Handover processes and practices of critically ill patients between nursing staff from the intensive care units of private hospitals in the eThekwini District, KwaZulu-Natal

Abstract

Nursing handover is an integral part of safe patient care in the Intensive Care Unit (ICU).The term handover refers to a nurse taking responsibility and accountability of care from another nurse at the end of the shift and is used interchangeably with terms such as hand-off, handover, sign off, inter-shift report and shift report. Nursing handover can represent a potential risk for patients and health institutions as information during the handover processes can be lost, misinterpreted or miscommunicated. Thus, the process of communication during handover is vital in the fast-paced world of an Intensive Care Unit. Purpose of the study The purpose of this study was to explore handover processes and practices between nursing staff from the Intensive Care Units of private hospitals in the eThekwini district. Methodology A qualitative, exploratory, descriptive design guided the study by implementing the Situation, Background, Assessment and Recommendations (SBAR) framework. In-depth interviews of Intensive Care Nurses were conducted to collect data. Intensive Care Unit trained and experienced Registered Nurses and Enrolled Nurses were interviewed. A total of twenty-two (22) participants were interviewed during the working hours of the participants. Findings The study findings revealed that during handover practices in the Intensive Care Unit communication is the most important component of human interaction and is necessary for the transfer of information from the sender to the receiver. Handover was, however, not consistent in all hospitals and the junior nurses were not given the necessary support and supervision at times, due to the acuity of the patients and the shortage of nurses in the unit. There was no structured handover tool in place to ensure that the process was formalized for all nurses in the Intensive Care Units to follow. Conclusion The study concluded with recommendations made to improve the handover process which included the use of Situation, Background, Assessment and Recommendations (SBAR) framework to ensure that the process is structured, having a team leader free to assist junior staff to ensure the handover runs smoothly, handover processes should be taught in nursing colleges and that nursing management should assist the staff by drawing up a proper handover policy. Further research should be conducted on this topic but in other departments in the hospitals to evaluate how their handover practices are done.