Examining the meaning of the language used to communicate the nursing hand‐off

• Published in: Research in nursing & health Vol. 44; no. 5; pp. 833 - 843
• Main Authors: Galatzan, Benjamin J., Carrington, Jane M.
• Format: Journal Article
• Language: English
• Published: New York Wiley Subscription Services, Inc 01-10-2021
• Subjects: Acute services; cognitive overload‐communication natural; Continuity of care; Current events; Health care; Inpatient care; Language; language processing; Meaning; Memory; Miscommunication; Nursing; Nursing administration; nursing hand‐off; nursing informatics; Patient information; Patient safety; Qualitative research; Verbal communication
• ISSN: 0160-6891; 1098-240X
• DOI: 10.1002/nur.22175

The miscommunication and inconsistent recall of patient information due to cognitive lapses that occur during the hand‐off between healthcare providers account for 80% of sentinel events in acute care. Cognitive lapses are a consequence of the nurse experiencing cognitive overload, which impedes the nurse's ability to recall relevant information during and after the hand‐off communication. The primary cognitive and human factor contributing to cognitive overload in the hand‐off is language. The purpose of this study was to examine the meaning of the language used to communicate the nurse‐to‐nurse change of shift hand‐off occurring at bedside and nonbedside on a medical‐surgical unit in an urban medical center. A qualitative descriptive design was used. The sample was 10 audio‐recorded hand‐offs (five bedside and five nonbedside), with a total of 19 nurses participating. A natural language process program was used to analyze the data. The hand‐off is a narrative story centered on communicating patient information delivered with a high degree of confidence. The hand‐off is focused on past and current events with minimal focus on future or anticipated events. The drive to communicate is minimally based on concern, fear, or danger. There is a difference in the language used to communicate the nursing hand‐off message at bedside as compared to the nonbedside hand‐off.