TASK SHIFTING TASK SHARING IN OPERATING ROOM,-PROSPECTS AND CHALLENGES BY-Nr. HALLIRU KABIR KANKARA -RPON-.pdf

TASK SHIFTING TASK SHARING IN OPERATING ROOM,-PROSPECTS AND CHALLENGES BY-Nr. HALLIRU KABIR KANKARA -RPON-.pdf

1. TASK SHIFTING TASK SHARING IN OPERATING ROOM,
PROSPECTS AND CHALLENGES
BY
Nr. HALLIRU KABIR KANKARA [RPON]
THEATER COMPLEX
NURSING SERVICES DEPARTMENT,
FEDERAL TEACHING HOSPITAL KATSINA

2. OUT LINE
•Historical overview
•Introduction
•Definition
•Policy objectives
•Policy developments
•Key principles
•Implementation strategies
•Tasks shifted to operating room nurses
•Tasks shared between surgeons and operating room nurses
•Tasks shared between anesthesiologists and operating room nurses
•Benefits
•Prospects and Future Directives
•Challenges and limitations
•Conclusion
•References

3. A HISTORICAL OVERVIEW
Early Years (1960s-1980s)
•Nigeriagainedindependencein1960,andthe
healthcaresystemwaslargelymodeledafter
the British system.
•Healthcareservicesweremainlyprovidedby
doctors and other high-level professionals.
•Limitedaccesstohealthcare,especiallyinrural
areas,ledtotheintroductionofcommunity
health workers (CHEWs) in the 1970s.

4. INTRODUCTION OF TASK SHIFTING
(1990S-2000S)
-ItisWHOpolicyaimedatmakinghealthcare
accessible to all in developing countries.
-Inthe1990s,Nigeriafacedasevereshortage
ofhealthcareworkers,particularlyinrural
areas.
-Thegovernmentintroducedtaskshiftingasa
strategy to improve access to healthcare.
-CHEWsweretrainedtoperformtaskssuch
asvaccination,maternalandchildhealth
services, and basic first aid.

5. TASK SHARING EMERGES
(2000S-2010S)
-Asthehealthcareworkforceshortage
persisted,tasksharingbegantoemerge
as a complementary strategy.
-Healthcareprofessionalsbegantowork
together, sharing tasks and
responsibilities to improve patient care.
-Examplesincludednursepractitioner-led
clinicsandpharmacist-ledmedication
management.

6. POLICY DEVELOPMENTS (2010S-PRESENT)
-2011:TheNigerianMinistryofHealthintroducedtheCommunity
Health Workers into the Program to scale up task shifting.
-2014:The"NationalPolicyonCommunityHealthWorkers"was
launched, outlining roles, responsibilities, and training requirements.
-2015:TheNigerianMedicalAssociation(NMA)andtheNational
AssociationofNigerianNursesandMidwives(NANNM)signeda
memorandumofunderstandingtopromotetasksharingand
collaboration.
-2018:TheFederalMinistryofHealthlaunchedthe"TaskShiftingand
Task Sharing Guidelines" to standardize implementation.
-2019:The"NationalTaskShiftingandTaskSharingPolicy"was
approved, providing a comprehensive framework for implementation.
-2020:TheCOVID-19pandemicacceleratedtheadoptionoftaskshifting
andtasksharing,withCHEWsplayingacriticalroleincontacttracing
and community surveillance.

7. TASK SHIFTING AND TASK SHARING POLICY:
DEFINITION:
TaskShifting:Redistributingtasksfrom
onehealthcareprofessionaltoanother,
oftentoapersonwithlesstrainingor
qualifications,toimproveefficiencyand
access to care.
TaskSharing:Collaborativepractice
amonghealthcareprofessionals,where
tasksaresharedtooptimizepatientcare
and utilize each professional's strengths.

8. POLICY OBJECTIVES:
1.Improve access to quality healthcare
services.
2.Enhance efficiency and productivity.
3.Reduce workload and burnout among
healthcare professionals.
4.Promote collaborative practice and
teamwork.
5.Ensure effective use of resources and
skills.

9. KEY PRINCIPLES;
1.Patient-centered care.
2.Evidence-based practice.
3.Clear communication and
coordination.
4.Defined roles and responsibilities.
5.Trainingandsupportfor
healthcare professionals.
6.Continuous monitoringand
evaluation

10. IMPLEMENTATION STRATEGIES:
1.Identifytaskssuitableforshiftingor
sharing.
2.Develop clear protocols and guidelines.
3.Providetrainingandcapacity-building
programs
4.Establish clear communication
channels.
5.Monitor and evaluate outcomes.
6.Fosteracultureofcollaborationand
teamwork

11. TASKS SHIFTED TO OPERATING ROOM
NURSES:
1.Preparingpatientsforsurgery,includingpositioningand
draping.
2.Maintaining asepsis and ensuring a sterile environment.
3.Assisting surgeons and anesthesiologists during procedures.
4.Managing surgical instruments and equipment.
5.Monitoring patient vital signs during surgery.
6.Administeringmedicationsandfluidsasdirectedbythe
anesthesiologist.
7.Conductingsurgicalsiteverificationandtimeout
procedures.
8.Preparing and managing surgical drapes and supplies.
9.Assisting with patient transfer and positioning.
10.Maintaining accurate surgical records.

