• Anne McMurray, Wendy Chaboyer, Marianne Wallis, and Cathy Fetherston.
• Murdoch University, Education Drive, Mandurah, WA, Australia. A.McMurray@murdoch.edu.au
• J Clin Nurs. 2010 Sep 1;19(17-18):2580-9.

Aims And ObjectivesTo identify factors influencing change in two hospitals that moved from taped and verbal nursing handover to bedside handover.BackgroundBedside handover is based on patient-centred care, where patients participate in communicating relevant and timely information for care planning. Patient input reduces care fragmentation, miscommunication-related adverse events, readmissions, duplication of services and enhances satisfaction and continuity of care.DesignAnalysing change management was a component of a study aimed at developing a standard operating protocol for bedside handover communication. The research was undertaken in two regional acute care hospitals in two different states of Australia.MethodData collection included 532 semi-structured observations in six wards in the two hospitals and 34 in-depth interviews conducted with a purposive sample of nursing staff involved in the handovers. Observation and interview data were analysed separately then combined to generate thematic analysis of factors influencing the change process in the transition to bedside handover.Results And ConclusionThemes included embedding the change as part of the big picture, the need to link the project to standardisation initiatives, providing reassurance on safety and quality, smoothing out logistical difficulties and learning to listen. We conclude that change is more likely to be successful when it is part of a broader initiative such as a quality improvement strategy.Relevance To Clinical PracticeNurses are generally supportive of quality improvement initiatives, particularly those aimed at standardising care. For successful implementation, change managers should be mindful of clinicians' attitudes, motivation and concerns and their need for reassurance when changing their practice. This is particularly important when change is dramatic, as in moving from verbal handover, conducted in the safety of the nursing office, to bedside handover where there is greater transparency and accountability for the accuracy and appropriateness of communication content and processes.© 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

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