Authors (including presenting author) :
CHIU, PL(1), LI, MN(1), CHAN, PH(1), NG, YSE(1), LEUNG, PMQ(1)
Affiliation :
(1) Nursing Services Division, New Territories West Cluster
Keyword 1: :
Clinical Handover
Keyword 3: :
Patient Safety
Keyword 4: :
Standardisation
Introduction :
Clinical handover is a critical component of patient safety, ensuring the continuity of care during shift transitions where communication discontinuities can significantly compromise patient outcomes. To mitigate information fragmentation and optimise proper shift-to-shift handover, the Nursing Services Division of the New Territories West Cluster introduced a standardised Nursing Handover System and Practices. This initiative sought to supersede heterogeneous communication styles with a structured, evidence-based approach across the cluster’s institutions.
Objectives :
The primary objective was to institutionalise a uniform handover framework across Tuen Mun Hospital, Pok Oi Hospital, and Tin Shui Wai Hospital. Specifically, the project aimed to standardise the adoption of the iSBAR (Identity, Situation, Background, Assessment & Action, Recommendation & Read back) model as the standard communication tool. Furthermore, the standard practice sought to synergise and integrate various electronic clinical information systems—including the Critical Result Acknowledgement System (CRAS), e-Vitals, Smart Care Centre—into the daily workflow to ensure data veracity and accessibility.
Methodology :
Following the standard’s effective implementation on 6 January 2025, a comprehensive self-checking audit was conducted over a two-week period from 24 February to 9 March 2025. The audit employed a stratified sampling method across all clinical areas, assessing both Shift-in-Charge and Cubicle Nurse roles. Ward Managers or their delegates utilised standardised audit instruments, endorsed by the Cluster Nursing Management Committee, to evaluate 304 handover episodes. Evaluation criteria scrutinised adherence to the iSBAR framework, the execution of bedside handovers for critical patients, and the timely completion of patient summaries.
Result & Outcome :
Data analysis demonstrated a 100% overall compliance rate across all participating departments, with zero deviations recorded regarding the retrieval of CRAS summaries or the documentation of nursing summary. These findings substantiate the successful establishment of the new standard of care and the efficacy of the dissemination strategy. To guarantee the sustainability of this practice, specifically targeting the newly recruited nurses, a mandatory e-learning module was developed, requiring completion within 12 weeks of entry to rank. Furthermore, to facilitate continuous monitoring and quality assurance, adherence will be rigorously reassessed in the forthcoming 18-month structured Cyclic Nursing Audit.
