Interdisciplinary handover between obstetric nursing and neonatal physician teams: an observational study

OBJECTIVE: We investigated the content and quality of communication of interservice interprofessional handover between obstetric nurses and neonatal physicians for high-risk deliveries. DESIGN: Observational study. SETTING: Labour and delivery unit at a tertiary care hospital. METHOD: We audio-recorded handovers between obstetric and neonatal teams (n=50) and conducted clinician interviews (n=29). A handover content framework was developed and used to qualitatively code missing core and ancillary content and their potential for adverse events. RESULTS: 26 (52%) handovers missed one or more clinical content elements; a third of the handovers missed at least one core clinical content element. Increase in the number of missed clinical content elements increased the odds of potential adverse events by 2.39 (95% CI1.18 to 5.37). Both residents and nurses perceived handovers to be of low quality and inconsistent and attributed it to the lack of a structured handover process. CONCLUSION: Streamlining handover processes by instituting standardisation approaches for both information organisation and communication can improve the quality of neonatal handovers.