Health Care Providers' Factors Influencing the Effectiveness of Handover of Critically Ill Patients in Intensive Care Units in the Western Region of Kenya

Abstract

Background: Handover involves the transfer of health care providers' responsibility and accountability for some or all aspects of care for  a patient, or groups of patients, to another clinician or nurse on a temporary or permanent basis with communication being a major  factor for the transfers. Effective handover is essential for safe health care and should used in all clinical situations. In Western Kenya,  there is little evidence of studies carried out on the effective handover of critically ill patients in ICUs.

Material and Methods: A cross-sectional mixed method was adopted and administered to the selected study participants from the  selected hospitals using a self-administered questionnaire and KII tool. The purposive sampling method was used to select the  institutions while convenient sampling was used to pick 80 study participants. Quantitative data was collected by use of questionnaires  and observation checklist while qualitative data was collected through key informant interviews and analysis was done thematically. 

Findings: Health Care Provider variables including gender, age group, cadre, level of education and years of experience in working in the  ICU showed no statistically significant association with the handover of critically ill patients. The mean age of the study participants was  34 years. In addition, the handover performance of Health care providers (p=0.3) and those with higher diploma qualifications (p=0.2) was  up to 11.8 and 18 times more likely to be effective in clinical handover.

Recommendation/Conclusion: While the identified health  care provider factors have no statistical significance to clinical handing over, having a higher diploma, being a nurse, having less than or  equal to seven years of working experience and receiving formal training on clinical handover have been shown by this study to be  beneficial for clinical handover. The study recommends further investigation into these factors through rigorous studies involving a  larger sample size. The lack of formal standardized guidelines for clinical handover and training calls for the urgent need to establish  standard guidelines and processes that can support clinical handover.