Nursing handover: Are its principles taught in universities during bachelor’s degree?

As a current PhD student working on my dissertation entitled “Developing a nursing handover process program in pediatric ward: An action research,” I interviewed nurses and students and found that they had little knowledge about the ethical and legal principles of nursing handover and expressed their dissatisfaction about this process. One of the reasons for this prob which lacks a structured course on nursing handover, while nursing handover is a substantial part of a nurse’s duty as each nurse should allocate 38% of his/her working hours in hospital wards every day.[1] Discussing this issue with my supervisors, we decided to further scrutinize the management course content of our bachelor’s program. So, we reviewed the course plan of nursing management in different universities in the country (Iran) and found that although these courses have enough content about general skills for a manager, such as leadership, planning, organizing, and budgeting, they lack specific skills related to nursing handover principles. To highlight this problem, we decided to let curriculum committees/developers know about this issue. Many literature reports highlight the importance of nursing handover, which cannot be substituted by any other method since handover is the only place where different aspects of professional nursing care are identified.[2] But studies have shown that nurses expressed enormous fear and anxiety during handover.[3] This fear and anxiety may be related to their lack of preparation for being involved in handover. Such a preparation, we think, is necessary during undergraduate educational program and as part of in-service educational program in clinical setting as well, because handover is not a simple process and according to literature reports, it should be accurate, complete, specific, relevant, timely, up-to-date, subjective, and objective. Handover that is inaccurate, incomplete, and biased may lead to many errors, mislead nursing practices, and increase patient complications.[4,5] As the Joint Commission on Accreditation of Health care Organizations (JCAHO) has established standardizing handover as a priority for improving patient safety from 2006,[6,7] we suggest that the principles of nursing handover be taught in a specially designed nursing course or be integrated in the existing course on management during bachelor’s degree, in order to decrease “reality shock” in novice nurses. Such education should become part of in-service education programs, and manuals and policies must be made in the wards to increase patient safety and the quality of providing care in hospitals. Moreover, handover as a very important competency should be considered as an evaluation criterion of nurses’ competencies to enhance their capabilities in this regard. Thank you for allowing us to express our opinion.