ABSTRACT

The nursing change of shift report or handover is a valuable opportunity to transfer responsibility and accountability from one nurse to another in most hospital wards. It is actually a substantial part of a nurse’s duty, and each nurse is required to allocate 38% of his or her working hours in a hospital ward every day to fulfill the handover process. The aim of this topic is to identify and assess handing over of shift practices by nurses and the challenges they face during the handing over of shift process at the Buea regional hospital. cross-sectional research design using quantitative methods was employed in this study to do an assessment of handing over of shift and challenges faced in the process by nurses at the Buea regional hospital was asses with the use of questionnaire. A sample size of 100 main respondents was selected according to Morgan Table, a non – probability convenient sampling techniques was used and participants were selected based on their willingness to participate. Data was analysis manually and will be input in a Microsoft 2013 Excel sheet in code that will represent the Socio-demographic data and objectives in accordance with the research questions. The results will be presented on tables and pie chart respectively. A total of 100 nurses were included in this study, majority of the participants 44(44.0%) were of the age range 27-31 years, 67(67.0%) being female and 35(35.0%) had HND in Nursing. Moreover, 63(63.0%) of the participants were single. Based on the types of handing over practice by nurses, majority of the nurses; 85(85.0%) mentioned verbal communication as a way of handing over, based on the effectiveness of handing over practice by nurses, majority (100%) said current medication is correct, (99%) mentioned age of patient, current condition and ward. Our study reveals that majority of the nurses mentioned verbal communication as a way of handing over. Minority said they practice handing over of shift by the patients bed side. To a greater proportion they said current medication is correct is an effective way of handing over shift. All of the nurses faced challenges in handing over shift which was mentioned as not being able to include all the vital information’s in the report due to shortage of time, not writing a complete report, and language barriers from either nurse or patient.

CHAPTER ONE

INTRODUCTION

1.1 Background

The nursing change of shift report or handover is a valuable opportunity to transfer responsibility and accountability from one nurse to another in most hospital wards (Lomond et al., 2010). It is actually a substantial part of a nurse’s duty, and each nurse is required to allocate 38% of his or her working hours in a hospital ward every day to fulfill the handover process (Thomas et al., 2010). Therefore, handover is a fundamental component of nursing care for a nurse to pass on patients’ care plan, practices, information, and priorities to the next (Rushton et al., 2010). Moreover, handover is an opportunity for nurses’ group cohesion, professional socialization, education, interaction, and emotional support (Griffin et al, 2010). Thus, handover should be accurate, complete, specific, relevant, timely, up to date, subjective, and objective. However, cases of handover that are inaccurate, incomplete, and biased may lead to many errors, mislead nursing practices, and increase patient complications (Rushton et al., 2010). A key component in patient safety and care quality is accurate communication during handover (Chaboyer et al., 2011). The Joint Commission on Accreditation of Health Care Organizations (JCAHO) has established standardizing handover as a priority for improving patient safety since 2006 (Chaboyer et al., 2011). However, limited study have been carried out to address the handing over of shift by nurses with some high lightening importance of nursing prioritizing it for patient safety (Scott et al., 2012). Although there are controversies about the efficacy of handover practices, some articles highlight the importance of oral shift report that could not be substituted by any other method because handover is the only place where different aspects of professional nursing care are identified and expected to be explained by the nurse during the handing over (Scovell et al., 2010). However other studies question its efficacy and report that there is no need to have an oral shift report because most of the discussed information could be located within nursing documentation, and, therefore, such a practice is time-consuming (Sexton et al., 2004). In practice, the complexity of patients’ conditions, lack of organization, and different interruptions during handover prolong the reporting process (Thomas et al., 2010). In a large scale study of 10 European countries (Meibner et al., 2007) explored the nurses’ perception of handover and the reason for dissatisfaction among them. She found that 22% to 61%of nurses were dissatisfied due to “too many disturbances,” “lack of time,” and “work organizational factors” (Meibner et al., 2007).

A body of literature reflects four modes of handover: the verbal handover in station, tape recording, written handover, and handover at bedside. In practice, the method of handover depends on the patient, the shift (day, evening, or night shift), and the model of service delivery (Johnson et al., 2012). Nevertheless, many studies have confirmed the efficacy of bedside handovers. (Chaboyer et al., 2011). For example, (Mott et al., 2010) conducted an action research in the Buea regional hospitals and incorporated bedside handover reports. She found that bedside handover was better than office reports in terms of ease and time efficiency. Interestingly, level of satisfaction increased among nurses and patients in the Buea regional hospital, and patients were more involved in their care; it also decreased the rate of errors (Bradley et al., 2010).

1.2 Problem Statement                      

Inadequate handovers lead to medication errors (Williams et al., 2014) duplication of work (Dean et al., 2012), undetected critical conditions (Lewton et al., 2012) and risks for adverse events (McCall-White et al., 2014). Consequences of error in healthcare are tragic, and may include inconvenience, disability, complications, delays in treatment, prolonged hospital admissions, costs, and both detrimental effects to the involved healthcare personnel, the family, the institution, and the trust relationship between the public and the healthcare sector (Institute of Medicine, 2018).

1.3 Rational of study.

To clearly educate nurses and the entire health term on the importance of effective                           handing over of shift in order to completely eliminate all possible errors and enhance quality of patient health. Also to make sure errors are not made in identifying patients and ensure treatment challenges do not occur.

1.4 Research questions

1. What are the types of handing over practices carried out by nurses at the Buea regional hospital?
2. How effective is the handing over practice carried out by nurses at the Buea regional hospital.
3. What are the challenges faced by nurses during handing over of shift practice at the Buea regional hospital.

1.5 Objectives

1.5.1 General Objectives.

The aim of this topic is to identify and assess handing over of shift practices by nurses and the challenges they face during the handing over of shift process at the Buea regional hospital.

1.5.2 Specific Objectives.

1. To identify the types of handing over practice carried out by nurses at the Buea regional hospital.
2. To assess the effectiveness of the handing over practice carried out by nurses at the Buea regional hospital.
3. To identify the challenges nurses encounter in handing over shift at Buea regional hospital.