Impact of patient handover structure on neonatal perioperative safety

• Published in: Journal of perinatology 2019-03, Vol.39 (3), p.453-467
• Main Authors: France, D. J., Slagle, J., Schremp, E., Moroz, S., Hatch, L. D., Grubb, P., Lorinc, A., Lehmann, C. U., Robinson, J., Crankshaw, M., Sullivan, M., Newman, T., Wallace, T., Weinger, M. B., Blakely, M. L.
• Format: Article
• Language: English
• Subjects: 692/308/409; 692/700/478/174; Acuity; Children; Continuity of care; Cross-Sectional Studies; Female; Hospitalization; Hospitals; Hospitals, Pediatric; Humans; Incidence; Infant, Newborn; Informed consent; Intensive care; Intensive Care Units, Neonatal; Interdisciplinary aspects; Male; Medicine; Medicine & Public Health; Morbidity; Mortality; Neonates; Newborn babies; Nurses; Nursing; Patient Handoff - statistics & numerical data; Patient Safety; Pediatric Surgery; Pediatrics; Perioperative care; Perioperative Care - standards; Prospective Studies; Quality control; Quality Improvement - organization & administration; Surgery
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-018-0305-6

Objective To compare the incidence, severity, preventability, and contributing factors of non-routine events— deviations from optimal care based on the clinical situation —associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates. Study design A prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children’s hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative NICU care. Results The incidence of clinician-reported NREs was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. National Surgical Quality Improvement—Pediatric occurrences of major morbidity were significantly higher ( p