Ethnographic observations from Nursing Handovers in ICU

In our study at a tertiary hospital in South Africa, we worked with 31 nurses to co-design a visual handover tool. We observed current handover practices, engaged nurses in an interactive journal club, and developed the tool through participatory action research. We used short, focused sessions, or "seven-minute scrums," and visual methods, including large scale graphics, to involve nurses from all categories despite their busy schedules. Leadership support was essential, with leaders showing openness to new approaches and encouraging nurse participation.The visual tool, co-designed in short sessions, uses simple icons to ensure no information is lost, guiding a standardised and structured reporting on patient care and infection prevention. By actively involving nurses in the design process, we invited shared ownership and responsibility. This tool aims to enhance handover accuracy to improve patient care delivery in a low resource setting.