Effect of coaching on nurses’ knowledge, attitude and practices regarding the use of a standardized tool during clinical handover at a rural hospital in Uganda

Abstract

Background. Handover is essential for continuity of care and safety of patients. However, inconsistence practices and lack of standardized approaches often result in communication errors. The ISBAR (Identification, Situation, Background, Assessment and Recommendation) tool provides a structured framework, yet its use remains limited. This study assessed the effect of coaching on nurses‘ competences and compliance with ISBAR during bedside handover at Kisiizi Hospital, western Uganda. Method. A one group pre and posttest cross-sectional quasi-experimental design was conducted among 58 nurses using consecutive sampling. Clinical coaching interventions were implemented, focusing on knowledge, attitude and practice of ISBAR. Data were collected through a structured, self-administered questionnaire and analyzed using with SPSS version 22. Results. Of the 58 participants,69% were females and 31% were males with 60% holding certificate level qualifications 28% diploma and 12% bachelor‘s degree. knowledge scores improved markedly with participants demonstrating very good knowledge rising from 39.7% at baseline to 91.4% post-intervention (paired t-test, p = .001). Attitude scores also improved significantly (Wilcoxon signed rank test), with mean scores increasing from 2.6, (SD = 0.19) and post-intervention scores 2.7(SD =0.14). Practice scores showed the strongest gains, rising a mean of 3.05 (SD = 0.33) to 3.69 (SD = 0.13) post intervention, (p = .001). Compliance with ISBAR increased across all domains, with nurses reporting greater confidence in structured communication, reduced omission and improved clarity during bedside handover. Conclusion. Coaching interventions significantly enhanced nurses‘ competences and compliance with ISBAR tool. Real-time coaching, continuous training and supervision are effective strategies for improving knowledge, attitude and practices in clinical handover. Continuous training and supervision are recommended to sustain these improvements and strengthen patient safety. Key words: Knowledge, attitude, practice, clinical handover, ISBAR tool.