Rose Monica, Newman Susan D
principal author, is a full-time staff nurse anesthetist at MedStar Washington Hospital Center, Washington, DC.
is director of the PhD in nursing science program and associate professor at Medical University of South Carolina School of Nursing, Charleston, South Carolina.
AANA J. 2016 Oct;84(5):329-338.
Patient safety continues to be a major concern for healthcare providers and organizations. Handovers, also called handoffs, serve as the transfer of postoperative care from the anesthesia provider to the postanesthesia care unit (PACU) provider. Ineffective handovers result in gaps in care and potential harm to the patient. We conducted a scoping review to identify key factors affecting patient safety during the process of postoperative handovers. We searched empirical literature examining factors associated with patient safety and postoperative handovers in the context of anesthesia, in the Cumulative Index to Nursing & Allied Health Literature, Ovid, Google Scholar, and The Joint Commission websites between January 2004 and March 2014. We excluded obstetric and cardiac anesthesia-related studies. A total of 31 articles met criteria for inclusion in the review. Factors at multiple levels of the Social Ecological Model affecting patient safety and handovers were identified. Intrapersonal factors included individual communication styles; interpersonal factors were related to anesthesia and to PACU provider team dynamics; organizational environmental factors described the dynamic PACU environment; and organizational policy-level factors included emphasizing a culture of patient safety. This scoping review demonstrates a multilevel analysis of factors affecting handovers and patient safety.
患者安全仍然是医疗保健提供者和机构主要关注的问题。交接班，也称为移交，是指术后护理从麻醉提供者转移至麻醉后护理单元（PACU）提供者的过程。无效的交接班会导致护理出现缺口，并对患者造成潜在伤害。我们进行了一项范围综述，以确定术后交接班过程中影响患者安全的关键因素。我们在2004年1月至2014年3月期间，在护理及相关健康文献累积索引数据库、Ovid数据库、谷歌学术以及联合委员会网站上，检索了实证文献，这些文献研究了麻醉背景下与患者安全及术后交接班相关的因素。我们排除了与产科和心脏麻醉相关的研究。共有31篇文章符合纳入该综述的标准。我们确定了社会生态模型多个层面影响患者安全和交接班的因素。个人层面的因素包括个人沟通方式；人际层面的因素与麻醉及PACU提供者团队动态有关；组织环境层面的因素描述了PACU的动态环境；组织政策层面的因素包括强调患者安全文化。这项范围综述展示了对影响交接班和患者安全的因素进行的多层次分析。
