The functions and roles of questioning during nursing handovers in specialty settings: an ethnographic study

BACKGROUND: Nursing handovers are an important component of patient safety and quality in communicating across transitions of care. OBJECTIVES: To determine the functions and roles of questions in nursing handovers, and of how questions contribute to handover quality improvement in specialty settings of an Australian tertiary hospital. DESIGN: An ethnographic research design was employed. METHODS: Participant observations were conducted which were audiorecorded and transcribed. Question-response sequences and the roles of questions in the handovers were coded. RESULTS: Questions served many functions, and included: requests for information, requests for confirmation, other initiations of repair, outloud utterances, understanding checks, requests for action and agreement, and knowledge checks. CONCLUSIONS: Questioning was mostly used to transmit patient-related information, and nurses could use questioning to jointly construct understandings about patients. Future research should examine how questions function in diverse clinical environments, such as rural and regional hospitals, and how questioning occurs in multidisciplinary handover situations.