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Pazar B, Kavakli O, Ak EN, Erten EE. Implementation and Evaluation of the SBAR Communication Model in Nursing Handover by Pediatric Surgery Nurses. J Perianesth Nurs 2024:S1089-9472(23)01108-5. [PMID: 38864801 DOI: 10.1016/j.jopan.2023.12.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 12/15/2023] [Accepted: 12/15/2023] [Indexed: 06/13/2024]
Abstract
PURPOSE Situation, Background, Assessment, Recommendations (SBAR) is recommended as a standardized model to improve communication between health professionals and increase patient safety. Correct use of the SBAR model reduces communication errors, facilitates rapid decision-making, and increases patient safety. Therefore, effective use of the SBAR model among health care professionals contributes to safer patients. This study examines the implementation and evaluation of the SBAR communication model in nursing handover by pediatric surgical nurses. DESIGN The study had a pretest-post-test semi-experimental design. METHODS Data were collected between April 1 and June 30, 2022 from 24 nurses, who worked at two pediatric surgery units of a training research hospital in Turkey. Ethical approval and written informed consent were obtained prior to the study. FINDINGS The mean age of the nurses was 26.00 ± 3.43 years and 75% were female. The mean score obtained from the handover rating scale was 60.33 ± 11.11 (18 to 70). The pretest and post-test scores obtained from the SBAR communication model questionnaire were 60.00 ± 20.64 (20 to 90) and 92.50 ± 9.89 (60 to 100), respectively. 66.7% of the nurses answered no to the statement "Using the SBAR communication model did not contribute positively to the handover." The majority answered yes to the items other than this statement, the ratio of those who answered yes and no to the statement "The SBAR communication model caused me to waste time during the handover" was equal, and the majority completed the SBAR handover form. CONCLUSIONS Some of the nurses felt that the SBAR communication model made a positive contribution to shift performance, while others felt that it did not. Although half of the nurses considered the SBAR communication model to be a waste of time, it was observed that no negative events occurred during the use of the model and that the nurses were willing to use the SBAR communication model. Therefore, it is recommended that in-service training programs be organized to increase the use of the SBAR communication model and that the use of SBAR should be continuously reviewed and improved.
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Affiliation(s)
- Berrin Pazar
- Department of Surgical Nursing, Lokman Hekim University, Çankaya, Ankara, Turkey
| | - Oznur Kavakli
- Department of Fundamentals of Nursing, Gulhane Faculty of Nursing, University of Health Sciences, Kecioren, Ankara, Turkey.
| | - Ecem Naz Ak
- Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
| | - Elif Emel Erten
- Pediatric Surgery, Ankara City Hospital, Cankaya, Ankara, Turkey
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Green A, Simmons VC, Taicher BM, Thompson JA, Manske B, Funk E. Sustainability of an Operating Room to Pediatric Postanesthesia Care Unit Handoff Tool. J Perianesth Nurs 2023; 38:851-859.e2. [PMID: 37589633 DOI: 10.1016/j.jopan.2022.12.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 12/07/2022] [Accepted: 12/11/2022] [Indexed: 08/18/2023]
Abstract
PURPOSE The purpose of this quality improvement (QI) project was to reintroduce and assess the feasibility of a standardized, electronic health record (EHR) handoff tool and to evaluate the sustainability of a structured, team-based approach in a pediatric postanesthesia care unit (PACU). DESIGN This QI project used an observational pre-post design using two separate convenience samples of handoffs and perianesthesia providers. METHODS A standardized EHR handoff tool was reintroduced for operating room to pediatric PACU handoff communication. Handoffs between anesthesia providers, surgery team members, and PACU nurses were observed pre- and postreintroduction of the EHR handoff