Clinical handover of the critically ill postoperative patient: an integrative review

The clinical handover of critically ill postoperative patients from the operating theatre to the intensive care unit is a dynamic and complex process that can lead to communication and technical errors. The objectives of this integrative review were to illustrate how the use of structured handover processes between the operating theatre and intensive care unit impacts information transfer, handover duration, post-handover technical error and high risk events.

Integrative review methodology was used to allow for the inclusion of broad research designs, summarising current knowledge from existing research and identify gaps in the literature.

A systematic search of electronic databases including the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Cochrane library, Embase, ProQuest central and PubMed were performed. Original research articles, in either adults or paediatrics, specific to handover between an operating theatre and intensive care unit were included.

Data extracted from studies included country of origin, sample size, number of hospital sites, study design, study aim, measures, key findings and limitations. The quality of the integrative review articles was assessed against the 'Standard Quality Assessment Criteria for Evaluating Primary Research Papers'.

Ten articles meeting the inclusion criteria were included in the final analysis. Information transfer, post-handover technical errors and high risk events were positively influenced by the use of structured clinical handover tools. Handover duration did not change when using structured handover protocols.

The body of literature on clinical handover between operating theatre and the intensive care unit is in its early stages of development. Future research using rigorous study designs, broader populations and varied surgical procedures are needed to further evaluate the effect of clinical handover protocols.