Understanding the perceptions and experiences of Certified Registered Nurse Anaesthetists regarding handovers: a focus group study

Abstract

AimThe aim of this exploratory study was to gain further insight into the perceptions and experiences of Certified Registered Nurse Anaesthetists regarding intraoperative handovers of care.BackgroundHandovers of care often result in adverse events in hospitalized patients and this risk is increased in the operating room setting where handovers occur frequently. Handovers between nurse anaesthetists, who provide the majority of anaesthesia in the United States today, is under‐researched.DesignFocus groups with Certified Registered Nurse Anaesthetists.MethodsTwo groups of nurse anaesthetists were recruited to participate in focus groups exploring their perception and experiences with intraoperative handovers of care. Content analysis was used to construe meaning from the context of the interviews. The findings were interpreted and discussed in a framework of Relationship‐Based Care.FindingsThere were four main themes that emerged from the data: (1) characteristics of the setting are a threat to handover quality; (2) individual provider characteristics have an impact on handover quality; (3) The timing of the handover represents a threat to handover quality and (4) individual patient characteristics have an impact on handover quality.ConclusionThe specific threats to safe handover of care between nurse anaesthetists were perceived to fall into four major themes; this provides information needed to strengthen the environment of care and to improve safety in handover of care in the operating suite.

Development and Psychometric Evaluation of the Nurse's Perception of the Relationship-Based Care Environment Scale

“…reflects findings that emerged from this study and a review of the literature on relationship based care (Koloroutis, 2004;Testa & Emery, 2014;Tressolini, 1994). The theoretical representation (Appendix B) differs from and expands on previous descriptions of RBC in the following ways:…”

“…The qualitative study, focused on nurse to nurse communication in an acute care setting (Testa & Emery, 2014), provided the conceptual grounding for the theoretical representation.…”

“…In a qualitative descriptive study of nurses caring for patients in the acute hospital setting, the environment and organizational support for nurses was found to play a key role in the quality of care delivered (Testa & Emery, 2014). Nurses perceived that the relationships between nurse and patient and those between the nurses themselves were important for the delivery of high quality care (Testa & Emery, 2014).…”

Postoperative patient handovers—Variability in perceptions of quality: A qualitative focus group study

“…The study also found that the transferring and receiving nurses had different evaluations of patient complexity. A study on intra-operative handovers between nurse anaesthetists also identified patient characteristics to affect handover quality (Testa & Emery, 2014). In our view, this emphasises the importance of a wellfunctioning team being present during the handover of a patient in a critical condition.…”

“…This was related to the transfer of information between different intra-operative teams prior to the postoperative handover resulting in limited time available to gain knowledge of the patient during surgery. Research on intra-operative handovers describes timing as a risk factor for handovers close to emergence and induction of anaesthesia (Testa & Emery, 2014) as well as linking the number of intra-operative handovers to increased mortality (Saager et al, 2014). Avoiding postoperative handovers with closeness in time to intra-operative handovers is difficult to eliminate, due to the way perioperative care is organised.…”