Improving clinical handovers and communication to improve continuity of care for hospitalized small and sick newborns in selected public hospitals in Kenya.
Wellcome Trust
KEMRI Wellcome Trust Research Programme
Clinical handovers involve transferring patient responsibility and accountability between outgoing and incoming healthcare providers across shifts and disciplines. It has been highlighted as the most vulnerable time in patient care. Communication failures during handovers have been linked to adverse events, jeopardizing patient safety. Many techniques have been used to improve handovers and communication in health care settings in High Income Countries (HICs) often focused on standardizing information transfer. The SBAR (Situation, Background, Assessment and Recommendation) structured handover approach is often regarded as a ‘best practice’ technique in critical care that has led to reductions of medical errors and enhanced safety culture. In LMICs, including Kenya interventions to improve handovers have not been implemented. In this study, focusing on neonatal ward care I propose: i) to systematically review tools used to improve and evaluate effects of handover interventions, ii) explore current Kenyan nurses’ handover practices and develop with them a contextually appropriate tool to improve and standardize handovers and, iii) to conduct a pilot implementation study using mixed methods (focus group discussions and a survey) to assess its potential effectiveness. This fellowship will then provide the preliminary evidence needed to inform the design future funding proposals for larger implementation studies.
8.1 Organisation and delivery of services