tool. Anesthesia providers and PACU RNs received training for giving and receiving handoffs and were provided directions on locating the EHR handoff tool. A bedside audit of items communicated for the six handoff phases (introductions, situation, background, assessment, recommendations, and questions), handoff duration, team member participation, and handoff tool utilization were performed for 149 handoffs pre- and 146 handoffs postimplementation. To evaluate sustainability, the audits were compared to postimplementation data from the 2014 pilot handoff project. FINDINGS Following reintroduction, EHR handoff tool use increased from 4% to 19%. There was a statistically significant increase in items communicated for three of the six handoff phases when using the EHR tool (P < .05). There was no statistically significant increase in handoff duration (mean = 3.66 minutes, SD = 1.57 minutes) with the EHR handoff tool. Surgical team member presence for the team-based handoff increased from 90.7% pre to 95.9% post. Provider compliance with the team-based handoff approach, which includes a PACU RN, surgical team member, and anesthesia team member present for handoff, was sustained and increased 6 years postimplementation. Feedback from anesthesia providers and PACU RNs indicated mixed reports of satisfaction with the EHR tool, perceived handoff efficiency, and consistency in both giving and receiving handoff. Adherence to five of the six structured handoff phases, except introductions, was sustained and even improved 6 years following implementation. CONCLUSIONS Evidence-based practice for handoff communication supports the use of a team approach and standardized EHR handoff tools. The reintroduction of a standardized EHR handoff tool improved the completeness of information transfer, yet did not lead to widespread adoption nor improved user satisfaction. There is an ongoing need to identify adoptable and sustainable perioperative handoff methods.
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Affiliation(s)
| | | | | | | | | | - Emily Funk
- Duke University School of Nursing, Durham, NC; Duke University Medical Center, Durham, NC.
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Lazzara EH, Simonson RJ, Gisick LM, Griggs AC, Rickel EA, Wahr J, Lane-Fall MB, Keebler JR. Does standardisation improve post-operative anaesthesia handoffs? Meta-analyses on provider, patient, organisational, and handoff outcomes. ERGONOMICS 2022; 65:1138-1153. [PMID: 35438045 DOI: 10.1080/00140139.2021.2020341] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 12/12/2021] [Indexed: 06/14/2023]
Abstract
Anaesthesia handoffs are associated with negative outcomes (e.g. inappropriate treatments, post-operative complications, and in-hospital mortality). To minimise these adverse outcomes, federal bodies (e.g. Joint Commission) have mandated handoff standardisation. Due to the proliferation of handoff interventions and research, there is a need to meta-analyze anaesthesia handoffs. Therefore, we performed meta-analyses on the provider, patient, organisational, and handoff outcomes related to post-operative anaesthesia handoff protocols. We meta-analysed 41 articles with post-operative anaesthesia handoffs that implemented a standardised handoff protocol. Compared to no standardisation, a standardised post-operative anaesthesia handoff changed provider outcomes with an OR of 4.03 (95% CI 3.20-5.08), patient outcomes with an OR of 1.49 (95% CI 1.32-1.69), organisational outcomes with an OR of 4.25 (95% CI 2.51-7.19), handoff outcomes with an OR of 8.52 (95% CI 7.05-10.31). Our meta-analyses demonstrate that standardised post-operative anaesthesia handoffs altered patient, provider, organisational, and handoff outcomes. Practitioner Summary: We conducted meta-analyses to assess the effects of post-operative anaesthesia handoff standardisation on provider, patient, organisational, and handoff outcomes. Our findings suggest that standardised post-operative anaesthesia handoffs changed all listed outcomes in a positive direction. We discuss the implications of these findings as well as notable limitations in this literature base.
