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Evaluation of postsurgical patient handovers at the interface between the operating room and the pediatric intensive care unit
Evaluation of postsurgical patient handovers at the interface between the operating room and the pediatric intensive care unit
Postsurgical patient handovers are largely unstandardized task and error- prone if insufficient teamwork and unfavorable surrounding conditions occur in the clinical setting. The focus of our study was on postsurgical patient handovers from the operating room (OR) to the pediatric intensive care unit (PICU). We conducted a prospective intervention study to assess the impact of a checklist-based intervention on the completeness of patient information, equipment preparation and teamwork characteristics. A mixed methods research design with structured observations of handovers in the designated area and standardized provider self-reports through questionnaires were used for data collection. The results of the 31 patient handovers of the baseline study, with the resulting 103 ratings of involved providers were compared to the 30 handovers and 110 ratings of the follow-up study. During the baseline study, the non-standardized actual status of postsurgical patient handovers was assessed. Based on the results, an ideal-typical handover process was defined in multidisciplinary cooperation and the handover protocol developed, the influence of which was subsequently observed in the follow-up study. We witnessed an improvement in the completeness of technical equipment preparation prior to patient handovers. The presence of team members from pediatric surgery increased slightly, but patient handovers still took place without a representative of this professional group in more than half of the cases. There was an improvement in the attention levels of all team members involved. The strongest change in the handover process could be determined with the simultaneous presence of participating team members, with a doubling value compared to the baseline study. The results indicate the positive effect of standardization of the handover process on the efficiency of information exchange and teamwork.
Postsurgical patient handover, operating room, intensive care unit, standardized checklist
Rivas, Julia
2023
English
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Rivas, Julia (2023): Evaluation of postsurgical patient handovers at the interface between the operating room and the pediatric intensive care unit. Dissertation, LMU München: Faculty of Medicine
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Abstract

Postsurgical patient handovers are largely unstandardized task and error- prone if insufficient teamwork and unfavorable surrounding conditions occur in the clinical setting. The focus of our study was on postsurgical patient handovers from the operating room (OR) to the pediatric intensive care unit (PICU). We conducted a prospective intervention study to assess the impact of a checklist-based intervention on the completeness of patient information, equipment preparation and teamwork characteristics. A mixed methods research design with structured observations of handovers in the designated area and standardized provider self-reports through questionnaires were used for data collection. The results of the 31 patient handovers of the baseline study, with the resulting 103 ratings of involved providers were compared to the 30 handovers and 110 ratings of the follow-up study. During the baseline study, the non-standardized actual status of postsurgical patient handovers was assessed. Based on the results, an ideal-typical handover process was defined in multidisciplinary cooperation and the handover protocol developed, the influence of which was subsequently observed in the follow-up study. We witnessed an improvement in the completeness of technical equipment preparation prior to patient handovers. The presence of team members from pediatric surgery increased slightly, but patient handovers still took place without a representative of this professional group in more than half of the cases. There was an improvement in the attention levels of all team members involved. The strongest change in the handover process could be determined with the simultaneous presence of participating team members, with a doubling value compared to the baseline study. The results indicate the positive effect of standardization of the handover process on the efficiency of information exchange and teamwork.