• Georgia Tobiano, Tracey Bucknall, Ishtar Sladdin, Jennifer A Whitty, and Wendy Chaboyer.
• Menzies Health Institute Queensland, Griffith University, Gold Coast Campus,Parklands Drive, Southport, QLD 4222 Australia. Electronic address: g.tobiano@griffith.edu.au.
• Int J Nurs Stud. 2019 Sep 1; 97: 63-77.

BackgroundNumerous reviews of nursing handover have been undertaken, but none have focused on the patient's role.ObjectivesTo explore how patient participation in nursing shift-to-shift bedside handover can be enacted.DesignSystematic mixed- methods review.Data SourcesThree search strategies were undertaken in July-August 2016: database searching, backwards citation searching and forward citation searching. To be included, papers had to either be research or quality improvement (QI) projects focusing on the patient role. Fifty-four articles were retrieved, including 21 studies and 25 QI projects.Review MethodsScreening, data extraction and quality appraisal was undertaken systematically by two reviewers. Research studies and QI projects were synthesised separately using thematic synthesis, then the results of this synthesis were combined using a mixed-method synthesis table.ResultsSegregated synthesis of research of patients' perceptions revealed two contrasting categories; patient-centred handover and nurse-centred handover. Segregated synthesis of research of nurses' perceptions included three categories: viewing the patient as an information resource; dealing with confidential and sensitive information; and enabling patient participation. The segregated synthesis of QI projects included two categories: nurse barriers to enacting patient participation in bedside handover; and involving patients in beside handover. Once segregated findings were configured, we discovered that the patient's role in bedside handover involves contributing clinical information related to their care or progress, which may influence patient safety. Barriers related to nurses' discomfort encouraging patient participation and worries for sharing confidential and sensitive information. The way nurses approach patients, and how patient-centred they are, constitute further potential barriers. Strategies to improve patient participation in handover include training nurses, making handovers predictable for patients and increasing the interpersonal approach during handover.ConclusionsUsing research and QI projects allowed diverse findings to expand each other and identify gaps between research and heuristic knowledge. Our review showed the tension between standardising handovers and making them predictable for patient participation, while promoting tailored and flexible handovers. Further investigation of this issue is required, to understand how to train nurses to achieve this and prepare patients to do this. Many barriers and strategies identified were from QI projects and the nurse perspective, thus caution interpreting results is required. We recommend steps be taken in the future to ensure high quality QI projects.Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

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