What's my line? A narrative review and synthesis of the literature on Registered Nurses' communication behaviours between shifts

Aim: To describe, appraise and synthesize the seminal and empirical literature around Registered Nurses' communication behaviours between shifts in acute hospital settings. Background: Effective communication between shifts (at nursing handover) is acknowledged as a prerequisite to safe and high-quality patient-centred care. However, gaps and inconsistencies continue to prevail. Design: Narrative review and synthesis. Data sources: The electronic databases PubMED, CINAHL and Scopus were used. Review methods: English language, peer-reviewed papers published between 1970-April 2012 were considered for review. Criteria included Registered Nurses' communication during handovers in adult hospital settings. Results: Twenty-nine papers were reviewed. The research lacks a clear conceptual framework to define the core purposes of Nurses' communication behaviours between shifts. Seven themes were identified: overall purpose; report givers and receivers; seeing the whole picture; teaching and education; language; patient-centred care; and social cohesion. Two main communication processes are required - one articulating the whole picture and the other detailing information about patients. Conclusion: This area of research is challenged by lack of consistency in terminology and methodological rigour. While recent research has confirmed the findings from the seminal work, it has not been able to elaborate on some of the key challenges to refine the knowledge base. A more integrated approach is required to understand the complex process of improving nursing communication behaviours, particularly around the nursing handover. A neglected area of study is the role of the unit lead in determining the communication standards of the whole nursing team.