Has bed number 12 been administered medicines? What time does he have to go for tests? Should he be given something to eat? These are some key questions a nurse has to communicate to her replacement during shift change or when the patient is shifted from ICU to ward. In medical terms, it is referred to as nursing handover protocol.
An audit carried out by AIIMS to evaluate adherence to this protocol has revealed several lacunae. For example, significant lapses were found during the morning shifts and weekends.
"The low morning compliance probably reflects the delay in arrival of the morning shift staff, busy morning duty corresponding with the doctor's rounds, and nurse fatigue due to night duty," the researchers have stated in their report, published in the latest issue of the Asian Journal of Neurosurgery. The weekend fall of compliance, it adds, may be a result of lack of supervision (absence of administrative nurses) and generalised fall in diligence.
The AIIMS study found least compliance (44%) with patient communication during handovers, which is important since the patient and family are the only constant and thus in a position to play a critical role in ensuring continuity of care.
"There are two nurses for each bed at AIIMS. Their skill and dedication is also much better than most other personnel employed in other hospitals. However, we found certain gaps in services in this study and our aim is to work on them to improvise the lacuna," said Dr Shakti Gupta, one of the authors of the study and head of the hospital administration department at the institute.