Changing the nursing handover

The clinical decision unit (CDU) at the Queen Elizabeth Hospital in Birmingham consists of 68 level-1 beds and 4 level-2 beds. The CDU also runs an ambulatory clinic alongside the main unit, with an average take of 100 patients every 24 hours. The CDU requires a team of 140 registered nurses (RNs) and healthcare assistants (HCAs).

Originally, RNs and HCAs received separate handovers. The RNs received a handover on those patients for whom they would be caring from an RN on the previous shift. This took place at the nurses' desk. The HCAs undertook a walk-around, covering every patient in the unit, and received a handover from an HCA on the previous shift. This process had undoubtedly led to a divide within the CDU team and, as a result, there had been a noticeable breakdown in communication and some critical tasks for patient care had been missed. This impact could not be ignored.