Clinical handover of immediate post-operative patients: A literature review

Abstract

The transfer of professional responsibility for some or all aspects of patient care, within and between professional groups on a temporary or permanent basis, is termed clinical handover. Communication during clinical handover is considered a challenging patient safety problem. A key principle of transfer of professional responsibility for patient care is the minimum amount of information or content that must be contained and transferred in any particular type of clinical handover. Aim: The purpose of this literature review was to establish the scope of the literature about clinical handover from the operating room to Post Anaesthesia Care Unit (PACU) published in the last ten years and identify relevant key sources, theories, concepts and ideas. Method: The literature included in this review is divided into policy framework, practice, theoretical and primary research literature. Findings: This literature review demonstrates that either clinicians perceive clinical handover as informal, unstructured and inconsistent or transfer of information in handover as incomplete or unclearly expressed. Anaesthetists and PACU nurses differed in expectations of content and timing of information transfer. Conclusion: There is a need to develop training and educational strategies to improve clinical handover practice, particularly in a way that encourages collaboration.

Assessment of postoperative patient handover practice and safety at post anesthesia care unit of Dilla University Referral Hospital, Ethiopia: A cross-sectional study

“…Good handovers are essential in providing the continuity of care, patient safety and error avoidance. This will help to ensure that after handover all members of the team will have the same understanding [ 2 , 16 , 18 , 19 ]. Our study in general found poor handover practice regarding sociodemographic and preoperative patient information, anesthesia and surgery related issues, and miscellaneous information.…”

An Examination of Nurses’ Empowerment and Speaking Up During Postanesthesia Clinical Hand Overs

“…Hand overs that transfer responsibility for patient care from anesthesia professionals to PACU nurses can be suboptimal, 16 inconsistent, 4,17 informal, 17,18 and incomplete. 16,19 In Australia, many health professionals provide care in the PACU, including anesthesia professionals, surgeons, perioperative nurses, theater technicians (ie, unlicensed staff members responsible for assisting the anesthesia professionals and nursing staff members with anesthesiarelated tasks, patient transportation, and equipment needs), and PACU nurses.…”

“…Hand overs that transfer responsibility for patient care from anesthesia professionals to PACU nurses can be suboptimal, 16 inconsistent, 4,17 informal, 17,18 and incomplete 16,19 …”

A brief intervention to standardize postanesthetic clinical handoff

“…Patient arrival in the PACU often involves interprofessional handoff to transfer responsibility for ongoing care from the anesthetists to a nurse. This handoff transition has particularly high risk for handoff communication errors due to high patient acuity; limited familiarity with patients; compromised patient autonomy due to pain, anxiety, sedation, and disorientation; and multiple previous movements across transition points of surgical care (Clarke, Clark‐Burg, & Pavlos, 2018; Lillibridge, Botti, Wood, & Redley, 2017). The effectiveness of handoff in the PACU is further negatively impacted by unfamiliar caregivers, limited or variable input from different members of the perioperative team, time pressures to maintain efficiency, a noisy environment, multiple interruptions, and one‐way conversations geared toward information giving with limited active interactions by receiving teams (Randmaa, Engstrom, Swenne, & Martensson, 2017).…”