Managing change in the nursing handover from traditional to bedside handover – a case study from Mauritius

A force field analysis in terms of the driving forces had shown that there was dissatisfaction with the traditional method of handover which had led to an increase in the number of critical incidents and complaints from patients, relatives and doctors. The restraining forces identified were a fear of accountability, lack of confidence and that this change would lead to more work. A 3 – step planned change model consisting of unfreezing, moving and refreezing was used to guide us through the change process. Resistance to change was managed by creating a climate of open communication where stakeholders were allowed to voice opinions, share concerns, insights, and ideas thereby actively participating in decision making.An evaluation had shown that this process was successfully implemented to the satisfaction of patients, and staff in general.This successful change should encourage other nurses to become more proactive in identifying areas for change management in order to improve our health care system.This study was undertaken in a 28 – bedded gynaecological ward catering for female patients aged 16 and above. There were 21 nurses based in this ward of whom 14 were qualified and the remaining were health care assistants, with experience ranging from 1 1/2 – 33 years. The shift handover in this ward was conducted as "a ritual inheritance," [3] distant from patients hearing and vision, such as the ward manager's office or the nurses' station, thus excluding patients participation in their care. The traditional handover used to consist of one-way communication, where the nurse in charge gave the relevant information and instructions to the nurses resuming their shift. A very salient feature of the handover was the absence of individual care planning and where all information about patients was either written in the ward diaries or in the patient files or nursing notes. The sample size of patients involved in the evaluation part of the study was 58.The verbal handover was