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Journal article
Implementing an emergency nursing framework improves the quality of clinical handover: A stepped-wedge cluster randomised control trial
Australasian emergency care, Vol.First online
23/01/2026
PMID: 41577531
Appears in Recent Faculty of Health Publications
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Abstract
Aim: To examine the effect of the HIRAID® emergency nursing framework on clinical handover.
Background: Clinical handover is very frequent in emergency departments and critical for patient safety. Inadequate handovers are associated with up to 80 % of adverse events.
Methods: This modified stepped-wedge cluster randomised control trial was conducted across 29 Australian rural, regional and metropolitan emergency departments between 2020 and 2024. HIRAID® was implemented using a behaviour change theory-informed strategy. Surveys were distributed to eligible staff. Quantitative data were analysed using a multiple regression approach; qualitative data using inductive content analysis.
Results: Surveys were completed by 1205 nurses (671 control, 534 intervention) and 328 medical staff (176 control, 152 intervention). Significant improvements were observed in satisfaction with nurse-to-nurse communication of patient history (t = 5.57, p < 0.001, 95 % C.I. = 0.33-0.69), physical assessment (t = 4.72, p < 0.001, 95 % C.I. = 0.28-0.68), recognition of clinical deterioration (t = 2.58, p = 0.01, 95 % C.I. = 0.06-0.43), information relevance (t = 3.29, p = 0.001, 95 % C.I. = 0.13-0.51) and completeness (t = 3.60, p < 0.001, 95 % C.I. = 0.17-0.56). Qualitative findings supported these results.
Conclusions: Implementing a structured emergency nursing framework improved nurse-to-nurse clinical handover, supporting safer patient care.
Details
- Title
- Implementing an emergency nursing framework improves the quality of clinical handover: A stepped-wedge cluster randomised control trial
- Creators
- Kate Curtis - The University of SydneyJulie Considine - The University of SydneyBelinda Kennedy - The University of SydneyMargaret Murphy - The University of SydneyMary K Lam - RMIT UniversityDarcy Morris - The University of SydneyChristina Aggar - Northern New South Wales Local Health District (Australia, Lismore)Margaret Fry - The University of SydneySteven M McPhail - Queensland University of TechnologyJames Hughes - Queensland University of TechnologyMichael Dinh - The University of SydneyRamon Z Shaban - The University of Sydney
- Publication Details
- Australasian emergency care, Vol.First online
- Publisher
- Elsevier
- Grant note
- This project is funded by grants from the National Health and Medical Research Council 2021 Partnership Projects funding scheme (PRC1) GNT2005403 and Thyne Reid Foundation, with partner agencies Thyne Reid Foundation, College Emergency Nursing Australasia, Australian College of Nursing, Agency for Clinical Innovation, Australian Commission for Quality and Safety in Health Care, Commonwealth Office of the Chief Nurse and Midwife, Southern NSW, Northern NSW and Western Sydney Local Health Districts, and Eastern Health Victoria.
- Identifiers
- 991013345495802368
- Copyright
- © 2026 Published by Elsevier Ltd on behalf of College of Emergency Nursing Australasia.
- Academic Unit
- Nursing; Faculty of Health
- Language
- English
- Resource Type
- Journal article