Description

Nursing education is based on two basic educational processes, namely theoretical education and practice-based education, so that students can gain competence in clinical skills. Theoretical education includes evidence-based scientific knowledge aimed at standardizing nursing practices, while practice-based education involves the implementation of theoretical knowledge and the observation of nursing interventions in clinics. Since nursing is a practice discipline, theoretical education and practice-based education should be fully integrated with each other.

Theoretical Nursing Education

Theoretical education should guide clinical practice by providing a scientific basis, while practice-based education given in clinics should constitute the source of theoretical knowledge. However, this division in traditional nursing education can make it difficult to maintain a balance and consistency between theoretical and practical education. As a result, both newly graduated nurses who have completed the education process and begun their careers and student nurses whose education is still in progress, may encounter a lack of harmony between the practices taught at nursing school and the practices performed in clinics, that is, a discrepancy between theory and practice. This is an ongoing problem encountered by members of the nursing profession and is often referred to as the “theorypractice gap”. Besides the nursing education model, factors such as system inadequacies, resource constraints, difficulties in the clinical learning environment and acceptance of traditional practices rather than evidence-based practices in clinics can also play a role in the formation of a “gap” and discrepancy between theory and practice.

The Angolan State has been looking for ways to strengthen the health sector with the necessary human resources in quantity, quality and distribution throughout the country and by levels of care, recognizing that without a balanced workforce, health gains are not possible. Nurses are a touchstone of such workforce. The government’s responses have been framed in a national health policy, a National Health Development Plan, successive human resources development plans and a national staff training strategy and its corresponding national staff training plan.

This study reviews the historical development of nursing education in Angola, from colonial times to 2021. Conducted by the authors, initially in the context of the development of a health workforce strategy for Angola in 2013, the review findings have been updated to current times, in order to understand the past and assist with the future transformation of nursing education in Angola.

Nursing handoff is defined as a communication process for transferring pertinent patient information from one nurse to another during patient care transition. Synonymous terms such as handover, shift report, or sign-out have been interchangeably used in a wide variety of clinical settings and studies across countries. Hereafter, the term handoff is used but represents such synonyms. High quality of handoff communication among health care professionals is critical for ensuring the continuity and safety of patient care.

The importance of optimal handoff communication has been recognized internationally with reports of poor handoff consequences and recommendations for effective and structured clinical handoff communication. Studies across countries over the years have reported that incomplete, delayed, or misinterpreted information in poor handoff communication increases the risk of diagnosis errors, treatment errors, patient misplacement, delayed patient care, and patient harm. The Joint Commission reported that an estimated 80 % of serious medical errors resulted from miscommunication between caregivers during the transfer of patients. In 2016, the Joint Commission (2016) explicitly documented communication failure as the third leading cause of unexpected severe but preventable events (sentinel events) in U.S. healthcare settings. Also, in the hospital survey on patient safety culture conducted by the agency for healthcare research and Quality, 56 % of respondents stated that critical patient care information was lost during shift changes. The Australian commission on safety and quality in health care has emphasized timely, purpose-driven, and effective communication with the communicating for safety standard. Many other countries, such as Belgium, Britain, China, Northern Ireland, the Netherlands, and Switzerland, have also set national or regional standards for effective handoff.

'Communication' has been emphasized as a key featured concept interwoven within the domains and core competencies of professional nursing education. The quality and safety education in nurses Institute (2020) has emphasized appropriate handoff communication skills as an essential competency of baccalaureate nursing students to maintain patient safety and prevent adverse events. The need for handoff education in prelicensure nursing programs is highlighted by research findings that handoff failures were implicated in seven out of eight novice nurses' near misses and adverse events. It is critical that students have opportunities throughout the curriculum to practice effective nursing handoff communication skills. Various tools and systems for nursing handoff have been developed and implemented in clinical settings. However, the process of teaching and learning handoff communication skills in prelicensure nursing programs has not been well reported. Students are likely to rely on handoff experiences in clinical sites and experience challenges in handoff training due to variations in handoff practice across clinical settings, leaving new graduates poorly prepared. It is valuable to review the existing literature to identify the state of nursing handoff education and students' handoff experiences. The findings of this review will facilitate nurse educators to improve handoff education to effectively prepare the future nursing workforce to competently perform the clinical nursing handoff.