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Quality of post-operative patient handover in the post-anaesthesia care unit: a prospective analysis
A Milby1, A Böhmer, M U Gerbershagen
1Medical School, University Witten/Herdecke, Witten, Germany.
Insights
Post-operative handovers in the post-anaesthesia care unit (PACU) are often incomplete, potentially impacting patient safety. Implementing a standardized checklist can improve information transfer during these critical patient handovers.
Area of Science:
- Perioperative Medicine
- Patient Safety
- Healthcare Communication
Background:
- Anaesthesiology is crucial for safe perioperative care.
- Incomplete information transfer during post-operative handovers in the post-anaesthesia care unit (PACU) can compromise patient safety.
- This study aimed to analyze information transfer during these handovers.
Purpose of the Study:
- To analyze the completeness of information transfer during post-operative handovers in the PACU.
- To identify critical information gaps in current handover practices.
Main Methods:
- A self-developed checklist with 59 items was used to document information transfer during post-operative handovers.
- Data were collected over a 2-month period and compared with patient anesthesia records.
Main Results:
- 790 handovers were analyzed, with an average duration of 73 seconds.
- High transfer rates were observed for surgery type (97%), regional anesthesia (94%), and cardiac instability (93%).
- Key information like ASA physical status (7%), pain management initiation (12%), antibiotic therapy (14%), and fluid management (15%) was rarely transferred. A slight correlation (r=0.5) was found between information amount and handover duration.
Conclusions:
- Post-operative handovers in the PACU are frequently incomplete.
- Standardizing the handover process, potentially with a checklist, is recommended to optimize information transfer and enhance patient safety.
Background:
Anaesthesiology plays a key role in promoting safe perioperative care. This includes the perioperative phase in the post-anaesthesia care unit (PACU) where problems with incomplete information transfer may have a negative impact on patient safety and can lead to patient harm. The objective of this study was to analyse information transfer during post-operative handovers in the PACU.
Methods:
With a self-developed checklist including 59 items the information transfer during post-operative handovers was documented and subsequently compared with patient information in anaesthesia records during a 2-month period.
Results:
A total number of 790 handovers with duration of 73 ± 49 s was analysed. Few items were transferred in most of the cases such as type of surgery (97% of the cases), regional anaesthesia (94% of the cases) and cardiac instability (93% of the cases). However, some items were rarely transferred, such as American Society of Anesthesiologists physical status (7% of the cases), initiation of post-operative pain management (12% of the cases), antibiotic therapy (14% of the cases) and fluid management (15% of the cases). There was a slight correlation between amount of information transferred and duration of post-operative handovers (r = 0.5).
Conclusion:
The study shows that post-operative handovers in the PACU are in most cases incomplete. It appears useful to optimise the post-operative handover process, for example by implementing a standardised handover checklist.
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