Turkish Validation and Reliability Study of the 'HANDOFF-CEX' Patient Handover Scale

Abstract Aim: Hospitals operate continuously, providing healthcare services around the clock. The seamless delivery of health services relies on nurses working 24 hours a day. Ensuring the effective transfer of information between shifts is crucial for maintaining the continuity of nursing care. Methods: This study aims to assess the validity and reliability of the Turkish version of the "Handoff CEX" handoff scale to gauge the quality of nurses' handoff practices objectively. A total of 99 handoff surveys were carried out by participating nurses in internal medicine, surgical medicine, and intensive care units. Each handoff was independently assessed by two observers, resulting in 396 handoff evaluations. Data were analyzed using SPSS 25.0, focusing on sociodemographic information, evaluations of handoff processes, satisfaction scores, item analyses, explanatory factor analysis, and reliability testing through Cronbach’s alpha. Results: The Turkish version of the Handoff CEX scale showed high reliability with Cronbach’s alpha values of 0.925 for the outgoing nurse and 0.914 for the incoming nurse. Content validity was confirmed with a CVI of 0.96. Factor analysis indicated high factor loadings, with values ranging from 0.745 to 0.935. Kappa statistics for inter-rater reliability were low, indicating a need for further refinement in observer training. Conclusion: The Handoff CEX scale adapted into Turkish is a valid and reliable measurement tool for evaluating patient handoff processes. Its continuous use in health institutions will contribute to the long-term development of nurses' communication skills and the quality of patient care.