Factors Influencing Patient Safety During Postoperative Handover

Patient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit (PACU) provider. Ineffective handovers result in gaps in care and potential harm to the patient. We conducted a scoping review to identify key factors affecting patient safety during the process of postoperative handovers. We searched empirical literature examining factors associated with patient safety and postoperative handovers in the context of anesthesia, in the Cumulative Index to Nursing & Allied Health Literature, Ovid, Google Scholar, and The Joint Commission websites between January 2004 and March 2014. We excluded obstetric and cardiac anesthesia-related studies. A total of 31 articles met criteria for inclusion in the review. Factors at multiple levels of the Social Ecological Model affecting patient safety and handovers were identified. Intrapersonal factors included individual communication styles; interpersonal factors were related to anesthesia and to PACU provider team dynamics; organizational environmental factors described the dynamic PACU environment; and organizational policy-level factors included emphasizing a culture of patient safety. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety.