Development and Implementation of a Postoperative Patient Handoff Guideline in a Postoperative Anesthesia Care Unit
Keywords:
Patient handoff, Completeness of handoff, Adequacy of handoff, Postoperative patientAbstract
Postoperative patient handoff is crucial for patient safety and continuity of patient care. This implementation research aimed to develop a postoperative patient handoff guideline in a postoperative anesthesia care unit and to examine its effectiveness. Participants in the guideline implementation phase were 31 nurses in the anesthetic team who delivered the handoff, 9 post-anesthetic care unit nurses who received the handoff, and the handoff patient’s data, which included 50 patients’ data before implementing the guideline and 55 patients’ data during the implementation. The instrument for data collection was comprised of the Completeness of Handoff Information Evaluation Form and the Adequacy of Handoff Information Questionnaire, which were developed by the researcher based on a literature review. They were checked for their content validity by 5 experts and yielded the item-objective congruence indexes of 0.98 and 0.93, respectively. The developed guideline had three components, including 1) preparation before transferring patients from the operating room, 2) the handoff process, and 3) the handoff method and handoff information. During the guideline implementation, the completeness of handoff information increased from 14.00% before implementation to 87.27%, the adequacy of handoff information increased from 42.00 % to 85.45%, and the percentage of callbacks for further information decreased from 58.00 % to 14.55%. The study findings reveal that the developed guideline is effective for increasing the completeness and adequacy of handoff information, as well as decreasing the number of callbacks for further information after handoff.
References
Naosuwan P. A Retrospective study: the Incidence of Complications in Patients under General Anesthesia Sichon Hospital, Nakhon Si Thammarat. Region 11 Medical Journal. 2018;32 (3):1121-30. (in Thai)
Nagpal K, Arora S, Abboudi M, Vats A, Wong HW, Manchanda C, et al. An evaluation of information transfer through the continuum of surgical care: a feasibility study. Annals of surgery. 2010;252(2):402-7.
Wang XL, He M, Feng Y. Handover Patterns in the PACU: A Review of the Literature. Journal of PeriAnesthesia Nursing. 2021;36(2):136-41.
Redley B, Bucknall TK, Evans S, Botti M. Inter-professional clinical handover in post-anaesthetic care units: tools to improve quality and safety. International Journal for Quality in Health Care. 2016;28(5):573-9.
Stephenson C, Mohabbat A, Raslau D, Gilman E, Wight E, Kashiwagi D. Management of Common Postoperative Complications. Mayo Clinic Proceedings. 2020;95(11):2540-54.
Bittner EA, Grecu L, George E. Postoperative Complications. In: Longnecker DE, Brown DL, Newman MF, Zapol WM, editors. Anesthesiology, 2e. New York: The McGraw-Hill Companies; 2012.
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. British Journal of Anaesthesia. 2021;127(6): 962-70.
Robins H-M, Dai F. Handoffs in the Postoperative Anesthesia Care Unit: Use of a Checklist for Transfer of Care. American Association of Nurse Anesthetists Journal 2015;83(4):264-8.
Robinson NL. Promoting Patient Safety With Perioperative Hand-off Communication. Journal of PeriAnesthesia Nursing. 2016; 31(3):245-53.
NHMRC. A guide to the development, implementation and evaluation of clinical practice guidelines. Commonwealth of Australia, Canberra. National Health and Medical Research Council; 1999.
Turner RC, Carlson L. Indexes of Item-Objective Congruence for Multidimensional Items. International Journal of Testing. 2003;3(2): 163-71.
The Joanna Briggs Institute. JBI Levels of Evidence 2013. Australia by Solito Fine Colour Printers: The Joanna Briggs Institute; 2014.
The Joanna Briggs Institute. Joanna Briggs Institute Reviewers’ Manual: 2014 edition. Australia by Solito Fine Colour Printers: The Joanna Briggs Institute; 2014.
