Handover Nurse Monitoring and Evaluation In Meeting The SNARS Accreditation Standards 1.1


 

 
Corresponding author: 
Kurnia Yuliastanti 
kurniayuliastanti@gmail.com  
South East Asia Nursing Research, Vol 2 No 4, December 2020 
ISSN:2685-032X 
DOI: https://doi.org/10.26714/seanr.2.4.2020.43-47   

 
 

 
 
 
 
 

 

Case Study 
 

Handover Nurse Monitoring and Evaluation In Meeting The SNARS 
Accreditation Standards 1.1  
 
Kurnia Yuliastanti1,2, Vivi Yosafianti Pohan2, Tri Hartiti2 

1 Nursing Department, Sultan Agung Islamic Hospital Semarang, Indonesia  
2 Master of Nursing Program, Universitas Muhammadiyah Semarang, Indonesia 

 
Article Info  Abstract 

Article History: 
Submit Dec 10th, 2020 
Accepted Dec 30th, 2020 
Published Dec 30th 2020 
 
Keywords:  
Monitoring and Evaluation; 
Nurse Handover; Nursing 
Management 

 Sultan Agung Islamic Hospital Semarang as one of the providers of health, 
education and research services must be supported by a strong organization 
and good management. The nurse plays an important role regarding the 
clinical outcome of the client, especially during the handover the process 
which has an impact on patient safety and the quality of the hospital. The 
implementation of monitoring and evaluation of handover in this hospital 
has never been implemented because there are no working tools and 
regulations that regulate it as a reference for implementation. This study 
uses the interviews and observations with the approach carried out on 7 - 
19 December 2020. Participants consisted of the Responsible Person / Head 
of the Room, the Responsible Nurse (PPJA) and the Implementing Nurse (PP) 
in the Baitul Izzah 2 room of the Sultan Agung Islamic Hospital Semarang. 
This study found 3 themes were found, namely the absence of monitoring 
and evaluation of handover nurses, lack of understanding of nurses 
regarding the implementation of handover monitoring and evaluation, the 
absence of regulations and work tools regarding the handover monitoring 
and evaluation. Work tools and regulations are very helpful in the 
implementation of monitoring and evaluation of handover in providing 
nursing care in the inpatient room. As well as fulfilling SNARS 1.1 
Accreditation standards. 

 

INTRODUCTION  

Sultan Agung Islamic Hospital Semarang as 
one of the providers of health, education 
and research services, aims to improve 
health status and is always oriented 
towards the interests of the community. For 
that, the hospital needs to be supported by 
the existence of a strong organization and 
good management oriented towards the 
quality of service for the community.  

Nursing management is a process of 
working through members of the nursing 
staff to provide nursing care professionally. 
It is a special task that must be carried out 
by nursing managers to plan, organize, 
direct and supervise existing resources, 
both human resources, tools and funds so 
that they can provide effective nursing 
services to patients, families and 
communities.1 Meanwhile, a nursing service 
is a form of professional service that is an 
integral part of health services based on 

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Kurnia Yuliastanti / Handover Nurse Monitoring and Evaluation In Meeting The SNARS Accreditation Standards 
1.1 

nursing knowledge and tips for individuals, 
families, groups or communities, both 
healthy and sick. Nursing practice is a 
service provided by nurses in the form of 
nursing care.2 

Nurses as an integral part of health services 
are required to have strong managerial 
abilities so that the services provided can 
increase patient satisfaction. Nurses' 
managerial abilities can be achieved in 
many ways. One of them is by increasing 
reliable managerial skills based on 
innovation and evidence-based.3  The nurse 
must know the concept correctly and have a 
positive attitude and be prepared to apply 
the evidence-based practice. In the 
inpatient installation, the nursing staff are 
in the forefront of the health service system 
with the first and longest contact with the 
patient, which is 24 hours per day and 7 
days per week, therefore nurses hold a key 
position in building the image of the 
hospital. Nursing services in the hospital are 
the biggest activity producers so that they 
reflect the quality of hospital services. This 
quality can be seen from one of them 
through the implementation of Handover 
nurses when weighing receipts between 
shifts.4 

National Hospital Accreditation Standards 
(SNARS) 1.1. The Patient Safety Goal 
(SKP.2.2) requires that the hospital 
establish and implement a communication 
process “Handover” and develop effective, 
timely, accurate, complete, clear and 
understandable communication methods 
for recipients.5 Weigh-acceptance is a 
technique used to convey and receive 
reports in connection with the client's 
condition, which is carried out between 
nurses and nurses and between nurses and 
clients in an accurate and more real way, it 
must be clear, concise and complete. 
Acceptance weighing is carried out starting 
from preparation, implementation at the 
nurse station and continued beside the 
patient's bed or bedside handover, as well 
as post-consideration. 1 