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Affiliation(s)
- Elizabeth H Lazzara
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Richard J Simonson
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Logan M Gisick
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Andrew C Griggs
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Emily A Rickel
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
| | - Joyce Wahr
- Department of Anesthesiology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - Meghan B Lane-Fall
- David E. Longnecker Associate Professor of Anesthesiology and Critical Care, Department of Anesthesiology and Critical Care, Perelman School of Medicine University of Pennsylvania, Philadelphia, PA, USA
| | - Joseph R Keebler
- Department of Human Factors and Behavioral Neurobiology, Embry-Riddle Aeronautical University, Daytona Beach, FL, USA
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Mastrogiovanni MJ, Michelle Moccia J. Optimizing handover in patients with stroke symptoms utilizing an organized protocol between emergency department providers and emergency medical personnel. Int Emerg Nurs 2022; 61:101129. [DOI: 10.1016/j.ienj.2021.101129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2021] [Revised: 11/20/2021] [Accepted: 12/13/2021] [Indexed: 11/05/2022]
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Communication in Health Care: Impact of Language and Accent on Health Care Safety, Quality, and Patient Experience. Am J Med Qual 2021; 36:355-364. [PMID: 34285178 DOI: 10.1097/01.jmq.0000735476.37189.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Permanent or temporary migration results in communication issues related to language barriers. The migrant's mother tongue is often different from that of the host country. Even when the same language is spoken, communication barriers arise because of differences in accent. These communication barriers have a significant negative impact on migrants accessing health care and their ability to understand instructions and seek follow-up care. A multidisciplinary team often has professionals from various countries. These migrant health care professionals find it difficult to communicate with patients of the host country and with their colleagues. Communication barriers, therefore, result in miscommunication or no communication between health care professionals and between health care professionals and patients. This increases the risk of medical errors and impacts quality of care and patient safety. This review looks at the impact of communication barriers in health care and endeavors to find effective solutions.
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Jaulin F, Lopes T, Martin F. Standardised handover process with checklist improves quality and safety of care in the postanaesthesia care unit: the Postanaesthesia Team Handover trial. Br J Anaesth 2021; 127:962-970. [PMID: 34364652 DOI: 10.1016/j.bja.2021.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 06/19/2021] [Accepted: 07/03/2021] [Indexed: 10/20/2022] Open
Abstract
BACKGROUND Miscommunication is a leading cause of preventable incidents in healthcare. A number of checklists have been created in an attempt to improve patient outcomes with only a small impact. However, the 2009 WHO Surgical Safety Checklist demonstrated benefits in terms of reduced morbidity and mortality. Our aim was to determine whether use of a Postanaesthesia Team Handover (PATH) checklist would reduce hypoxaemic events in the postanaesthesia care unit (PACU). METHODS This single-centre, prospective, pre-/post-implementation study was conducted between February 2019 and July 2020 in the PACU of Versailles Private Hospital, Paris, France. Pre-PATH implementation data were collected for 294 consecutive adult patients (≥18 yr old) admitted to the PACU and post-PATH implementation data were collected for 293 consecutive patients. The primary outcome was the rate of hypoxaemic events post-surgery during PACU stay. RESULTS The rates of hypoxaemic events were 4.1% (11/267 [95% confidence interval {CI}: 2.3-7.2%]) before the PATH checklist was introduced and 0.8% (2/266 [95% CI: 0.2-2.7%]) after. Patients in the PATH group were 5.6 times (odds ratio [OR] [95% CI: 1.3-33.6], P=0.041) less likely to have a hypoxaemic event than those in the control group. The handover process in the PATH checklist group also had significantly less interruptions (38.6% control vs 20.7% PATH; OR=2.5 [95% CI: 1.7-3.7]; P<0.0001). CONCLUSIONS Implementation of the PATH checklist in adult patients post-surgery was associated with a reduction in the rate of hypoxaemic events in the PACU. These findings support standardisation of the handover process with checklists following anaesthesia and surgery. CLINICAL TRIAL REGISTRATION NCT03972423.
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Affiliation(s)
- François Jaulin
- Patient Safety Database, SafeTeam Academy, Facteurs Humains en Santé Association, Paris, France
| | - Thomas Lopes
- Versailles Private Hospital, Ramsay Santé, Paris, France
| | - Frederic Martin
- Patient Safety Database, SafeTeam Academy, Facteurs Humains en Santé Association, Paris, France; Versailles Private Hospital, Ramsay Santé, Paris, France.
