Responsibility The nurse anaesthetists, anaesthesiologists and PACU nurses expressed different perspectives on the transfer of responsibility (Paper IV). There is a lack of research on the transfer of responsibility and/or accountability during handover.30, 131 However, some studies have been conducted. Using focus group interviews with midwives, nurses and physicians, Chin et al.132 found that the participants did not spontaneously connect the transfer of responsibility and accountability as a function of clinical handover. They concluded that there is a lack of consensus on the transition of responsibility and accountability.132 In another study133 with surgeons and nurses using observations, focus groups, and a web-based survey, the authors argued that blurred boundaries of responsibility can result in no one assuming responsibility.133 Another study by Smith et al.37 showed that, during postoperative handover, the time of responsibility transfer varied depending on the professional relationship between the nurse and physician as well as the patient’s condition.37 Furthermore, Greenberg et al.11 investigated malpractice claims due to error of communication during the perioperative period and found that 43% occurred during handover and that ambiguity concerning responsibilities was a commonly associated factor.11 A view from psychology expressed by Parker and Coiera47 was that if a healthcare personnel member hands over responsibility, in cases where the consequences of errors can be serious, without an explicit acknowledgement from the receiver, the responsibility may not truly have been handed over. This means that the task cannot be removed from working memory.47 Despite the limited amount of research in the area, it indicates that the transfer of responsibility and/or accountability during handovers is quite unspoken and unsafe.
Responsibility The nurse anaesthetists, anaesthesiologists and PACU nurses expressed different perspectives on the transfer of responsibility (Paper IV). There is a lack of research on the transfer of responsibility and/or accountability during handover.30, 131 However, some studies have been conducted. Using focus group interviews with midwives, nurses and physicians, Chin et al.132 found that the participants did not spontaneously connect the transfer of responsibility and accountability as a function of clinical handover. They concluded that there is a lack of consensus on the transition of responsibility and accountability.132 In another study133 with surgeons and nurses using observations, focus groups, and a web-based survey, the authors argued that blurred boundaries of responsibility can result in no one assuming responsibility.133 Another study by Smith et al.37 showed that, during postoperative handover, the time of responsibility transfer varied depending on the professional relationship between the nurse and physician as well as the patient’s condition.37 Furthermore, Greenberg et al.11 investigated malpractice claims due to error of communication during the perioperative period and found that 43% occurred during handover and that ambiguity concerning responsibilities was a commonly associated factor.11 A view from psychology expressed by Parker and Coiera47 was that if a healthcare personnel member hands over responsibility, in cases where the consequences of errors can be serious, without an explicit acknowledgement from the receiver, the responsibility may not truly have been handed over. This means that the task cannot be removed from working memory.47 Despite the limited amount of research in the area, it indicates that the transfer of responsibility and/or accountability during handovers is quite unspoken and unsafe.
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