Completeness of the operating room to intensive care unit handover: a matter of time?

Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE

Original Publication: [London] : BioMed Central, 2001-

Communication* ; Intensive Care Units* ; Operating Rooms*; Checklist/*methods ; Critical Care/*methods ; Patient Handoff/*statistics & numerical data ; Patient Safety/*statistics & numerical data; Adult ; Aged ; Aged, 80 and over ; Female ; Germany ; Humans ; Male ; Middle Aged ; Prospective Studies ; Time ; Young Adult

Background: Handovers of post-anesthesia patients to the intensive care unit (ICU) are often unstructured and performed under time pressure. Hence, they bear a high risk of poor communication, loss of information and potential patient harm. The aim of this study was to investigate the completeness of information transfer and the quantity of information loss during post anesthesia handovers of critical care patients.
Methods: Using a self-developed checklist, including 55 peri-operative items, patient handovers from the operation room or post anesthesia care unit to the ICU staff were observed and documented in real time. Observations were analyzed for the amount of correct and completely transferred patient data in relation to the written documentation within the anesthesia record and the patient's chart.
Results: During a ten-week study period, 97 handovers were included. The mean duration of a handover was 146 seconds, interruptions occurred in 34% of all cases. While some items were transferred frequently (basic patient characteristics [72%], surgical procedure [83%], intraoperative complications [93.8%]) others were commonly missed (underlying diseases [23%], long-term medication [6%]). The completeness of information transfer is associated with the handover's duration [B coefficient (95% CI): 0.118 (0.084-0.152), p<0.001] and increases significantly in handovers exceeding a duration of 2 minutes (24% ± 11.7 vs. 40% ± 18.04, p<0.001).
Conclusions: Handover completeness is affected by time pressure, interruptions, and inappropriate surroundings, which increase the risk of information loss. To improve completeness and ensure patient safety, an adequate time span for handover, and the implementation of communication tools are required.

Pediatr Crit Care Med. 2018 Feb;19(2):e72-e79. (PMID: 29206726)
N Engl J Med. 2009 Jan 29;360(5):491-9. (PMID: 19144931)
JAMA. 2018 Jan 9;319(2):125-127. (PMID: 29318263)
Qual Saf Health Care. 2005 Dec;14(6):401-7. (PMID: 16326783)
Eur J Anaesthesiol. 2012 Sep;29(9):438-45. (PMID: 22569028)
Syst Rev. 2017 Dec 19;6(1):260. (PMID: 29258599)
J Perianesth Nurs. 2016 Feb;31(1):63-72. (PMID: 26847782)
Acad Emerg Med. 2007 Oct;14(10):884-94. (PMID: 17898250)
Anesth Analg. 2017 Aug;125(2):477-482. (PMID: 28504990)
Anesth Analg. 2012 Nov;115(5):1183-7. (PMID: 22984152)
Paediatr Anaesth. 2015 Jul;25(7):746-52. (PMID: 25833388)
Am J Nurs. 2010 Apr;110(4):24-34; quiz 35-6. (PMID: 20335686)
Int Emerg Nurs. 2018 Jan;36:7-15. (PMID: 28807696)
Int J Health Care Qual Assur. 2017 May 8;30(4):304-311. (PMID: 28470134)
Jt Comm J Qual Patient Saf. 2008 Oct;34(10):563-70. (PMID: 18947116)
J Clin Epidemiol. 2014 Mar;67(3):267-77. (PMID: 24275499)
Eur J Anaesthesiol. 2016 Mar;33(3):172-8. (PMID: 26760400)
Jt Comm J Qual Patient Saf. 2011 Jun;37(6):274-84. (PMID: 21706987)
BMJ Qual Saf. 2012 Dec;21 Suppl 1:i121-8. (PMID: 23173182)
Paediatr Anaesth. 2007 May;17(5):470-8. (PMID: 17474955)
Intensive Care Med. 2017 Oct;43(10):1485-1494. (PMID: 28852789)
J Adv Nurs. 2017 Dec;73(12):3090-3101. (PMID: 28677173)
Emerg (Tehran). 2017;5(1):e76. (PMID: 29201958)
J Intensive Care Soc. 2017 Feb;18(1):17-23. (PMID: 28979532)
Acta Anaesthesiol Scand. 2014 Feb;58(2):192-7. (PMID: 24355063)
Jt Comm Perspect. 2007 May;27(5):1, 3. (PMID: 17575822)
Int Anesthesiol Clin. 2013 Winter;51(1):43-61. (PMID: 23282721)
Anesthesiology. 2016 Oct;125(4):690-9. (PMID: 27466034)
Am J Surg. 2018 Jan;215(1):28-36. (PMID: 28823594)
Singapore Med J. 2016 May;57(5):242-53. (PMID: 27211792)
Resuscitation. 2013 Sep;84(9):1192-6. (PMID: 23537699)
Jt Comm J Qual Patient Saf. 2016 Sep;42(9):400-14. (PMID: 27535457)
BMJ Open. 2014 Jan 21;4(1):e004268. (PMID: 24448849)
JAMA. 2018 Jan 9;319(2):143-153. (PMID: 29318277)
Caspian J Intern Med. 2016 Spring;7(2):99-104. (PMID: 27386061)
Arch Intern Med. 2007 Oct 22;167(19):2030-6. (PMID: 17954795)
Sentinel Event Alert. ;(58):1-6. (PMID: 28914519)
Anesth Analg. 2012 Jul;115(1):102-15. (PMID: 22543067)
Br J Anaesth. 2008 Sep;101(3):332-7. (PMID: 18556692)

Keywords: Communication; Handover duration; Hand‐off; ICU; Information loss; Patient handover; Patient safety

Date Created: 20210206 Date Completed: 20211208 Latest Revision: 20211214

20240628

PMC7863365

10.1186/s12871-021-01247-3

33546588