Patient handover is designed as a method to 
provide relevant information to the nursing 
team at each shift, as a practical guide 
providing information about the patient's 
current condition, treatment goals, 
treatment plans and determining priority 
services that are carried out in a timely, 
accurate, complete, and clear manner, so 
that it can be understood, and will reduce 
errors, and result in increased patient 
safety.6 

Handover implementation in several 
hospitals in Indonesia is still not optimally 
implemented. This shows that the handover 
condition still requires a lot of improvement 
and recommendations to become a better 
process. Therefore, if the communication in 
handover is not effective, it can cause errors 
in the continuity of services and improper 
treatment and result in potential losses for 
patients.7 

Baitul Izzah 2 room is an adult inpatient 
room led by a Person in Charge / Head of 
Room with 4 (four) Nurses in Charge of Care 
(PPJA). PPJA in implementing nursing care 
is assisted by 17 implementing nurses 
(Associate Nurse / PA). The room 
designated as a practice place for nursing 
management applications, is an adult care 
room for classes I and III with cases of 
Internal Medicine, Eyes, Nerves, ENT, Skin 
and genitals, and Teeth and Mouth. Has a 
capacity of 26 patient beds (TT). BOR for the 
last 3 (three) months averaged 73.5%. The 
number of nurses is 21 (twenty-one) with 
D3 Nursing Education amounting to 17 and 
Nurse Education: amounting to 4. 

Based on the results of the assessment, 
through interviews and observations made 
to the Head of the Baitul Izzah 2 Room at the 
Sultan Agung Islamic Hospital, Semarang 
revealed that in the application of the 
second patient safety goal, namely 
increasing effective communication, 
manifested in the implementation of nurse 
handover between shifts. Handover is 
carried out at the nurse station then 
proceed to the patient's bedside (bedside 



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Kurnia Yuliastanti / Handover Nurse Monitoring and Evaluation In Meeting The SNARS Accreditation Standards 
1.1 

handover). For the handover the material, 
the nurse uses the patient's medical record 
data and uses a tool in the form of an SBAR-
based Handover Form (Situation, 
Background, Assessment, 
Recommendation). The handover is 
routinely carried out and runs smoothly, 
however so far there has never been any 
monitoring or evaluation related to the 
implementation of the handover. This study 
aims to determine the implementation of 
Handover Nurse Monitoring and Evaluation 
In Meeting The SNARS Accreditation 
Standards 1.1. 

METHODS 

The scientific way to obtain data with 
specific purposes and uses.8 Activities 
carried out in obtaining data through 
observation and interviews, started with 
problem identification, then continued with 
problem analysis, determination of problem 
priorities, preparation of plans of action, 
implementation, and evaluation of 
structures, processes and results. The data 
is used in determining the problems 
identified using a fishbone diagram. The 
method used to determine the priority of 
several problems using the CAR method, 
which consists of: 

C =  Capability, namely the availability of 
resources (funds, facilities and 
equipment) 
A = Accessibility, namely convenience, 
the existing problem is easy to solve or 
not. Convenience can be based on the 
availability of 
methods/methods/technology as well 
as implementation support such as 
regulations or implementation 
guidelines. 

R =  Readiness, namely the readiness of the 
executive staff and the readiness of 
targets, such as expertise or ability 
and motivation. 

L =  Leverage, namely how much influence 
the criteria have on one another in 
solving the problems discussed. 

To get the priority value, that is by 
multiplying the value of each criterion. The 
higher the value of the product, the more 
priority the problem is to solve. 

RESULTS 

In determining the problem according to 
the CARL method, there are 2 (two) 
problems, namely: 

1. Not yet implemented monitoring and 
evaluation of Handover by the Head of 
the Room (score 256) 

2. Not yet implemented nursing 
supervision activities by the head of the 
room, the team leader in a structured 
manner (score 96) 

Based on the highest score, the priority of 
the problem in the Baitul Izzah 2 room is 
"The Head of the Room has not carried out 
monitoring and evaluation of Handover". 

Intervention implemented by conducting 
socialization/ refreshing about handover 
through zoom meeting. Followed by 
coordination and consultation with the 
Head of Nursing and the Head of the Room 
for making work tools in the form of 
monitoring forms, evaluation forms and 
making SPO Monitoring and SPO Evaluation 
handover. 