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Evidence-Based Guideline on Critical Patient Transport and Handover to ICU. Anesthesiol Res Pract 2021; 2021:6618709. [PMID: 34035805 PMCID: PMC8118726 DOI: 10.1155/2021/6618709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 04/08/2021] [Accepted: 04/16/2021] [Indexed: 12/02/2022] Open
Abstract
The perioperative period is a time in which significant physiological change occurs. Improper transfer of information at this point can lead to medical errors. Planning and preparation for critical patient transport to ICU is vital to prevent adverse events. Critical patient transport to ICU must be as safe as possible and should not cause additional risks. It needs good communication, planning, and appropriate staffing with standard monitoring. Evidence shows inconsistency and variability on the use of standardized protocols during critical patient transfer and handover to the ICU. There is a variety of controversial approaches about the need of sedation, use of end-tidal CO2 monitoring, and manual versus mechanical ventilation based on different evidence. The objective of this review was to recommend safer options of critical patient transfer to the ICU that help reduce patient morbidity and mortality. Methods. Google Scholars, PubMed through HINARI, and other search engines were used to search high-quality evidence that help reach appropriate conclusions. Discussion. Critical patient transfer and handover to ICU is a complex procedure that needs experienced hands, availability of appropriate team members, standard monitoring, and necessary emergency and patient-specific medications. Appropriate and adequate transfer of patient information to the receiving team decreases patient morbidity and mortality when the transfer team uses standardized checklist. Conclusion. Involvement of senior physicians, use of standard monitoring, and appropriate transfer of information have been shown to decrease critical patient morbidity and mortality.
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Ghosh S, Ramamoorthy L, Pottakat B. Impact of Structured Clinical Handover Protocol on Communication and Patient Satisfaction. J Patient Exp 2021; 8:2374373521997733. [PMID: 34179390 PMCID: PMC8205370 DOI: 10.1177/2374373521997733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The Handover process is an essential aspect of patient care in daily clinical
practice to ensure continuity of patient care. Standardization of clinical
handover may reduce sentinel events due to inaccurate and ineffective
communication. Single arm experimental trial was conducted to assess the effect
of standard Situation, Background, Assessment, Recommendation (SBAR) protocol
implementation in overall bedside nursing handover process, patient
satisfaction, and nurses’ acceptance. As a sample, all nursing staff of
specified unit, all handover process performed by them, and patients admitted
during study the period were included. Initially, the prevailing handover
process and patient satisfaction regarding nursing handover was assessed using a
structured observation checklist. During the implementation phase, nurses were
trained on an SBAR handover protocol. After implementation, nursing handovers
were again assessed and data regarding patient satisfaction and nurses’
acceptance were collected. There was a statistically significant difference
(P < .05) in median scores between the pre and
post-intervention group on overall nursing handover and patient satisfaction
regarding nursing handover. Standardization of patient’s handover process is
effective in terms of improving nursing handover process, patient satisfaction,
and health professionals’ acceptance.
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Affiliation(s)
| | | | - Biju Pottakat
- Department Surgical Gastro Enterology, JIPMER, Puducherry, India
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Dusse F, Pütz J, Böhmer A, Schieren M, Joppich R, Wappler F. Completeness of the operating room to intensive care unit handover: a matter of time? BMC Anesthesiol 2021; 21:38. [PMID: 33546588 PMCID: PMC7863365 DOI: 10.1186/s12871-021-01247-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 01/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Handovers of post-anesthesia patients to the intensive care unit (ICU) are often unstructured and performed under time pressure. Hence, they bear a high risk of poor communication, loss of information and potential patient harm. The aim of this study was to investigate the completeness of information transfer and the quantity of information loss during post anesthesia handovers of critical care patients. METHODS Using a self-developed checklist, including 55 peri-operative items, patient handovers from the operation room or post anesthesia care unit to the ICU staff were observed and documented in real time. Observations were analyzed for the amount of correct and completely transferred patient data in relation to the written documentation within the anesthesia record and the patient's chart. RESULTS During a ten-week study period, 97 handovers were included. The mean duration of a handover was 146 seconds, interruptions occurred in 34% of all cases. While some items were transferred frequently (basic patient characteristics [72%], surgical procedure [83%], intraoperative complications [93.8%]) others were commonly missed (underlying diseases [23%], long-term medication [6%]). The completeness of information transfer is associated with the handover's duration [B coefficient (95% CI): 0.118 (0.084-0.152), p<0.001] and increases significantly in handovers exceeding a duration of 2 minutes (24% ± 11.7 vs. 40% ± 18.04, p<0.001). CONCLUSIONS Handover completeness is affected by time pressure, interruptions, and inappropriate surroundings, which increase the risk of information loss. To improve completeness and ensure patient safety, an adequate time span for handover, and the implementation of communication tools are required.
