Free Standard AU & NZ Shipping For All Book Orders Over $80!
Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Utility of a digital app to enhance patient–nurse communications and patient involvement in bedside handover: patient and nurse perceptions

Penelope Casey A B * , Eva Yuen C D , Raj Liskaser E , Philippa Blencowe E F , Leanne Boyd E F , Mohamed Abdelrazek G , Zoe Wang H and Julie Considine A B
+ Author Affiliations
- Author Affiliations

A School of Nursing and Midwifery, Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Vic, Australia.

B Centre for Quality and Patient Safety Research – Eastern Health Partnership, Eastern Health, Box Hill, Vic, Australia.

C Centre for Quality and Patient Safety Research in the Institute for Health Transformation, Deakin University, Geelong, Vic, Australia.

D Centre for Quality and Patient Safety Research – Monash Health Partnership, Monash Health, Clayton, Vic, Australia.

E Eastern Health, Box Hill, Vic, Australia.

F School of Nursing and Midwifery, Deakin University, Geelong, Vic, Australia.

G The Applied Artificial Intelligence Institute - A2I2, Deakin University, Burwood Highway, Burwood, Vic, Australia.

H School of Information Technology, Faculty of Science, Engineering and Built Environment, Deakin University, Burwood Highway, Burwood, Vic, Australia.

* Correspondence to: penny.casey@deakin.edu.au

Australian Health Review https://doi.org/10.1071/AH23270
Submitted: 13 December 2023  Accepted: 29 August 2024  Published: 18 September 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of AHHA.

Abstract

Objective

This study aimed to explore patient and nurse perceptions of using a prototype co-designed app to support patient–nurse communication and patient engagement in bedside handover.

Methods

This qualitative descriptive study evaluated usability of the app with a convenience sample of patient–nurse dyads in a 22-bed medical/oncology ward, during morning shifts. Participants were nurses, and patients proficient in English but without cognitive impairment or physical or mental distress. Patients entered healthcare questions and preferences into the app, nurses acknowledged the information in the app and responded during their usual workflow. Patient comfort level with app use was surveyed. Handovers were observed, and patient involvement rated. After handover, semi-structured interviews and feedback surveys on app usability were conducted. Interviews were recorded, transcribed, and then analysed thematically. Survey data were analysed using descriptive statistics.

Results

Patient–nurse dyads (n = 18) used the app between March and May 2023. Patients were mostly older (median 69.5 years; IQR 52.3, 75), female, and frequent users of smartphones. Nurses were mostly younger (median 23 years; IQR 21, 40) and female. Five themes were identified, which indicated that using the app empowered patients to engage in healthcare communications, facilitated opportunities for patient-centred information sharing, and refocused nurses’ attention onto patient-centred care. Views differed on the app’s influence on patient involvement in handover. Surveys (n = 36, 100%) indicated that the interface was easy to navigate, features were useful, and only minor amendments were suggested.

Conclusion

This prototype app shows potential to facilitate patient-centred communication and patient engagement with health care, including bedside handover. With further refinement and testing, this app could enhance experiences of care and reduce harm from miscommunication.

Keywords: clinical handover, co-design, digital app, hospital care, nurse–patient communication, nursing care, patient safety, patient-centred care, quality of care.

References

Australian Commission on Safety and Quality in Health Care. National Safety and Quality Health Service Standards. 2nd edn. Sydney: ACSQHC; 2021. Available at: https://www.safetyandquality.gov.au/standards/nsqhs-standards

Kwame A, Petrucka PM. A literature-based study of patient-centered care and communication in nurse-patient interactions: Barriers, facilitators, and the way forward. BMC Nurs 2021; 20(1): 158.
| Crossref | Google Scholar | PubMed |

Merten H, Van Galen LS, Wagner C. Safe handover. BMJ 2017; 359: j4328.
| Crossref | Google Scholar | PubMed |