On December 10, 2020, the form and SPO 
were socialized directly to the Head of the 
Room, PPJA and PP continued with 
implementation on December 11, 2020. 
Form and SPO were well received by all 
Baitul Izzah Room nurses 2. 
Implementation was carried out with 
continuous assistance 

Interviews and observations to the Head of 
the Room and PPJA obtained data on the 
implementation of the monitoring form, 
evaluation form, SPO monitoring and SPO 
evaluation can be carried out smoothly. The 
form is filled in completely, the nurse also 
does not feel burdened in filling out the 
complete form. With this form, it makes it 



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Kurnia Yuliastanti / Handover Nurse Monitoring and Evaluation In Meeting The SNARS Accreditation Standards 
1.1 

easier for nurses to handover. Nurses are 
more able to focus and be structured on 
what things will be handed over to the next 
shift. The information provided is more 
accurate, which can minimize errors in 
communication that can harm patients. 

DISCUSSION 

Based on the results of interviews and 
observations, the patient's overall handover 
from the preparation, implementation, and 
post-consideration stages constitutes a 
unified process that becomes one of the 
activities that support nursing services on 
an ongoing basis and with integrity through 
reporting and documentation.1 Following 
the purpose of the consideration and 
acceptance based on the SPO of the Sultan 
Agung Islamic Hospital Semarang which 
was issued on January 7, 2020, among 
others, is to improve communication skills 
between nurses so that there is a 
responsible collaborative relationship 
between members of the nursing team and 
can follow the complete development of 
clients and the implementation of nursing 
care towards clients on an ongoing basis. 

Efforts to improve service quality following 
standards and following the latest hospital 
accreditation provisions Handover, in 
Baitul Izzah 2 room have been implemented 
following the existing SPO. Handover is 
carried out every shift change at the nurse 
station then continued to the patient's 
bedside (bedside handover). For the 
handover the material, the nurse uses the 
patient's medical record data and uses a tool 
in the form of an SBAR-based Handover 
Form (Situation, Background, Assessment, 
Recommendation). The method of 
implementing this weigh-and-receipt has 
been implemented since the issuance of the 
SPO as a reference for the implementation 
of the handover. There were no obstacles in 
its implementation. It was found that the 
handover had never been monitored and 
evaluated in its implementation. Whereas in 
the SNARS 1.1 Accreditation standard.5 

The Head of the Room, PPJA and PP do not 
carry out monitoring and evaluation due to 
lack of understanding and understanding, 
that handover must always be monitored 
and evaluated to find out any obstacles in its 
implementation for quality assurance and 
patient safety. The impact if this happens 
continuously and there is no improvement 
or improvement, it will have a negative 
impact on the implementation of the 
consideration itself, for the staff or nurses 
who carry out these activities and for the 
institution which is the container and 
provider of the facilities, and especially for 
patients as clients who involved in this 
activity. Thus, this activity will ultimately 
have an impact on patient safety goals 
which ultimately lead to patient satisfaction 
with the service and quality of the hospital 
institution. 

With the existence of forms, SPO monitoring 
and evaluation handover, monitoring and 
evaluation are always carried out in every 
handover implementation. In interviews 
and observations to the Head of the Room 
and PPJA, the monitoring form, evaluation 
form, monitoring SPO and SPO evaluation 
were carried out properly. The form is filled 
in completely and the nurse finds it easy to 
carry out the contents of the form. Nurses 
can be more focused and structured on 
what things will be handed over to the next 
shift. the information provided is more 
accurate, which can minimize errors in 
communication that can harm the patient 

The positive impact felt by the nurses 
themselves is to motivate to improve 
communication skills between nurses, to 
establish a cooperative and responsible 
relationship between nurses and to be able 
to follow the patient's development 
comprehensively 9. Nurses' job satisfaction 
in nursing practice is achieved when the 
nurse feels that she has contributed, is 
considered important, has received support 
from existing sources, and many nursing 
outcomes are achieved.10 

 



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Kurnia Yuliastanti / Handover Nurse Monitoring and Evaluation In Meeting The SNARS Accreditation Standards 
1.1 

CONCLUSION 

Activities run well and can increase the 
knowledge and skills of nurses in the 
application of monitoring and evaluation of 
handover nurses. It was shown from the 
results of the mentoring evaluation that the 
implementation of monitoring and 
evaluation of handover nurses had been 
carried out well with 100% achievement 
which previously did not exist. This was 
supported by the joint commitment of all 
nurses in the Baitul Izzah 2 care room to 
always carry out monitoring and evaluation 
of handover. 

ACKNOWLEDGMENTS 

The author is thankful to Sultan Agung 
Islamic Hospital Semarang and the nurses 
who took part in this study. 

CONFLICTS OF INTEREST 

The author disclosures no potential 
conflicts of interest, financial or otherwise. 

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