Assessment of medical surgical nurses shift handover practices at a tertiary care hospital in Karachi

Date of Award


Document Type


Degree Name

Master of Science in Nursing (MScN)


School of Nursing and Midwifery, Pakistan


Background: Shift handover is an essential clinical practice that permits the transfer of patient information among nurses; it plays a significant role in maintaining continuity, safety, and quality of patient care. Objectives: This study aimed to assess the compliance of nursing shift handover practices with respect to the ISBAPARRST (introduction, situation background, assessment, problem, action, response, recommendation, scan, and thank you) tool. It also aimed to determine the differences in the level of compliance with regard to the participants' demographic and professional characteristics, the nursing shifts, and the day of the week' Method The shift handover practice of 43 nurses, working at one medical and one surgical unit of a Tertiary Care Hospital (TCH) in Karachi, Pakistan, were observed, utilizing a descriptive cross-sectional study design. Each nurse was observed thrice while she/he gave handover of three patients consecutively' and each tine nurse's shift handover practices were e-valuated against the ISBAPARRST tool, This tool was adapted by the researcher from the TCH's shift report policy, shift handover tool, and evidence based literature. The tool's content validity was ensured through experts' opinions, and inter-rater reliability was also tested (K=0,938). The researcher developed a conceptual framework for the current study that guided the analysis of the study findings. Findings: The study findings divulge that shift handovers at the study setting were performed face-to-face, at the patient's bedside; and the mean duration of individual patient handover was 1.69 (±0.983) minutes. From a total of 129 observations, 88.4% of the observations showed that the practices were partially compliant as they scored less than 60% on the ISBAPARRST tool; whereas, 11.6% observations showed that they were compliant, as they scored 60%-80% on the tool. This study also highlighted significant differences in the level of compliance with regard to nursing shifts (p=<0.001) and the day of the week (p=0.008). Conclusion and Recommendations: The study results highlight the need for improving the compliance of shift handover practices to ensure patient safety; and suggest recommendations for administration, nursing education, and research, This study is the first national study on this topic; thus, its findings can be used as a baseline to plan shift handover improvement interventions in the national context.

This document is available in the relevant AKU library