Development of Patient Handover Documentation Tool for Staff Nurses using Modified Delphi Technique

The handoff is a mechanism for transferring information, primary responsibility, and authority from one or a set of caregivers, to oncoming staff. The concept of a handoff is complex and includes communication between the change of shift, communication between care providers about patient care, handoff, records, and information tools to assist in communication between care providers about patient care.¹ Evidence suggests that nurse documentation is often inconsistent and lacks a coherent and standardized approach. In most of the hospitals there seemed to be no clear policy for delivering handover and each nurse chose their own method, making handover inconsistent. Inadequate communication handovers have been identified as the primary root cause in sentinel events. The different unit cultures and contexts and the resulting lack of collaboration and cohesion between nurses create increased risk for adverse events. In addition, the nurses developed an appreciation for the challenges of the different work environments.²

The aim of study is to develop Patient Handover Documentation Tool for Staff Nurses.

To select and pool items for Patient Handover Documentation Tool for Staff Nurses

To obtain consensus of panelists for Patient Handover Documentation Tool for Staff Nurses

To organize valid items in a structured format for development of Patient Handover Documentation Tool for Staff Nurses

Using instrument development design for Patient Handover Documentation Tool for Staff Nurses. 252 Items were generated from evidence and qualitative data. Face and content validity were established through experts by 3 modified Delphi round. Content validity was computed. The content validity index (CVI) was calculated for each item i.e CVI-i, content validity index for experts i.e CVI-e and general content validity index for the tool i.e CVI-total. Item level CVI (CVI-i) is calculated by number of experts agreeing on the value of relevance of each item (value between 3 and 4) divided by total number of experts, expert level CVI (CVI-e) is calculated by number of items scored between 3 and 4 by an expert divided by total number of items and general CVI (CVI-total) is calculated by sum of all experts individual CVI divided by number of experts. Based on expert panel, CVI-i lower than 0.6 were deleted, (CVI-e) is 0.8, and CVI-total) 0.825. The 252 items was reduced to 98 items.

Patient Handover Documentation Tool for Staff Nurses had face and content validity. The content validity index was 0.80.

The study concluded that proper documentation during shift change plays an important and integral part for providing accurate and quality of care for the patient. Using Patient Handover Documentation Tool for Staff Nurses for communicating patient's needs and information improves nurses’ safe practice in the area of basic nursing care and improve the quality of patient handover.