Structured shift-huddle training linked with short-term gains in nurses’ knowledge and safety practice

A one-group quasi-experimental study of 82 nurses found that participation in structured training on shift huddles and the six International Patient Safety Goals was associated with higher measured knowledge, safety awareness and observed patient-safety practice immediately after training. The largest changes occurred at the immediate post-training assessment, while scores were lower but generally remained above baseline at follow-up.

The study was conducted in critical and non-critical inpatient units at the Cardiovascular Surgery Hospital affiliated with Ain Shams University Hospitals in Cairo, Egypt. The sample comprised 52 staff nurses and 30 supervisors or head nurses. Baseline assessment occurred in December 2022, training was delivered from February through March 2023, and the final follow-up assessment was conducted in August 2023.

Researchers used a one-group pretest-posttest design with assessments at baseline, immediately after training and at follow-up. They measured shift-huddle and patient-safety knowledge through questionnaires, patient-safety awareness through a 63-item questionnaire, and clinical performance through two observational checklists. Each nurse was observed on three non-consecutive days during each observational assessment period, and the mean of the three observations was used in the original analysis.

The training comprised six two-hour sessions, totaling 12 hours of theoretical and practical instruction. Activities included mini-lectures, small-group discussion, case-based scenarios, demonstrations, re-demonstrations, role-play, instructional videos and WhatsApp-supported learning. The curriculum addressed the concept and structure of shift huddles, patient-safety concepts, the six International Patient Safety Goals, practical huddle performance and the application of each patient-safety goal.

The proportion of nurses classified as having satisfactory overall knowledge rose from 32.9% at baseline to 93.9% immediately after training and 82.9% at follow-up. Huddle knowledge alone increased from 2.4% to 93.9% and then 75.6%, while patient-safety knowledge increased from 53.7% to 93.9% and then 86.6%. Individual patient-safety domains did not all change in the same way; for example, Goal 4 knowledge was 75.6% at baseline and 80.5% at follow-up.

Overall high awareness of the International Patient Safety Goals increased from 29.3% at baseline to 100.0% immediately after training and 79.3% at follow-up. At baseline, the proportion meeting the high-awareness threshold was below 50% for every goal, ranging from 29.3% for Goal 6 to 46.3% for Goal 3. At follow-up, goal-specific proportions ranged from 78.0% to 89.0%.

Observed adequate patient-safety practice increased from 50.0% at baseline to 100.0% during the post-training observation period and 75.6% at follow-up. The source clinical-performance table included goals 1, 2, 3, 5 and 6 but did not provide a separate row for Goal 4, so the report cannot assign a follow-up value to that goal. Reported correlations between outcomes were modest to moderate, with Spearman coefficients of 0.360 for knowledge and practice, 0.256 for knowledge and the awareness-score difference, and 0.199 for the awareness-score difference and practice.

Regression models reported an R² of 0.91 for knowledge scores and 0.39 for awareness scores. Because the reported model specifications did not document a repeated-measures correlation structure, phase coefficients were treated as exploratory adjusted associations rather than causal effects. Similarly, Pearson chi-square phase comparisons did not account for the repeated measurements from the same nurses, so the article emphasized descriptive changes rather than treating those p-values as definitive evidence of intervention effectiveness.

The findings are limited by the absence of a concurrent control group, repeated testing, direct observation and possible observer effects. Formal observer blinding was not feasible in the sequential design, no separate inter-rater agreement statistic was reported, and the awareness questionnaire’s Cronbach’s alpha of 1.00 after rounding may indicate item redundancy. The single-hospital sample and combined inclusion of staff nurses and supervisors also restrict generalization and subgroup interpretation.

Overall, the study supports an association between structured training and short-term improvements in measured outcomes, not proof that training alone caused the changes. The authors call for controlled, multicentre evaluations using validated and discriminating measures, appropriate longitudinal analyses, documented intervention-fidelity procedures and, where feasible, patient-level safety outcomes to assess whether the improvements are sustained and clinically meaningful.

Subject of Research: Evaluation of structured shift-huddle and patient-safety training among inpatient nurses

Article Title: Structured shift huddle training and its influence on nurses’ knowledge, safety awareness, and clinical performance: a quasi-experimental investigation

Article References: Sayed Abdel Wahab, S., Fakhry, S. F., & Saad, N. F. (2026). Structured shift huddle training and its influence on nurses’ knowledge, safety awareness, and clinical performance: a quasi-experimental investigation. BMC Nursing, 25(1), Article 852. https://doi.org/10.1186/s12912-026-05307-2

Image Credits: AI Generated

DOI: 10.1186/s12912-026-05307-2

Keywords: shift huddles, nursing education, patient safety, knowledge assessment, safety awareness, clinical performance, quasi-experimental study, Egypt, Structured, shift, huddle, training