12. TASKS SHARED BETWEEN SURGEONS
AND OPERATING ROOM NURSES:
1.Patientassessmentandpreparation
for surgery.
2.Intraoperative care and monitoring.
3.Surgicalsiteidentificationand
verification.
4.Managingsurgicalcomplications
and emergencies.
5.Postoperative care and recovery

13. TASKS SHARED BETWEEN ANESTHESIOLOGISTS
AND OPERATING ROOM NURSES:
1.Patientassessmentandpreparation
for anesthesia.
2.Administeringmedicationsand
anesthesia.
3.Monitoringpatientvitalsignsduring
anesthesia.
4.Managinganesthesiaequipmentand
supplies.
5.Assistingwithpatientrecoveryand
postoperative care.

14. EXAMPLES OF TASK SHIFTING AND TASK
SHARING MODELS IN OPERATING ROOMS IN
NIGERIA:
1.The"NurseAnesthetistModel"inLagosState,where
nursesaretrainedtoadministeranesthesiaunderthe
supervision of an anesthesiologist.
2.The"SurgicalNursePractitionerModel"inAbuja,
wherenursesaretrainedtoassistsurgeonsand
perform minor surgical procedures.
3.The"OperatingRoomCoordinatorModel"inKano
State,wherenursesareresponsibleforcoordinating
surgicalproceduresandmanagingoperatingroom
staff.
NOTE;Theseexamplesillustratetheevolvingroleof
NursesinOperatingRoomsinNigeria,astheytakeon
newresponsibilitiesandworkcollaborativelywith
surgeonsandanesthesiologiststoprovidehigh-quality
patient care.

15. BENEFITS :
1.Improved patient outcomes
2.Enhanced patient satisfaction
3.Increased efficiency and
productivity
4.Reduced costs
5.Betterwork-lifebalancefor
healthcare professionals
6.Increasedjobsatisfactionand
engagement

16. PROSPECTS OF TASK SHIFTING AND TASK
SHARING POLICY:
 SHORT-TERM PROSPECTS:
1. Improved Access to Care: Increased availability of
healthcare services, especially in rural and underserved areas.
2. Enhanced Patient Experience: Better coordination of care,
reduced wait times, and improved patient satisfaction.
3. Increased Efficiency: Streamlined workflows, reduced
bureaucracy, and improved productivity.
4. Cost Savings: Reduced healthcare costs through optimized
resource utilization and reduced waste.
5. Improved Workforce Utilization: Effective use of
healthcare professionals' skills and abilities.
 

17. LONG-TERM PROSPECTS
1.SustainableHealthcareSystems:Taskshiftingand
tasksharingcanhelpaddressworkforceshortages
and sustainability challenges.
2.IncreasedCapacity:Expandedcapacitytoprovide
healthcare services, including specialized care.
3.ImprovedHealthOutcomes:Enhancedqualityof
care, reduced morbidity, and mortality rates.
4.EnhancedCollaboration:Fosteredcollaboration
and teamwork among healthcare professionals.
5.InnovativeCareModels:Developmentof
innovativecaremodels,suchascommunity-based
care and telemedicine

18. NIGERIA-SPECIFIC PROSPECTS:
1. Improved Healthcare Access: Increased access to healthcare
services, especially in rural and underserved areas.
2. Reduced Healthcare Costs: Cost savings through optimized resource
utilization and reduced waste.
3. Enhanced Healthcare Quality: Improved quality of care, reduced
morbidity, and mortality rates.
4. Increased Economic Growth: Contribution to economic growth
through improved healthcare outcomes and increased productivity.
5. Global Leadership: Nigeria can become a leader in task shifting and
task sharing policy in Africa and globally.
FUTURE DIRECTIONS:
1. Scaling Up: Scaling up task shifting and task sharing policy to all
healthcare settings.
2. Monitoring and Evaluation: Establishing robust monitoring and
evaluation

