A scoping review of clinical handover mnemonic devices

Protocols for Postanesthesia Care Unit Handoff and Patient Safety: A Scoping Review

AIM

To map studies that tested an intervention orienting patient transfer to Postanesthesia Care Unit (PACU) and identify outcomes related to care safety.

METHODS

Scoping review guided by recommendations of the JBI Manual and the Preferred Reporting Items for Systematic Reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) guide. The Population, Concept, and Context (PCC) framework was used to develop the research question and consolidate inclusion and exclusion criteria in databases consulted without date parameters. The review protocol was registered in the Open Science Framework.

RESULTS

The systematic search identified 182 records. After reading their titles and abstracts, 49 studies were read in full. The final sample consisted of 17 texts published between 2013 and 2024. The main elements evaluated in the implementation of interventions to guide patient transfer to the PACU related to patient safety were as follows: increase in the number of transferred information; higher rates of professional satisfaction with teamwork; presence of surgical professionals; questions from the receiver and adequacy to the instrument. Also was identified a pause to monitor the patient before the transfer and reduction of omitting information, interruptions, distractions, task errors, hypoxemia, nausea, vomiting and excessive pain.

CONCLUSIONS

The variables evaluated after the interventions to promote a structured patient transfer to the PACU have the potential to guide the development of quality assessment indicators and contribute to the promotion of a safety culture in institutions.

IMPACT

Considering the constant increase in complexity and demand for perioperative care, the investigation of patient transfer processes to the PACU can provide support for the management of surgical practices and contribute to improving patient safety and the experience of the health professionals involved.

PATIENT OR PUBLIC CONTRIBUTION

No patient or public contribution. OSF registration: https://doi.org/10.17605/OSF.IO/M2FYN.

Improved recall of handover information in a simulated emergency - A randomised controlled trial

Background

Handovers during medical emergencies are challenging due to time-critical, dynamic and oftentimes unorderly and distracting situations. We evaluated the effect of distraction-reduced clinical surroundings during handover on (1) the recall of handover information, (2) the recall of information from the surroundings and (3) self-reported workload in a simulated in-hospital cardiac arrest scenario.

Methods

In a parallel group design, emergency team leaders were randomly assigned to receive a structured handover of a cardio-pulmonary resuscitation (CPR) either inside the room ("inside group") right next to the ongoing CPR or in front of the room ("outside group") with no audio-visual distractions from the ongoing CPR. Based on the concept of situation awareness, the primary outcome was a handover score for the content of the handover (0-19 points) derived from the pieces of information given during handover. Furthermore, we assessed team leaders' perception of their surroundings during the scenario (0-5 points) and they rated their subjective workload using the NASA Task Load Index.

Results

The outside group (n = 30) showed significant better recall of handover information than the inside group (n = 30; mean difference = 1.86, 95% CI = 0.67 to 3.06, p = 0.003). The perception of the surroundings (n = 60; mean difference = -0.27, 95% CI = -0.85 to 0.32, p = 0.365) and the NASA Task Load Index (n = 58; mean difference = 1.1; p = 0.112) did not differ between the groups.

Conclusions

Concerning in-hospital emergencies, a structured handover in a distraction reduced environment can improve information uptake of the team leader.