The aims of the study were to extract organizational climate factors surrounding patient handoffs, and to capture their crucial characteristics in the current Japanese hospital context. A questionnaire survey was conducted between October and December 2017. A total of 5,117 valid responses were collected from nursing staff in 31 general hospitals with a response rate of 69%. The sample collected in 2011, which had 1,462 responses, was also used for comparison with the current data. Seven handoff factors were derived by applying principal component analysis to the 2017 sample with 44% of cumulative variance accounted for. Nursing staff perceived overall handoff adequacy and its elements moderately good. Significantly different views were observed between work units for all the factors. The most negative view was exhibited to information and responsibility continuity by respondents in ED. Regarding information transfer, compared with other intra-hospital handoff cases, information was transferred well in handoffs related to OR and ICU. There were also significant hospital differences in staff perceptions of patient handoff adequacy that the largest difference was identified in training and education. Comparing to six years ago, staff views became significantly more positive, and that the largest improvement was perceived for handoff process, training and education. Sufficiency of information transfer was also improved in the six-year interval. In conclusion, nursing staff perceptions of patient handoff practices and contributing factors have been improved in Japanese hospitals for the last six years, and currently viewed them moderately well. In addition, different views were extracted across work settings.
Nursing handoff Communication Patient safety
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This work was in part supported by Grant-in-Aid for Young Scientists (B) (No. 15K16291), Japan Society for the Promotion of Science. The authors thank to the risk management personnel of the hospitals and nurses who participated in the survey.
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