Managing perturbations during handover meetings: a joint activity framework

<b>Aim</b><br> To document the prevalence of perturbations of handover meetings and understand how nurses manage temporal, physical and social meeting boundaries in response to perturbations.<br> <b>Background</b><br> Handovers are joint activities performed collaboratively by participating nurses. Perturbations of handover are frequent and may potentially threaten continuity of care.<br> <b>Design</b><br> We observed and videotaped handovers during five successive days in four nursing care units in two Swiss hospitals in 2009.<br> <b>Methods</b><br> Videorecordings were transcribed. All perturbations during the handovers were noted. We performed content analysis of the sources of perturbations from the notes and interactional micro-analyses of handover interactions based on video and transcripts.<br> <b>Results</b><br> Nurses are the most frequent sources of perturbations during handovers. Perturbations are collaboratively managed. A tacit division of labour is enacted via multimodal communication strategies, whereby perturbations are dealt with using both linguistic and bodily signals.