Clinical handover in trauma settings: can it be improved?

This qualitative study, undertaken in Australia, had four aims: 1) to produce a minimum dataset to assist paramedics in clinical handover; 2) to outline attributes of effective and ineffective handover; 3) to determine feasibility of advanced data transmission; 4) to identify how best to display data in trauma bays.

Through purposive sampling, 27 participants were identified including 10 paramedics (6 mobile intensive care ambulance (MICA) paramedics and 4 road paramedics) all of whom had experience of handing over critically injured trauma patients to a trauma service; and 17 trauma team members (12 doctors, and 5 nurses) who worked in a variety of specialities.

Using semi-structured interviews, the researchers explored several areas: the process of handover itself, content of handover, data transmission, and data display.

During the interview, participants were asked to comment on the strengths and limitations of an existing handover template known as MIST (M=mechanism of injury/illness; I=injuries, either actual or suspected; S=signs, including observations and monitoring, T=treatment given) so that the researchers could subsequently tailor the template's content more specifically to trauma patients in civilian settings.