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Affiliation(s)
- Fabian Dusse
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany.,Department of Anesthesiology and Intensive Care Medicine, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Johanna Pütz
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Andreas Böhmer
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Mark Schieren
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany.
| | - Robin Joppich
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany
| | - Frank Wappler
- Department of Anesthesiology and Intensive Care Medicine, University Witten/Herdecke, Medical Center Cologne-Merheim, Ostmerheimer Str. 200, 51109, Cologne, Germany
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Noh YG, Lee I. Effects of a stepwise handovers ISBARQ programme among nursing college students. Nurs Open 2020; 7:1551-1559. [PMID: 32802376 PMCID: PMC7424453 DOI: 10.1002/nop2.537] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 04/01/2020] [Accepted: 05/18/2020] [Indexed: 11/28/2022] Open
Abstract
Background Due to a lack of standardized guidelines, it is necessary to verify the effectiveness of educational programmes for nursing students' systematic handover training. Aims This study aimed to develop a stepwise nursing handover programme and to examine its effects on awareness of handover Situation, Background, Assessment, Recommendation, communication self-efficacy and satisfaction with handover education. Design This was a single-group repeated measures ANOVA study. Methods This study was conducted in a nursing department, using a convenience sample of 25 senior nursing students from April 2 to June 22, 2018. The programme was divided into lectures, scenario role-playing and nursing case role-playing. The research questions were analysed using repeated measures ANOVA. Results Awareness of handover Situation, Background, Assessment, Recommendation, communication self-efficacy and satisfaction with handover education gradually increased after each step of the programme. The stepwise nursing handover programme, progressing from low to high levels of learning, can be used to improve the nursing handover system and handover communication ability.
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Affiliation(s)
- Yoon Goo Noh
- Department of NursingChangwon National UniversityChangwonKorea
| | - Insook Lee
- Department of NursingChangwon National UniversityChangwonKorea
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Espin S, Indar A, Gross M, Labricciosa A, D'Arpino M. Processes and tools to improve teamwork and communication in surgical settings: a narrative review. BMJ Open Qual 2020; 9:bmjoq-2020-000937. [PMID: 32554445 PMCID: PMC7304801 DOI: 10.1136/bmjoq-2020-000937] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Revised: 05/13/2020] [Accepted: 05/27/2020] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sherry Espin
- Daphne Cockwell School of Nursing, Ryerson University, Toronto, Ontario, Canada
| | - Alyssa Indar
- Faculty of Health Sciences and Wellness, Humber College Institute of Technology and Advanced Learning, Toronto, Ontario, Canada
| | | | | | - Maryanne D'Arpino
- Safety Improvement and Capability Building, Canadian Patient Safety Institute, Ottawa, Ontario, Canada
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Halladay ML, Thompson JA, Vacchiano CA. Enhancing the Quality of the Anesthesia to Postanesthesia Care Unit Patient Transfer Through Use of an Electronic Medical Record-Based Handoff Tool. J Perianesth Nurs 2018; 34:622-632. [PMID: 30528308 DOI: 10.1016/j.jopan.2018.09.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2018] [Revised: 08/30/2018] [Accepted: 09/03/2018] [Indexed: 11/17/2022]
Abstract
PURPOSE Anesthesia to postanesthesia care unit (PACU) handoffs are often incomplete, imprecise, and highly variable with respect to information transfer, and therefore can jeopardize patient safety. A standardized anesthesia to PACU electronic medical record (EMR)-based patient handoff checklist was implemented and evaluated for its effect on the information transfer. DESIGN An observational preimplementation and postimplementation design was used. METHODS Assessment of the completeness and accuracy of information transfer during the PACU handoff was performed for a convenience samples of 100 patients preimplementation, 3 weeks postimplementation, and 3 months postimplementation. FINDINGS The mean percentage of total handoff checklist items addressed significantly increased 3 weeks and 3 months postimplementation compared with baseline. CONCLUSIONS The use of a standardized anesthesia to PACU EMR-based handoff checklist significantly increased the percent of accurate information transferred without considerably affecting the duration of the PACU handoff process.
