Communication handover barriers among nurses and paramedics in emergency care settings: A call for structured interprofessional solutions

Abstract

Effective communication during clinical handovers is a fundamental component of patient safety and care continuity, particularly in emergency care settings where time-critical decisions are routine. Yet, numerous studies have revealed significant barriers in interprofessional handovers between nurses and paramedics, ranging from structural communication deficits to role ambiguity and organizational culture [1, 2]. In a comprehensive review, Cohen and Hilligoss (2010) emphasized that hospital handoff practices remain highly variable, fragmented, and inadequately standardized, resulting in information gaps that can compromise the quality of care [2]. This issue is exacerbated in resource-constrained and high-stakes environments such as emergency departments, where rapid patient turnover demands seamless coordination [1]. Structured handover frameworks, particularly the SBAR (Situation, Background, Assessment, and Recommendation) tool, have been widely recognized as practical interventions for improving communication clarity and consistency. Abdollahi et al., (2022) demonstrated that integrating SBAR into emergency department workflows significantly increased both patient and nurse satisfaction [3]. At the same time, Ghonem and El-Husany (2023) reported that SBAR training enhanced nurses’ knowledge, communication confidence, and handoff efficiency [4]. However, despite their efficacy, these tools are inconsistently implemented across settings, particularly in low-resource health systems lacking policy mandates or dedicated training programs [3, 4].