Improving the postoperative handover process in the intensive care unit of a tertiary teaching hospital

• Published in: Journal of clinical nursing 2016-04, Vol.25 (7-8), p.1062-1072
• Main Authors: Yang, Jian-Guo, Zhang, Jun
• Format: Article
• Language: English
• Subjects: Adult; Aged; checklist; China; Clinical Protocols; Communication; Critical Care; Critical Pathways; Female; Hospitals, Teaching; Humans; Intensive care; Male; Middle Aged; Nursing; Nursing care; Outcome Assessment (Health Care); Patient Handoff; Patient Safety; postoperative handover; Postoperative Period; Teaching hospitals; teamwork; Tertiary Care Centers
• ISSN: 0962-1067; 1365-2702
• DOI: 10.1111/jocn.13115

Aims and objectives The aim of this study was to improve the postoperative handover process and immediate postoperative patient outcomes. The objective was to implement a postoperative handover protocol in the neurosurgical intensive care unit of a tertiary teaching hospital. Background Postoperative handover is a multidisciplinary collaborative medical activity that involves information transfer, sequenced tasks and high‐quality teamwork. Evidence suggests that a lack of a standardised postoperative handover protocol adversely influences care quality and potentially compromises patient safety. As there is a lack of such protocols in China, there is an identified need for improvement. Design This was a pretest/post‐test study with follow‐up after three months. Methods A postoperative handover protocol that included a postoperative handover checklist, a standardised handover pathway and core team member involvement was developed based on research evidence and expert opinions and was then implemented and evaluated. Results Following the implementation of this protocol, improved teamwork was achieved, surgeons were more frequently present at bedside handovers, the rate of transferring key messages increased, the rate of ventilator weaning within the first six hours of neurosurgical intensive care unit admission increased, and the ventilation duration per patient decreased without any clinical incident occurring in the first 24 hours after neurosurgical intensive care unit admission. Conclusions Following the implementation of a tailored standardised handover protocol, communication, teamwork and short‐term patient outcomes were improved. Relevance to clinical practice This clinically based research highlights the need for policy makers and administrators to create unit‐specific protocols for improving postoperative handovers.