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Hovenkamp GT, Olgers TJ, Wortel RR, Noltes ME, Dercksen B, Ter Maaten JC. The satisfaction regarding handovers between ambulance and emergency department nurses: an observational study. Scand J Trauma Resusc Emerg Med 2018; 26:78. [PMID: 30201007 PMCID: PMC6131795 DOI: 10.1186/s13049-018-0545-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 09/03/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND A thorough handover in the emergency department (ED) is of great importance for improving the quality and safety in the chain of care. The satisfaction of handover may reflect the quality of handover. Research to discover the variables influencing the satisfaction of handovers is scarce. The goal of this study was to determine the factors influencing the satisfaction regarding handovers from ambulance and ED nurses. METHODS We performed a prospective observational study in the University Medical Center of Groningen. Data regarding prehospital-hospital handovers has been collected by observing handovers and assessing patient chart information. Data regarding the satisfaction has been collected with a questionnaire including a 5-point scale for the level of satisfaction. RESULTS In total, 97 handovers were observed and 97 ambulance nurses and 89 ED nurses completed the questionnaire. The satisfaction of ambulance nurses showed a negative correlation with the waiting time prior to handover (r = -.287, p = .004) and a positive correlation with the presence of a physician in the receiving team (r = .224, p = .028). The satisfaction of ED nurses showed a positive correlation with the use of the ABCDE (r = .288, p = .006) and AMPLE instrument (r = .208, p = .050). CONCLUSION The satisfaction of ambulance and ED nurses as sender or receiver of the handover is determined by different factors. The satisfaction of ambulance nurses is mainly affected by the waiting time and presence of a physician, while the satisfaction of ED nurses is affected by the use of handover instruments and the completeness of medical information.
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Affiliation(s)
- Gijs Thomas Hovenkamp
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands
| | - Tycho Joan Olgers
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands.
| | - Remco Robert Wortel
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands
| | - Milou Esmée Noltes
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands
| | - Bert Dercksen
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands
| | - Jan Cornelis Ter Maaten
- Department of Internal Medicine, Emergency Medicine, University of Groningen, University Medical Center Groningen, Hanzeplein 1 9700RB, Groningen, The Netherlands
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Shahid S, Thomas S. Situation, Background, Assessment, Recommendation (SBAR) Communication Tool for Handoff in Health Care – A Narrative Review. ACTA ACUST UNITED AC 2018. [DOI: 10.1186/s40886-018-0073-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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15
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Thomson H, Tourangeau A, Jeffs L, Puts M. Factors affecting quality of nurse shift handover in the emergency department. J Adv Nurs 2017; 74:876-886. [DOI: 10.1111/jan.13499] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/25/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Heather Thomson
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Ann Tourangeau
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
| | - Lianne Jeffs
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
- St. Michael's Hospital; Toronto ON Canada
- Institute for Health Policy Management and Evaluation; University of Toronto; Toronto ON Canada
| | - Martine Puts
- Lawrence S. Bloomberg Faculty of Nursing; University of Toronto; Toronto ON Canada
