Nursing handover practices in the emergency department: A descriptive qualitative study

Abstract

Introduction: Nursing handover is a critical communication process for maintaining continuity of care and patient safety in emergency departments, where patient flow, clinical urgency, and workload may change rapidly. In high-volume situations, handover information may become incomplete, documentation may be rushed, and opportunities for family clarification may be limited. This study aimed to explore nursing handover practices in an emergency department, focusing on communication patterns, documentation, bedside validation, family involvement, and barriers during mass patient arrivals.

Method: A descriptive qualitative study was conducted at the Emergency Department of Buleleng Regional Hospital on April 5, 2026. Seventeen participants were selected using purposive sampling, consisting of one unit head, one deputy unit head, two team leaders, six nurses, and seven family members of patients. Data were collected through direct observation, semi-structured interviews, managerial discussion, and document review. The data were analyzed using descriptive thematic analysis.

Results: Five themes were identified: handover as a routine activity, inconsistent structured communication, selective bedside validation, limited family involvement, and suboptimal documentation during mass patient arrivals. Handover was routinely performed during shift changes, supported by verbal reports, medical records, handover logs, and report books. However, when patient volume increased, information transfer became shorter, bedside validation was not consistently conducted, family involvement remained limited, and documentation was sometimes incomplete.

Conclusions: Emergency nursing handover requires a more adaptive system that strengthens structured communication, concise documentation, selective bedside validation, proportional family involvement, and specific procedures for mass patient arrivals.