The EPIC (Excellent Practice in Communication) Project. Neurosurgical Nursing Clinical Handover Improvement Practices among acute inpatients: a Best Practice Implementation Project.


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Australasian Journal of Neuroscience

Australian Association of Neuroscience Nursing

Subject: Nursing


ISSN: 1032-335X
eISSN: 2208-6781





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VOLUME 26 , ISSUE 1 (May 2016) > List of articles

The EPIC (Excellent Practice in Communication) Project. Neurosurgical Nursing Clinical Handover Improvement Practices among acute inpatients: a Best Practice Implementation Project.

Kylie M. Wright *

Keywords : Nursing clinical handover, evidence implementation, best practice, audit, acute neurosurgical inpatients.

Citation Information : Australasian Journal of Neuroscience. Volume 26, Issue 1, Pages 21-32, DOI:

License : (CC BY-NC-ND 4.0)

Published Online: 25-January-2018



The nursing handover normally occurs at the beginning of a nurse’s shift and is considered essential for continuity of care. Nursing handover has the potential to communicate accurate information about a patient’s condition, treatment and anticipated needs but also has the potential
to be ineffective or even harmful if information is incomplete or omitted. The Australian Commission on Safety and Quality in Health Care (ACSQHC) has recognised clinical handover as a National Standard, thus reinforcing its importance. This project aimed to conduct an audit of nursing clinical handover practices, to implement evidence-based best practice recommendations and to maximise the effectiveness of clinical handover in a neurosurgical unit of a large tertiary hospital. The project used the Joanna Briggs Institute’s (JBI) Practical Application of Clinical Evidence System (PACES) and Getting Research into Practice (GRiP) audit tool for promoting change in healthcare practice. A baseline audit of 30 observations of nursing clinical handover was conducted and measured against seven best practice recommendations, followed by the implementation of targeted strategies and follow up audits. The baseline audit revealed deficits between current practice and best practice in four of the seven criteria. Barriers for implementation of nursing clinical handover best practice criteria were identified by the project team and a neuroscience specific nursing handover framework and bundled education strategy was implemented. There were improved outcomes across the best practice criteria in the follow up audit. The findings showed how audit may be used to promote best practice in healthcare and that focussed education and provision of relevant resources can have an immediate and positive impact on clinical practice. Some of the measured criteria improved to a moderate degree,leaving plenty of room for improvement, however by the end of the project attitudes towards nursing clinical handover had been ‘transformed’ from a passive, routine ‘must do’ task, to an active process with a focus on safety and patient/carer engagement. Future audits are planned to ensure sustainability.

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  1. Clemow R (2006), ‘Care plans as the main focus of nursing handover: information exchange model’,Journal of Clinical Nursing, Vol15 (11): pp1463-1465.
  2. Evans AM, Pereira DA, Parker JM (2008), ‘Discourses of anxiety in nursing practice: a psychoanalytic case study of the hange-of-shift handover ritual’, Nursing Inquiry, Vol 15, No 1: pp40-48.
  3. Currie J (2002), ‘Improving the efficiency of patient handover’, Emergency Nurse, Vol 10 (3): pp24-27.
  4. Fenton W (2006), ‘Developing a guide to improve the quality of nurses' handover’, Nursing Older People, Vol 18 (11): pp32-36.
  5. Sexton A, Chan C, Elliott M, Stuart J, Jayasuriya R,Crookes P (2004) ‘Nursing handovers: do we really need them?’, Journal of Nursing Management, Vol 12 (1): pp37-42.
  6. Davies S, Priestley MJ (2006) ‘A reflective evaluation of patient handover practices’, Nursing Standard,Vol 20 (21): pp49-52.
  7. Hopkinson JB (2002) ‘The hidden benefit: the supportive function of the nursing handover for qualified nurses caring for dying people in hospital’, Jour nal of Clinical Nursing, Vol 11: pp168-175.
  8. McFetridge B, Gillespie M, Goode D, Melby V (2007) ‘Anexploration of the handover process of critically ill patients between nursing staff from the emergency department and the intensive care unit’, Nursing Critical Care, Vol 12 (6): pp261-269.
  9. Australian Commission on Safety and Quality in Health Care ( 2012). Safety and Quality improvement guide Standard 6 – Clinical Handover.
  10. New South Wales Ministry of Health (2009). Clinical Handover-Standard Key Principles Policy Directive 2009_060.