Halterman Reed S, Gaber Mohamed, Janjua Muhammad S T, Hogan Gerard T, Cartwright Sarah M I
J Perianesth Nurs. 2019 Aug;34(4):834-841. doi: 10.1016/j.jopan.2018.10.007. Epub 2019 Feb 7.
This quality improvement project aimed to evaluate the benefits of implementing a checklist in the postanesthesia care unit (PACU) setting to decrease the omission of health information during the handoff from anesthesia to PACU nurses.
Patient handoffs from anesthesia providers were anonymously assessed by PACU nurses before and after the implementation of a handoff checklist with the Situation, Background, Assessment, Recommendation format.
PACU nurses recorded use of the handoff checklist and if five items of health information were included in the handoff during the preintervention and postintervention phase.
Checklist use increased from 0% to 73% with omitted information decreasing with checklist use: procedure from 19% to 2%, allergies 23% to 4%, input and output 16% to 0%, antiemetic used 21% to 4%, and lines 19% to 11%. Completed handoffs increased from 13% to 82% whereas checklist use remained high, at over 79%, for the 12 weeks after implementation.
The project was successful in implementing a standardized checklist and echoed the success of the articles reviewed. The use of a PACU handoff checklist can improve transfer of care by ensuring the provider receives more pertinent medical information during these transfers.
本质量改进项目旨在评估在麻醉后护理单元(PACU)环境中实施检查表的益处,以减少麻醉医师向PACU护士交接患者时健康信息的遗漏。
在采用“情况、背景、评估、建议”格式的交接检查表实施前后,由PACU护士对麻醉医师的患者交接情况进行匿名评估。
PACU护士记录交接检查表的使用情况,以及在干预前和干预后阶段的交接过程中是否包含五项健康信息。
检查表的使用从0%增加到73%,随着检查表的使用,遗漏信息减少:手术信息从19%降至2%,过敏信息从23%降至4%,出入量信息从16%降至0%,使用的止吐药信息从21%降至4%,管路信息从19%降至11%。完整交接从13%增加到82%,而在实施后的12周内,检查表的使用率仍保持在79%以上的较高水平。
该项目成功实施了标准化检查表,与所审查文章的成功经验相呼应。使用PACU交接检查表可通过确保医护人员在这些交接过程中获得更相关的医疗信息来改善护理交接。