Implementation of a Standardized Postanesthesia Care Handoff Increases Information Transfer Without Increasing Handoff Duration

被引:25
作者
Caruso, Thomas J. [1 ,2 ]
Marquez, Juan L. [2 ]
Wu, Diane S. [2 ]
Shaffer, Jenny A. [2 ]
Balise, Raymond R. [2 ]
Groom, Marguerite [3 ]
Leong, Kit [3 ]
Mariano, Karley [3 ]
Honkanen, Anita [2 ,4 ,5 ]
Sharek, Paul, I [6 ]
机构
[1] Lucile Packard Childrens Hosp, Perioperat Qual Improvement, Palo Alto, CA 94304 USA
[2] Stanford Univ, Med Ctr, Stanford, CA 94305 USA
[3] Lucile Packard Childrens Hosp, Palo Alto, CA USA
[4] Lucile Packard Childrens Hosp, Anesthesiol, Palo Alto, CA USA
[5] Lucile Packard Childrens Hosp, Div Pediat Anesthesia, Palo Alto, CA USA
[6] Lucile Packard Childrens Hosp, Pediat, Palo Alto, CA USA
基金
美国国家卫生研究院;
关键词
D O I
10.1016/S1553-7250(15)41005-0
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background: In the transition of a patient from the operating room (OR) to the postanesthesia care unit (PACU), it was hypothesized that (1) standardizing the members of sending and receiving teams and (2) requiring a structured handoff process would increase the overall amount of paTIent information transferred in the OR-to-PACU handoff process. Methods: A prospective cohort study was conducted at a 311-bed freestanding academic pediatric hospital in Northern California. The intervention, which was conducted in February-March 2013, consisted of (1) requiring the sending team to include a surgeon, an anesthesiologist, and a circulating nurse, and the receiving team to include the PACU nurse; (2) standardizing the content of the handoff on the basis of literature-guided recommendations; and (3) presenting the handoff verbally in the I-PASS format. Data included amount of patient information transferred, duration of handoff, provider presence, and nurse satisfaction. Results: Forty-one audits during the preimplementation phase and 45 audits during the postimplementation phase were analyzed. Overall information transfer scores increased significantly from a mean score of 49% to 83% (p < .0001). Twenty-two PACU nurse satisfaction surveys were completed after the preimplementation phase and 14 surveys were completed in the postimplementation phase. Paired mean total satisfaction scores increased from 36 to 44 (p =. 004). The duration of the handoffs trended downward from 4.1 min to 3.5 min (p = 0.10). Conclusion: A standardized, team-based approach to ORto-PACU handoffs increased the quantity of patient information transferred, increased PACU nurse satisfaction, and did not increase the handoff duration.
引用
收藏
页码:35 / 42
页数:8
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