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Transitions of Care in the Perioperative Period. CURRENT ANESTHESIOLOGY REPORTS 2017. [DOI: 10.1007/s40140-017-0244-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Operating Room-to-ICU Patient Handovers: A Multidisciplinary Human-Centered Design Approach. Jt Comm J Qual Patient Saf 2017; 42:400-14. [PMID: 27535457 DOI: 10.1016/s1553-7250(16)42081-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Patient handovers (handoffs) following surgery have often been characterized by poor teamwork, unclear procedures, unstructured processes, and distractions. A study was conducted to apply a human-centered approach to the redesign of operating room (OR)-to-ICU patient handovers in a broad surgical ICU (SICU) population. This approach entailed (1) the study of existing practices, (2) the redesign of the handover on the basis of the input of hand over participants and evidence in the medical literature, and (3) the study of the effects of this change on processes and communication. METHODS The Durham [North Carolina] Veterans Affairs Medical Center SICU is an 11-bed mixed surgical specialty unit. To understand the existing process for receiving postoperative patients in the SICU, ethnographic methods-a series of observations, surveys, interviews, and focus groups-were used. The handover process was redesigned to better address providers' work flow, information needs, and expectations, as well as concerns identified in the literature. RESULTS Technical and communication flaws were uncovered, and the handover was redesigned to address them. For the 49 preintervention and 49 postintervention handovers, the information transfer score and number of interruptions were not significantly different. However, staff workload and team behaviors scores improved significantly, while the hand over duration was not prolonged by the new process. Handover participants were also significantly more satisfied with the new handover method. CONCLUSIONS An HCD approach led to improvements in the patient handover process from the OR to the ICU in a mixed adult surgical population. Although the specific handover process would unlikely be optimal in another clinical setting if replicated exactly, the HCD foundation behind the redesign process is widely applicable.
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Wilson D, Kochar A, Whyte-Lewis A, Whyte H, Lee KS. Evaluation of Situation, Background, Assessment, Recommendation Tool During Neonatal and Pediatric Interfacility Transport. Air Med J 2017; 36:182-187. [PMID: 28739240 DOI: 10.1016/j.amj.2017.02.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/21/2017] [Accepted: 02/28/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE We aimed to determine if the implementation of Situation, Background, Assessment, Recommendation (SBAR) training improved the quality of real-life telephone communication. We evaluated interfacility neonatal and pediatric transports performed by registered nurses, respiratory therapists, and physicians (MDs). METHODS This was a quality improvement study performed to evaluate telephone communication before and after SBAR training. Training consisted of lectures, review of audio files, and simulated role-playing. Recorded audio files of real-life transports were evaluated for clarity and content by 3 raters using a standardized scoring tool. RESULTS Ninety-four and ninety-three calls were evaluated before and after the intervention, respectively. The total item scores were higher posttraining (mean ± standard deviation [pre: 15.06 ± 2.60, post: 17.60 ± 2.61], P < .001). Global rating scores ≥ 4 were higher in the posttraining group (pre: 50.0% vs. post: 66.7%; P = .02; odds ratio = 1.43; 95% confidence interval, 1.04-1.97). There was no significant difference in the duration of calls (mean ± SD [pre: 9.29 ± 4.59 minutes, post: 9.70 ± 4.65 minutes). In subgroup analysis, the total item score was significantly improved posttraining for registered nurses and respiratory therapists but not MDs. CONCLUSION Standardized SBAR training was effective in improving telephone communication by RNs and RTs. The inclusion of SBAR training routinely within the educational curriculum of transport programs can enhance communication.
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Affiliation(s)
- Diane Wilson
- The Hospital for Sick Children, Toronto, Ontario, Canada
| | | | | | - Hilary Whyte
- The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada
| | - Kyong-Soon Lee
- The Hospital for Sick Children, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
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Voepel-Lewis T. Just Let Kids be Kids. J Perianesth Nurs 2016; 31:1-2. [DOI: 10.1016/j.jopan.2015.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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