Servas L, Hayes C, Mayhorn T, Milner KA. Navigating the Path to a Sustainable “PACU Pause” and Standardized Perioperative Handoff: A Quality Improvement Project. Journal of PeriAnesthesia Nursing. 2022;37(1): 44-7.
Nagpal K, Arora S, Abboudi M, Vats A, Wong HW, Manchanda C, et al. Postoperative handover: problems, pitfalls, and prevention of error. Annals of surgery. 2010;252(1):171-6.
Segall N, Bonifacio AS, Schroeder RA, Barbeito A, Rogers D, Thornlow DK, et al. Can We Make Postoperative Patient Handovers Safer? A Systematic Review of the Literature. Survey of Anesthesiology. 2012;115(1):102–15.
Kaltoft A, Jacobsen YI, Tangsgaard M, Jensen HI. ISBAR as a Structured Tool for Patient Handover During Postoperative Recovery. Journal of PeriAnesthesia Nursing. 2022; 37(1):34-9.
López-Parra M, Porcar-Andreu L, Arizu-Puigvert M, Pujol-Caballé G. Cohort Study on the Implementation of a Surgical Checklist from the Operating Room to the Postanesthesia Care Unit. Journal of PeriAnesthesia Nursing 2020;35(2):155-9.
Burns S, Parikh R, Schuller K. Utilization of a checklist to standardize the operating room to post-anesthesia care unit patient handoff process. Perioperative Care and Operating Room Management. 2018;13(1):1-5.
Potestio C, Mottla J, Kelley E, DeGroot K. Improving Post Anesthesia Care Unit (PACU) Handoff by Implementing a Succinct Checklist. APSF NEWSLETTER. 2015;30(1):13-5.
Caruso TJ, Marquez JL, Wu DS, Shaffer JA, Balise RR, Groom M, et al. Implementation of a standardized postanesthesia care handoff increases information transfer without increasing handoff duration. Joint Commission Journal on Quality and Patient Safety. 2015; 41(1):35-42.
Park LS, Yang G, Tan KS, Wong CH, Oskar S, Borchardt RA, Tollinche LE. Does Checklist Implementation Improve Quantity of Data Transfer: An Observation in Postanesthesia Care Unit (PACU). The Open Anesthesia Journal. 2017;7(4):69-82.
Kitney P, Tam R, Bennett P, Buttigieg D, Bramley D, Wang W. Handover between anaesthetists and post-anaesthetic care unit nursing staff using ISBAR principles: A quality improvement study. Journal of Perioperative Nursing. 2016; 29(1):30-5.
Halterman RS, Gaber M, Janjua MST, Hogan GT, Cartwright SMI. Use of a Checklist for the Postanesthesia Care Unit Patient Handoff. Journal of Perianesthesia Nursing. 2019; 34(4):834-41.
Leonardsen A-C, Moen EK, Karlsøen G, Hovland T. A Quantitative Study on Personnel’s Experiences with Patient Handovers between the Operating Room and the Postoperative Anesthesia Care Unit before and after the Implementation of a Structured Communication Tool. Nursing Reports. 2019; 9(1):1-5.
NHMRC. How to put the evidence into practice: implementation and dissemination strategies. Australia: National Health and Medical Research Council 2000.
Pawadee W & Pitchalard K. The development of guidelines for the management of overweight and obesity in the elderly. Journal of The Royal Thai Army Nurses. 2016;17(1):115-23. (in Thai)
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Journal of The Royal Thai Army Nurses
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
บทความหรือข้อคิดเห็นใดใดที่ปรากฏในวารสารพยาบาลทหารบกเป็นวรรณกรรมของผู้เขียน ซึ่งบรรณาธิการหรือสมาคมพยาบาลทหารบก ไม่จำเป็นต้องเห็นด้วย
บทความที่ได้รับการตีพิมพ์เป็นลิขสิทธิ์ของวารสารพยาบาลทหารบก
The ideas and opinions expressed in the Journal of The Royal Thai Army Nurses are those of the authors and not necessarily those
of the editor or Royal Thai Army Nurses Association.
