Adequacy of intraoperative patient handover

Abstract

Background: Intraoperative handover is essential for patient safety as failure in communication may lead to morbidity and mortality. Effective handover plays a key part in ensuring the continuity, quality, and safety of patient care.1 SBAR (situation, background, assessment, recommendation) provides a structured handover approach and is endorsed by the hospital policy.2 It can make handovers quicker yet more effective, thereby releasing more time for clinical care. Handover should be structured to ensure continuity of care.3 The aim of this hospital Quality Improvement Project was to compare the handover given between anaesthesia residents using an internationally defined handover template (Association of Anaesthetists), followed by a training package and re-audit. Methods: Eight operating lists on 5 days with a total of 120 handovers were checked for the information given at the time of handover. This was cross checked with the international standards on a proforma. After the first audit, residents received training and a checklist was provided in each operating room. Later on, a loop audit was done to check compliance. This time the total number of handovers assessed was 131. Results: There were total 23 residents when this audit was performed; 26.1 % (n=6) were female and 73.9% (n=17) were male. In the first audit, compliance with mentioning the situation was 61.7% (n=74); background was mentioned in 9.1% (n=11) cases; assessment was provided in 5% (n=6) of the times; recommendations were given in 43.3% (n=52) of the cases. The loop audit after the training package showed improvement in the results (Fig. 4). The compliance was as follows: situation 87.8% (n=115), background 93.9% (n=120), assessment 90.1% (n=118), and recommendations were 100% (n=131). Conclusions: A comprehensive and standardised handover of important patient information is vital for ensuring continuity of care, patient safety, and avoids poor/inadequate communication. By completing an audit cycle, we improved the quality of handover. 1.Boet S, Djokhdem H, Leir SA, Théberge I, Mansour F, Etherington C. Br J Anaesth 2020; 125: 605–132.Oswal S, Ingham C, Sykes A. Postoperative handover protocol. Bradford Teaching Hospitals NHS Foundation Trust. 2018. (Accessed 20/03/2023)3.Jullia M, Tronet A, Fraumar F, et al. Eur J Anaesthesiol 2017; 34: 471–6