Implementation of bedside handover that includes patients or carers in hospital settings: A systematic review.

Objective: Increasing complexity in healthcare systems necessitates effective handover. While a universal structure is often recommended, many frameworks do not include the patient. A systematic review was completed examining outcomes following handover that included patients or carers using a realist‐orientated paradigm. Methods: The research group used Covidence™ software and followed PRISMA guidelines. A librarian‐led search of Embase, Medline, PsycINFO and SCOPUS yielded 5,790 relevant studies for screening. Included studies reported on peer‐reviewed studies that assessed qualitative or quantitative outcomes resulting from patient‐centred handover. To assess quality, we used the McMaster Mixed Methods Appraisal Tool (MMAT). Patient‐orientated and quantitative outcomes are reported descriptively. For qualitative outcomes, we employed a deductive analytical approach. Braun and Clarke's steps were followed to develop themes with group work used to clarify and discuss the various codes. Heterogenous reporting precluded meta‐analysis. Results: Thirty studies were eligible (10 mixed methods; 11 quantitative; 9 qualitative) with variable quality and scope. Most studies related to nursing‐led bedside handover and originated in Anglophone countries. Positive effects were reported for patient satisfaction, engagement, autonomy and effective information exchange. Providers reported a positive experience but also barriers to implementation, cognitive load and reducing compliance over time. There were contradicting findings for patient‐orientated outcomes including falls risk. Publication bias may have led to under reporting of negative trials. There was limited reporting on physician‐led handovers that included patients. Conclusions: Patient‐centred handover was associated with self‐reported benefits for patients and providers but potential advantages over conventional handover could be undermined by barriers such as time, implementation challenges and a perceived increase in staff workload. [ABSTRACT FROM AUTHOR]