Handover among nurses working in selected newborn units in Kenya; its purpose and structure

Examining how nurses hand over provides an opportunity to identify opportunities for improvement. Although recognised as a complex and dynamic interaction among nurses, there is little consensus regarding the primary function, location and structure of handover. The aim of this study was to understand from nurses' perspectives, the purpose and structure of handover in three different health sector newborn units in Nairobi.

This was an ethnographic qualitative research designed study. Between January 2017 and March 2018, I carried out 150 hours of non-participant observations, conducted 29 in-depth interviews with nurses (10) public sector (8) faith based and (11) private sector. All data was managed by Nvivo 10 (QSR International) and analysed using a thematic framework.

The purpose of handover was to pass on the management of a patient (s) from one outgoing nurse to incoming nurse at the end of a shift. In all three hospitals, handover took place at the nurse station, but for the nurses in both public and faith based hospitals, this was followed up by bed to bed handover. The structure differed from hospital to hospital, from nurse to nurse and what was actually handed over. The shift system, time available for handover, familiarity with babies, medical emergencies and use of notes were factors that influenced the structure of handover across hospitals.

Although the purpose of handover was similar across the newborn units, the structure was different. There is need to perhaps develop communication guidelines for this key care process sothat all relevant information about the patients is maintained across nurses.