Weingart SN, Zhu J, Chiappetta L, Stuver SO, Schneider EC, Epstein AM, et al. Hospitalized patients’ participation and its impact on quality of care and patient safety. Int J Qual Health Care 2011; 23(3): 269-77.
| Crossref | Google Scholar | PubMed |

Mardis T, Mardis M, Davis J, Justice EM, Riley Holdinsky S, Donnelly J, et al. Bedside shift-to-shift handoffs. A systematic review of the literature. J Nurs Care Qual 2016; 31(1): 54-60.
| Crossref | Google Scholar | PubMed |

Coleman E, Smith J, Frank J, Min S, Parry C, Kramer A. Preparing patients and caregivers to participate in care delivered across settings: The care transitions intervention. J Am Geriatr Soc 2004; 52(11): 1817-25.
| Crossref | Google Scholar | PubMed |

Street M, Dempster J, Berry D, Gray E, Mapes J, Liskaser R, et al. Enhancing active patient participation in nursing handover: A mixed methods study. J Clin Nurs 2022; 31(7/8): 1016-29.
| Crossref | Google Scholar | PubMed |

Smeulers M, Lucas C, Vermeulen H. Effectiveness of different nursing handover styles for ensuring continuity of information in hospitalised patients. Cochrane Database Syst Rev 2014; 6: CD009979.
| Crossref | Google Scholar |

Stewart KR, Hand KA. SBAR, communication, and patient safety: An integrated literature review. Medsurg Nurs 2017; 26(5): 297-305 Available at https://go.gale.com/ps/i.do?p=AONE&u=googlescholar&id=GALE%7CA514512708&v=2.1&it=r&asid=fd24efde.
| Google Scholar |

10  Tobiano G, Bucknall T, Sladdin I, Whitty JA, Chaboyer W. Patient participation in nursing bedside handover: A systematic mixed-methods review. Int J Nurs Stud 2018; 77: 243-58.
| Crossref | Google Scholar | PubMed |

11  Australian Commission on Safety and Quality in Health Care. Engaging patients in communication at transitions of care. Report by a consortium from deakin and griffith universities. Sydney: ACSQHC; 2015. Available at: https://www.safetyandquality.gov.au/sites/default/files/migrated/Engaging-Patients-in-Communication-at-Transitions.pdf

12  Naughton C. Patient-centered communication. Pharmacy 2018; 6(1): 18.
| Crossref | Google Scholar | PubMed |

13  Edgman-Levitan S, Schoenbaum SC. Patient-centered care: Achieving higher quality by designing care through the patient’s eyes. Isr J Health Policy Res 2021; 10(1): 21.
| Google Scholar | PubMed |

14  Bello O. Effective communication in nursing practice: A literature review. Arcada; 2017. Available at https://core.ac.uk/download/pdf/84798372.pdf.

15  Bergeson SC, Dean JD. A systems approach to patient-centered care. JAMA 2006; 296(23): 2848-51.
| Crossref | Google Scholar | PubMed |

16  Ruben BD. Communication theory and health communication practice: The more things change, the more they stay the same. Health Commun 2016; 31(1): 1-11.
| Crossref | Google Scholar | PubMed |

17  Chaboyer W, McMurray A, Marshall A, Gillespie B, Roberts S, Hutchinson AM, et al. Patient engagement in clinical communication: An exploratory study. Scand J Caring Sci 2016; 30(3): 565-73.
| Crossref | Google Scholar | PubMed |

18  Chan EA, Wong F, Cheung MY, Lam W. Patients’ perceptions of their experiences with nurse-patient communication in oncology settings: A focused ethnographic study. PLoS One 2018; 13(6): e0199183.
| Crossref | Google Scholar | PubMed |

19  Joseph-Williams N, Edwards A, Elwyn G. Power imbalance prevents shared decision making. BMJ 2014; 348: g3178.
| Crossref | Google Scholar | PubMed |

