Managing Patients’ Health Records: Practices in Government General Hospital, Ughelli, Delta State

Abstract

The study explored how patients' health records are managed at a government hospital in Ughelli, Delta State, Nigeria. It aimed to examine how records are created and organised, how they are preserved and disposed of, and the challenges of effective records management. Using a descriptive approach, the study gathered data through interviews with the hospital's Health Records Officer. Results showed that records are generated during patient interactions with healthcare providers, such as doctors and nurses. The hospital uses a paper-based system and stores records in physical folders organised by Out-Patient Department (OPD) numbers. The
records unit maintains records, moving inactive files to an archive for long-term storage. Records are retained for ten years before disposal, in line with retention policies. The main challenge is limited storage space due to the rising volume of paper records, which hampers storage and retrieval efficiency. The study concluded that while procedures for creating, organising, preserving, and disposing of records are in place, reliance on manual systems hampers efficiency and causes storage issues. It recommended adopting Electronic Health Records (EHR) to enhance efficiency, accessibility, security, and patient care.