19. CHALLENGES AND LIMITATIONS:
1.ResistancetoChange:Somesurgeonsandanesthesiologistsmayresist
delegating tasks to Nurses, questioning their competence.
2.TrainingandCapacityBuilding:Nursesmayrequireadditionaltrainingto
perform new tasks, which can be time-consuming and costly.
3.RegulatoryFramework:Inconsistentorinadequateregulationscanhinder
implementation and create uncertainty.
4.WorkforceShortages:OperatingRoomstaffshortagescanmakeitdifficultto
implement task shifting and sharing.
5.CommunicationBreakdowns:Poorcommunicationamongteammemberscan
lead to errors and complications.
6.EquipmentandResourceLimitations:Inadequateequipmentandresources
can hinder effective task shifting and sharing.
7.CulturalandSocialBarriers:Culturalandsocialnormsmayinfluence
attitudes towards task shifting and sharing.
8.LiabilityandAccountability:Concernsaboutliabilityandaccountabilitycan
arise when tasks are shifted or shared.
9.MonitoringandEvaluation:Lackofrobustmonitoringandevaluationsystems
can make it difficult to assess effectiveness.
10.Sustainability:Taskshiftingandsharingmaynotbesustainableifnot
integrated into existing healthcare systems

20. NIGERIA-SPECIFIC CHALLENGES:
1.InadequateHealthcareInfrastructure:Limited
accesstobasichealthcareservices,equipment,and
resources.
2.BrainDrain:Lossofskilledhealthcare
professionals to other countries.
3.FundingConstraints:Limitedfinancialresources
to support training, equipment, and personnel.
4.CulturalandSocialFactors:Strongculturaland
social norms influencing healthcare delivery.
5.GeographicalDisparities:Unevendistributionof
healthcareresourcesandservicesacrossthe
country.

21. ADDRESSING CHALLENGES:
1.EstablishClearPoliciesandGuidelines:Developand
disseminate comprehensive policies and guidelines.
2.ProvideTrainingandCapacityBuilding:Offerregular
trainingandcapacity-buildingprogramsforOperating
Room staff.
3.PromoteCollaborationandCommunication:Fosteropen
communication and collaboration among team members.
4.InvestinHealthcareInfrastructure:Upgradehealthcare
infrastructure, equipment, and resources.
5.MonitorandEvaluate:Establishrobustmonitoringand
evaluation systems to assess effectiveness.
NOTE;Byacknowledgingandaddressingthesechallenges,
NigeriacaneffectivelyimplementTaskShiftingand
SharingPolicyinOperatingRooms,improvingpatient
care and outcomes.

22. CONCLUSION
TaskshiftingandtasksharingpoliciesinNigeriahave
evolvedovertheyears,drivenbytheneedtoimprove
accesstohealthcare,particularlyinruralareas.While
challengespersist,thecountryhasmadesignificant
progress in implementing these strategies.
Thispoliciescanimprovehealthcareaccess,efficiency,
andquality.Successfulimplementationrequirescareful
planning,training,andmonitoring.Byleveragingthe
strengthsofvarioushealthcareprofessionals,wecan
createmoreeffectiveandpatient-centeredhealthcare
systems.
Continuedinvestmentintraining,infrastructure,and
technologywillbecrucialtosustainingandscalingup
task shifting and task sharing in Nigeria.

23. REFERENCES
1.WorldHealthOrganization(2019).TaskShiftingandTaskSharinginHealthcare:
A Guide for Policymakers and Managers.
2.NigerianMinistryofHealth(2019).NationalTaskShiftingandTaskSharing
Policy.
3.Ojo,A.O.,etal.(2020).TaskShiftingandTaskSharinginNigeria:ASystematic
Review. Journal of Healthcare Management, 65(4), 263-275.
4.Adetifa,I.M.,etal.(2020).ChallengesofImplementingTaskShiftingandTask
Sharing in Operating Rooms in Nigeria. Journal of Surgical Research, 244, 112-119.
5.Olagunju,S.A.,etal.(2019).BarrierstoImplementingTaskShiftingandTask
SharinginNigerianOperatingRooms.JournalofNursingManagement,27(8),
1520-1528.
6.Afolabi,A.T.,etal.(2020).TaskShiftingandTaskSharinginNigerianOperating
Rooms: A Qualitative Study. BMC Health Services Research, 20(1), 1-11.
7.Lagos State Ministry of Health (2020). Nurse Practitioner Model for Primary Care.
8.AbujaMinistryofHealth(2019).Midwife-LedUnitModelforMaternalandChild
Health.
9.SokotoStateMinistryofHealth(2020).CommunityHealthWorkerModelfor
BasicHealthServices.*Nigeria-SpecificChallenges*1.WorldBank(2020).Nigeria:
HealthSectorOverview.2.NigerianMinistryofHealth(2020).NationalHealth
Policy. 3. UNICEF (2020). Nigeria: Health and Nutrition

24. THANK YOU