20  van Bruinessen IR, van Weel-Baumgarten EM, Gouw H, Zijlstra JM, Albada A, van Dulmen S. Barriers and facilitators to effective communication experienced by patients with malignant lymphoma at all stages after diagnosis. Psychooncology 2013; 22(12): 2807-14.
| Crossref | Google Scholar | PubMed |

21  Nezamdoust S, Abdekhoda M, Ranjbaran F, Azami-Aghdash S. Adopting mobile health applications by nurses: A scoping review. J Res Nurs 2022; 27(5): 480-91.
| Crossref | Google Scholar | PubMed |

22  Booth RG, Strudwick G, McBride S, O’Connor S, Solano López AL. How the nursing profession should adapt for a digital future. BMJ 2021; 373: n1190.
| Crossref | Google Scholar |

23  Bichel-Findlay J. The nursing profession in a digital age. The Hive 2019. 2019. Available from https://www.acn.edu.au/the-hive-2019/nursing-profession-in-digital-age

24  Albrecht U-V, Behrends M, Matthies HK, Von Jan U. Usage of multilingual mobile translation applications in clinical settings. JMIR Mhealth Uhealth 2013; 1(1): e4.
| Crossref | Google Scholar | PubMed |

25  Sugg HVR, Richards DA, Russell AM, Burnett S, Cockcroft EJ, Thompson Coon J, et al. Nurses’ strategies for overcoming barriers to fundamental nursing care in patients with COVID‐19 caused by infection with the SARS‐COV‐2 virus: Results from the ‘COVID‐nurse’ survey. J Adv Nurs 2023; 79(3): 1003-17.
| Crossref | Google Scholar | PubMed |

26  Silvera-Tawil D, Pocock C, Bradford D, Donnell A, Freyne J, Harrap K, Brinkmann S. Enabling nurse-patient communication with a mobile app: Controlled pretest-posttest study with nurses and non–English-speaking patients. JMIR Nurs 2021; 4(3): e19709.
| Crossref | Google Scholar | PubMed |

27  Street M, Eustace P, Livingston PM, Craike MJ, Kent B, Patterson D. Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover. Int J Nurs Pract 2011; 17(2): 133-40.
| Crossref | Google Scholar |

28  Yuen EYN, Street M, Abdelrazek M, Blencowe P, Etienne G, Liskaser R, et al. Evaluating the efficacy of a digital app to enhance patient-centred nursing handover: A simulation study. J Clin Nurs 2023; 32: 7626-37.
| Crossref | Google Scholar |

29  Krupat E, Frankel R, Stein T, Irish J. The four habits coding scheme: Validation of an instrument to assess clinicians’ communication behavior. Patient Educ Couns 2006; 62(1): 38-45.
| Crossref | Google Scholar | PubMed |

30  QSR International Pty Ltd. NVivo (version 12). Released in March 2020. Available at https://www.qsrinternational.com/nvivo-qualitative-data-analysis-software/home

31  Braun V, Clarke V. ‘Thematic analysis: A practical guide.’ London: SAGE Publications; 2006.

32  Braun V, Clarke V. Reflecting on reflexive thematic analysis. Qual Res Sport Exerc Health 2019; 11: 1-9.
| Crossref | Google Scholar |

33  Silvera-Tawil D, Pocock C, Bradford D, Donnell A, Harrap K, Freyne J, Brinkmann S. CALD Assist—Nursing: Improving communication in the absence of interpreters. J Clin Nurs 2018; 27: 4168-78.
| Crossref | Google Scholar | PubMed |

34  Arnold M, Goldschmitt M, Rigotti T. Dealing with information overload: A comprehensive review. Front Psychol 2023; 14: 1122200.
| Crossref | Google Scholar | PubMed |

35  Vaportzis E, Clausen MG, Gow AJ. Older adults perceptions of technology and barriers to interacting with tablet computers: A focus group study. Front Psychol 2017; 8: 1687.
| Crossref | Google Scholar | PubMed |