Development of clinical practice guidelines for person-centred handover practices in the emergency department

Abstract

Background: Handover practices are an integral part of an emergency department’s activities and ensures continuity of patient care and patient safety. Handover practices between emergency care practitioners and healthcare professionals in the emergency department are a crucial point of information transfer and should involve the patient and/or significant others. This handover should be done in a structured, yet context-specific manner, and directed towards person-centredness. The gold standard for a structured, context-specific manner has not been determined. Determining this gold standard is important to improve person-centred handover practices. Aim of the study: The aim of the study was to establish the elements underpinning a person-centred approach to handover practices between emergency care practitioners and healthcare professionals in the emergency department. Methodology: The study followed a sequential multimethod approach in phases. For phase 1, objective 1, the researcher conducted a concept analysis using Walker and Avant’s (2014) 8-step method followed by an online modified Delphi study to achieve objective 2, reach consensus on the concept definition of person-centred handover and related attributes. Phase 2, objective 3 involved a scoping review using the Johanna Briggs Institute guidelines (2021) for conducting scoping reviews, to inform clinical practice guidelines. For objectives 4 and 5 in phase three guideline development method was used. Sampling for the Delphi study involved purposive and snowball sampling. The context of the study involved emergency departments, and experts in person-centred care, handover practices and guideline development were involved in the various phases. In phase 3, objective 4 was to develop preliminary clinical practice guidelines for person- centred handover practices in the emergency department and objective 5 was to achieve consensus on clinical practice guidelines for person-centred handover practices in the emergency department. A Delphi study, involving

experts in person-centred care practices, emergency care practitioners involved in handover practices in the emergency department, was conducted. Results: The concept of person-centred handover practices was defined with its related attributes. The scoping review produced one clinical practice guideline together with information on current national and international handover practices. Preliminary guidelines were developed, and an expert Delphi panel achieved consensus on the final definition and the clinical practice guidelines. The external panel’s comments were integrated into the final clinical practice guidelines. Conclusion: This study contributes to the body of knowledge on person-centred care and handover practices. The study developed an agreed upon concept definition for person- centred handover practices to identify and guide structured person-centred handover practices. Furthermore, the developed clinical practice guidelines for person-centred handover practices in the emergency department should provide the gold standard to perform person-centred handover practices in future.