Assessing Handover Quality in the Emergency Department: Evaluating Communication Between EMS and Triage Nurses Using the Handoff CEX Italian Scale.

Abstract

Introduction: Patient handover is a crucial process that ensures the transfer of essential patient information from prehospital teams to hospital staff. Although these risks are widely recognized, significant variability persists in handover practices in health care settings. This highlights the need for robust, evidence-based strategies to standardize the process.

Methods: A prospective and descriptive study of a single-center design was implemented to evaluate the quality of handover between emergency medical personnel and clinical nurses within the emergency department using the validated Handoff Clinical Evaluation Exercise (CEX) Italian scale. The study used this scale in evaluating 6 distinct domains: organization/efficiency, mnemonic structures employed by health care professionals, communication skills, completeness of clinical information, treatments performed, and professional qualities manifested during handover.

Results: A total of 112 health care professionals participated in the study: 51 triage nurses and 62 emergency personnel, including physicians and nurses. Of 154 handover transactions, 84 interruptions (54.5%) occurred: 38.3% caused by health care professionals and 16.2% by others, such as patients, family members, administrative staff, etc. The results highlighted statistically significant differences in information transfer between emergency medical services personnel and triage nurses, with the latter generally receiving higher evaluations. The receiver group obtained better evaluations in all the variables analyzed than the providers.

Discussion: This study provides a significant contribution to understanding a crucial communication process in critical patient management, laying the foundations for future studies that can explore strategies to improve handover in similar settings.