Improving Postoperative Handoff in a Surgical Intensive Care Unit

Crit Care Nurse. 2019 Oct;39(5):e13-e21. doi: 10.4037/ccn2019523.

Abstract

Background: Evidence-based research demonstrates that postoperative formalized handoff improves communication and satisfaction among hospital staff members, leading to improved patient outcomes.

Objective: To improve postoperative patient safety in the surgical intensive care unit of a tertiary academic medical center.

Methods: A verbal and written formal reporting method was designed, implemented, and evaluated. The intervention created an admission "time-out," allowing the handoff from surgical and anesthesia teams to the intensive care unit team and bedside nurses to occur in a more structured manner. Before and 1 year after implementation of the intervention, nurses completed surveys on the quality of postoperative handoff.

Results: After the intervention, the proportion of nurses who reported receiving handoff from the surgical team increased from 20% to 60% (P < .001). More nurses felt satisfied with the surgical handoff (46% before vs 74% after the intervention; P < .001), and more nurses frequently felt included in the handoff process (42% vs 74%; P < .001). Nurses perceived improved communication with surgical teams (93%), anesthesia teams (89%), and the intensive care unit team (94%), resulting in a perception of better patient care (88%).

Conclusion: After implementation of a systematic multidisciplinary handoff process, surgical intensive care nurses reported improved frequency and completeness of the postoperative handoff process, resulting in a perception of better patient care.

MeSH terms

  • Academic Medical Centers
  • Adult
  • Aged
  • Aged, 80 and over
  • Baltimore
  • Critical Care / standards*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nursing Care / standards*
  • Patient Care Team / standards*
  • Patient Handoff / standards*
  • Patient Transfer / standards*
  • Postoperative Care / standards*
  • Practice Guidelines as Topic*
  • Surveys and Questionnaires
  • Tertiary Care Centers