursing students in Seoul(video group: 43, simulation group: 41). Both groups were given a lecture and pre-briefing on handoff education. The simulation group had nursing practice on resolving health issues for respiratory distress using a high-fidelity baby simulator. The video group watched a video recording of a scenario based simulation, and used a summarized handoff situation to practice patient handoff to another student. RESULTS: There was no significant difference between the two groups for handoff self-confidence, problem solving ability, handoff competence(self-assessment of students), or learning satisfaction. Self-confidence increased significantly in both groups. Handoff competency evaluated by the instructor was higher in the video group compared to the simulation group(t=2.33, p=.022). CONCLUSION: Nursing student education for handoff practice utilizing a video in the pediatric unit was more cost effective. Therefore, it could be a useful educational method for students in learning patient handoff practices and helpful for related research.
Clinical Competence ; Education ; Humans ; Learning ; Methods ; Nursing ; Patient Handoff ; Patient Simulation ; Pediatric Nursing ; Problem Solving ; Students, Nursing ; Video Recording

PURPOSE: Advocates for societal change and consumerism have been instrumental in popularizing patient involvement in various aspects of health care. Patient involvement in bedside handovers during shift changes should facilitate patient-centered care. This study's purpose was to explore Malaysian nurses' opinions about patient involvement during bedside handovers, and whether patient involvement during bedside handovers reflected patient-centered care. METHODS: A qualitative study with four focus-group discussions was conducted with 20 registered nurses from general wards in a Malaysian public hospital. Semi-structured interviews were used to elicit participants' opinions. NVivo 10 software was used for data management and content analysis was used to analyze the data. RESULTS: Several participants used inconsistent methods to involve patients in bedside handovers and others did not involve the patients at all. The participants' interpretations of the concept of patient-centered care were ambiguous; they claimed that patient involvement during bedside handovers was impractical and, therefore, not reflective of patient-centered care. Some nurses' subjective views of patient involvement as impractical during bedside handovers were manifested in their deliberate exclusion of patients from the handover process. CONCLUSIONS: Changes in patient involvement and nursing practices congruent with patient-centered care require that nurse educators in hospital settings reform nursing education to focus on fostering of communication skills needed to function in nurse-patient partnerships. Guidelines for patient involvement consistent with patient-centered values should be developed using ward nurses' subjective views and introduced to all registered nurses in practice.
Delivery of Health Care ; Education, Nursing ; Focus Groups ; Foster Home Care ; Hospitals, Public ; Humans ; Nurses ; Nursing ; Patient Handoff ; Patient Participation* ; Patient-Centered Care* ; Patients' Rooms

INTRODUCTIONThe efficiency of postoperative handover of paediatric patients to the children's intensive care unit (CICU) varies according to institutions, clinical setup and workflow. Reorganisation of handover flow based on findings from observational studies has been shown to improve the efficiency of information transfer. This study aimed to evaluate a new handover process based on recipients' perceptions, focusing on completeness and comprehensiveness of verbal communication, and the usability of a situation, background, assessment and recommendation (SBAR) form.

METHODSThis was a prospective interventional study conducted in the CICU of KK Women's and Children's Hospital, Singapore. It comprised four phases: (1) evaluation of the current handover process through an audit and opinion survey; (2) development of a new handover process based on the opinion survey and hospital personnel feedback; (3) implementation; and (4) evaluation of the new handover process. The new handover process was based on a PETS (pre-handover, equipment handover, timeout and sign out) protocol with a 'single traffic communication' flow and a new SBAR handover document. It included relevant patient information, and the options 'not applicable' and 'none', to increase compliance and reduce ambiguity.

RESULTSSignificantly more recipients indicated that the new SBAR form was the most important handover tool and provided more useful information. Recipients' perceptions indicated improvement in information sufficiency and clarity; reduction of omission errors; and fewer inconsistencies in patient descriptions in the new process.

CONCLUSIONDual customisation of the handover process, PETS protocol and SBAR form is necessary to meet the workflow and information demands of the receiving team.

Anesthesia ; Attitude of Health Personnel ; Child ; Critical Care ; methods ; Hospitals, Pediatric ; organization & administration ; Humans ; Intensive Care Units ; Medical Errors ; prevention & control ; Nurses ; Observational Studies as Topic ; Patient Handoff ; Pediatrics ; methods ; Postoperative Care ; methods ; Postoperative Period ; Prospective Studies ; Singapore ; Surveys and Questionnaires

INTRODUCTIONThe aim of the present study was to investigate the challenges faced by physicians during shift handovers in a university hospital that has a high handover sender/recipient ratio.

METHODSA multifaceted approach was adopted, comprising recording and analysis of handover information, rating of handover quality, and shadowing of handover recipients. Data was collected at the general medical ward of a university hospital in Singapore for a period of three months. Handover information transfer (i.e. senders' and recipients' verbal communication, and recipients' handwritten notes) and handover environmental factors were analysed. The relationship between 'to-do' tasks, and information transfer, handover quality and handover duration, were examined using analysis of variance.

RESULTSVerbal handovers for 152 patients were observed; handwritten notes on 102 (67.1%) patients and handover quality ratings for the handovers of 98 (64.5%) patients were collected. Although there was good task prioritisation (information transfer: p < 0.005, handover duration: p < 0.01), incomplete information transfer and poor implementation of nonmodifiable identifiers were observed. The high sender/recipient ratio of the hospital made face-to-face and/or bedside handover difficult to implement. Although the current handover method (i.e. use of telephone communication), allowed interactive communication, it resulted in systemic information loss due to the lack of written information. The handover environment was chaotic in the high sender/recipient ratio setting, and the physicians had no designated handover time or location.

CONCLUSIONHandovers in high sender/recipient ratio settings are challenging. Efforts should be made to improve the handover processes in such situations, so that patient care is not compromised.

Adult ; Communication ; Continuity of Patient Care ; Data Collection ; Female ; Hospitals, University ; Humans ; Male ; Patient Handoff ; Patient Safety ; Physicians ; Singapore ; Young Adult

PURPOSE: This study was done to analyze the effectiveness of simulation-based integrated practice program (maternal-child) on nursing knowledge, self-confidence, and clinical competence of nursing students. METHODS: A nonequivalent control group pre-post experimental design was used to compare experimental and control group. The experimental group received the integrated simulation practice and the control group received a separate simulation for maternal care and for newborn care. RESULTS: The experimental group who had the integrated simulation had significantly higher scores for self-efficacy on nursing handover (F=0.480 p=.012) and oxygen therapy in newborn care (F=3.262 p=.037), and for clinical competence (F=2.639, p<.001) and personal satisfaction with debriefing compared to the control group (F=2.179, p=.044). But the experimental group did not have significantly higher scores in nursing knowledge. Conclusions The results indicate that an integrated simulation practice is an effective practice method to improve self-confidence, clinical competence and satisfaction. Also this study had significance in providing a setting similar to the clinical situation.
Clinical Competence ; Humans ; Infant, Newborn ; Nursing* ; Oxygen ; Patient Handoff ; Patient Simulation ; Personal Satisfaction ; Research Design ; Students, Nursing*