Evaluating the Safety, Feasibility, and Usability of a Virtual Nursing Handover From the Post-Anesthesia Care Unit to...

Traditional in-person handovers from the Post-Anaesthesia Care Unit (PACU) to inpatient wards often require PACU nurses to leave their post-operative patients for extended periods, which may delay the handover and management of other patients awaiting transfer. Alternatively, the PACU nurse-in-charge may hand over patient information to another individual to assist with in-person handover in the inpatient ward. Multiple care transitions increase the risk of omission of critical handover information, which compromises patient safety. A Virtual Nursing Handover (VNH) model may address these workflow and safety challenges by enabling direct, real-time communication between PACU and ward nurses, while reducing unnecessary staff movement.

To evaluate the safety, feasibility, and usability of a VNH from the PACU to the inpatient ward.

This process innovation study was underpinned by the Technology Acceptance Model (TAM). A three-component evaluation was conducted to assess the safety, feasibility, and usability of a VNH from the PACU to the inpatient ward. The study was undertaken in an acute care hospital in Singapore between October and November 2024. Handover safety was evaluated using structured audits based on the Queensland Health Handover Audit Tool, aligned with National Safety and Quality Health Service standards. The tool comprised 17 items assessing handover completeness and safety, along with additional open-ended questions to capture technical quality and notable observations. Feasibility was assessed using implementation metrics, including handover duration, adherence to the intended workflow, and technical reliability. Usability was evaluated using the System Usability Scale (SUS) administered to PACU and ward nurses, supplemented by qualitative feedback. Consistent with the TAM, safety and feasibility were interpreted as indicators of perceived usefulness, while usability reflected perceived ease of use. Quantitative data were analysed using SPSS version 26.0, and qualitative data were analysed thematically.

A total of 31 handover safety audits were conducted. Adherence to handover safety standards was high, with all audits meeting at least 15 of the 17 audit criteria (≥ 88%). The VNH demonstrated high feasibility, resulting in an estimated time saving of approximately 4.7 h per day for PACU nurses. No major technical failures were observed, and handovers were conducted as intended. In contrast, system usability was rated below average, with a mean SUS score of 41.9.

VNH from the PACU to the inpatient ward was safe and feasible in routine clinical practice; however, suboptimal usability may limit technology acceptance. Further system refinement is required to improve user experience and support sustained adoption.