Quality of handover assessment by registered nurses on transfer of patients from emergency departments to intensive care units

A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg In partial fulfillment the requirements for the degree of Master of Science in Nursing Johannesburg, 2017Background: Continuity of quality care and patient safety depends mainly on the effective handover. Gaps in communication might lead to omissions of vital information affecting continuity and safety of care and leading to negative consequences and sentinel events. Purpose: The aim of this study was to describe the opinions of nurses regarding the effectiveness of handover practices between nurses in the Emergency Departments and Intensive Care Units in an academic hospital in Johannesburg using a handover rating tool. The recommendations for clinical practice and education were provided thereafter. Method: A descriptive quantitative cross sectional survey was used. Convenience sampling was used. A sample size of hundred and eleven handovers (n=111) was used. Data was collected using a 16 item handover evaluation tool developed by Manser et al. (2010). The handover rating tool is divided into two sections. The first section was the demographic data, the second section asks about the information transfer, shared understanding, working atmosphere, overall handover assessment and circumstances of handover. Data analysis was done by means of descriptive and non parametric statistics using graphs, frequency distributions, medians and interquartile ranges, Wilcoxon rank sum and logistic regression. Testing was done at the 0.05 level of significance. Results: A higher level of qualification and years of experience in trauma and Intensive Care Unit were significant factors related to information transfer, shared understanding and overall handover quality. Univariate ordinal model showed statistical that respondents handing over were more likely to agree with information transfer, shared understanding, working atmosphere, overall handover quality and circumstances of handover compared with those receiving. Univariate ordinal model showed statistical difference that non specialist handing over were likely to agree to overall handover quality whereas multivariate ordinal model also showed statistical difference that non specialist handing over were likely to agree with circumstances of handover. The study suggests that it is necessary for ED and ICU nurses to have an agreement on the content of the structured handover framework as different specialists have different expectations.MT201

Effectiveness of handover practices between emergency department and intensive care unit nurses

Background: Nurses from the emergency department (ED) and the intensive care unit (ICU) must interact during the handover procedure. Factors such as unit boundaries, the interaction between different specialities, patient acuities, and treatment adjustments generate specific negotiating and teamwork problems during the transition of patients from ED to ICU. Objective: This study aimed to describe the opinions of nurses regarding the effectiveness of handover practices between nurses in the ED and ICU in a major academic hospital in Gauteng province, South Africa. Method: An analytical cross-sectional survey design was used. Data were collected using a 16-item handover evaluation tool. It comprises two sections (1) biographical details and (2) 16 statements about handover quality divided into five constructs, namely information transfer, shared understanding, working atmosphere, overall handover quality, and circumstances of handover. Data analysis was done utilising descriptive and non-parametric statistics. Results: The majority (51.8%; n = 115) of the handovers occurred during the day. Out of 171 nurses, there were specialist practice emergency (19.2%; n = 33) and intensive care (28.0%; n = 48) nurses. There was statistical significance in information transfer between the ED and ICU nurses. (Me = 4.0, p < 0.05), compared to ICU nurses (Me = 3.0). Nurse specialist and non-specialist nurses' handovers differed statistically significantly on 12 of the 16 items on the rating scale, compared to 10 for non-specialist nurses' handovers. Conclusion: The study showed that ED and ICU nurses have significantly different requirements and expectations for handover procedures. In addition to completed documentation, subtle interpretations of the information provided and received also impact the need. The ED and ICU nurses would need to agree on the contents of a structured handover framework because different specialities and departments have varied expectations to achieve an effective handover

Health Promotion and Disease Prevention in Botswana

This chapter discusses health promotion and its usefulness in preventing diseases in Botswana. Document analysis, published and non-published, was conducted to illustrate how health promotion is implemented in Botswana. First, the contextual definition and meaning of health promotion is given, emphasising the cultivation of positive health behaviours in individuals, communities and the nation to prevent numerous health problems and diseases that Botswana faces. Next, health promotion models, programs, strategies and interventions applicable to the Botswana situation and the achievements made were examined. Finally, the chapter concludes by assessing health promotion processes and measures that have enabled people to increase control in improving their health and cultivating a positive health concept through participation and involvement are examined