Communication handover barriers among nurses and paramedics in emergency care settings

Background: Clear communication during emergency care handovers is crucial for patient safety, but barriers can compromise the process, increasing risks. The aim of this study is to compare and assess communication handover barriers perceived by nurses and paramedics in emergency care settings. Methods: A cross-sectional survey was conducted using the modified Nursing Handover Perspectives Questionnaire. A convenience sample was used to recruit nurses and paramedics from multiple prehospital and emergency care settings in the Eastern Province of Saudi Arabia. Data were analyzed with SPSS 29, employing descriptive statistics, independent samples t-tests to compare scores between nurses and paramedics. Pearson correlations were utilized to explore relationships between perceptions and demographic variables. Statistical significance was set at P < 0.05. Results: Out of 250 distributed questionnaires, 219 were completed (87.6% response rate). Most participants were male (75.3%) and held a bachelor’s degree (70.8%). Nurses tended to be older compared to paramedics, who were younger. Nurses reported greater awareness regarding the omission of important vital sign measurements during handover (p = 0.006) and greater opportunities to ask questions about things they did not understand (p = 0.049). Paramedics reported experiencing interruptions during handover at a higher rate than nurses (p = 0.036). Nurses also perceived greater benefit in using a structured handover tool like ISBAR for improving communication (p = 0.014) and patient safety (p = 0.019). No significant correlations were found between demographic variables and perceptions of communication handover barriers. Conclusions: Nurses reported a higher awareness of omitted vital signs during handover, while paramedics experienced more frequent interruptions. Addressing these barriers through targeted training and the use of supportive technologies may improve communication and patient safety in emergency care. Strengthening collaboration between nurses and paramedics, along with reducing interruptions, could support more effective care transitions. This study adds a comparative perspective on handover barriers in emergency settings and identifies areas for potential intervention. The findings contribute to ongoing discussions on enhancing handover practices and highlight the perceived value of structured frameworks and technology-driven solutions for improving communication efficiency and safety.