European Journal of Anaesthesiology:
June 2011 - Volume 28 - Issue - p 214
Abstracts and Programme: EUROANAESTHESIA 2011: The European Anaesthesiology Congress: Patient Safety
Quality of handover of patients to the postanaesthetic care unit staff: 17AP1‐2
Nagdeve, N.; Kada, Venkata K.
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Antrim Area Hospital, Department of Anaesthesiology and Intensive Care, Antrim, United Kingdom
Background: Postoperative handover involves transfer of information of patient's state & care by anaesthetist to postanaesthetic care unit (PACU) staff. Effective handover is essential for continuity, quality and safety of patient's care.
However failure to transfer essential information to PACU nurse is not uncommon. Kluger et al1 observed 14% adverse events in the recovery were related to handover failure. The aim of the present audit was to assess the quality of the handover by the anaesthetists to PACU nurses.
Materials and Methods: After local ethic committee approval, a prospective audit was conducted over 2 weeks period without the knowledge of anaesthetists in the department. After postoperative handover, PACU nurses completed a questionnaire about quality of handover. The relevant points of information expected were based upon preoperative health, intraoperative care and postoperative plan.
Results and Discussion: Total 70 handovers were assessed. The patients' age range was 3 ‐77 years. There were almost equal proportions of ENT, gynaecological and general surgical procedures. The relevant information handed over by anaesthetist is as shown.
Anaesthetist is the ideal person for planning of analgesia, antiemetic and intravenous fluid in recovery and 24 hour postoperative period. We assessed these by reviewing ward prescription chart taking into consideration of the type of surgical procedure. The result shown in following table.
Table. Type of verba...
Table. Type of verba...
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Overall we identified factors that need attention to improve the quality of handover. We also suggest that PACU handover should be a formal and standardised procedure with appropriate documentation such as handover protocol.
Table. Postoperative...
Table. Postoperative...
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Conclusion: The present audit identified that the postoperative handover is often incomplete & there is a need to standardise the procedure.
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References:
1. Kluger MT, Bullock MF. Recovery room incidents: a review of 419 reports from the Anaesthetic Incident Monitoring Study (AIMS). Anaesthesia. 2002;57:1060-8