Doctors' and nurses' perceptions of barriers to conducting handover in hospitals in the Czech Republic

Background: Patient care is shared between clinicians, and the effectiveness of their collaboration and information exchange will often determine the safety and quality of care provided. Handover enables clinicians to exchange information aboutprovision of patient care. Handovers are complex, their level of standardisation varies across departments and hospitals and they are influenced by the work environment. If during handover information pertinent to a patient's care is not transferred between clinicians it may lead to adverse events, including death. Methods: This paper reports a study of doctors 1F and nurses 1F perceptions of barriers to conducting handover in hospitals in the Czech Republic. This was an exploratory study using a self-administered questionnaire survey. The questionnaire evaluated clinicians 1F perceptions of barriers to handover, including individual performance-related, organisational and environmental factors. Results: The questionnaire was sent to clinicians in two hospitals in the Czech Republic. A total of 181 doctors and 118 nurses returned the questionnaire. They held similar perceptions as to the most common performance-related obstacles to handover: messy, illegible and out-of-date records; and handover between more senior/junior members of staff. Also, social relationships and hierarchy seemed to have a negative impact on handover. The environmental factors negatively influenced handover included: not enough time, poor workforce planning, busy periods in the department, and interruptions. Conclusions: Handover emerged as a complex process negatively influenced by the work environment and social relationships. Nursing handover emerged as being conducted in a more standardised manner than handover between doctors; however, standardisation did not enhance the quality of information conveyed. Improvements in handover practices require organisational changes such as a reduction in workload and training for staff in conducting handover.