Department of Nurse Anaesthesia, Division of Emergencies and Critical Care, Oslo University Hospital, Oslo, Norway.
Department of Nursing Science, Institute of Health and Society, Faculty of Medicine, University of Oslo, Oslo, Norway.
J Clin Nurs. 2021 Apr;30(7-8):1046-1059. doi: 10.1111/jocn.15650. Epub 2021 Feb 18.
To describe postoperative handover reporting and tasks in relation to patient condition and situational circumstances, in order to identify facilitators for best practices.
High-quality handovers in postoperative settings are important for patient safety and continuity of care. There is a need to explore handover quality in relation to patient condition and other affecting factors.
Observational mixed methods convergent design.
Postoperative patient handovers were observed collecting quantitative (n = 109) and qualitative data (n = 48). Quantitative data were collected using the postoperative handover assessment tool (PoHAT), and a scoring system assessing patient condition. Qualitative data were collected using free-text field notes and an observational guide. The study adheres to the GRAMMS guideline for reporting mixed methods research.
Information omissions in the handovers observed ranged from 1-13 (median 7). Handovers of vitally stable and comfortable patients were associated with more information omissions in the report. A total of 50 handovers (46%) were subjected to interruptions, and checklist compliance was low (13%, n = 14). Thematic analysis of the qualitative data identified three themes: "adaptation of handover," "strategies for information transfer" and "contextual and individual factors." Factors facilitating best practices were related to adaptation of the handover to patient condition and situational circumstances, structured verbal reporting, providing patient assessments and dialogue within the handover team.
The variations in items reported and tasks performed during the handovers observed were related to patient conditions, situational circumstances and low checklist compliance. Adaptation of the handover to patient condition and situation, structured reporting, dialogue within the team and patient assessments contributed to quality.
It is important to acknowledge that handover quality is related to more than transfer of information. The present study has described how factors related to the patient and situation affect handover quality.
描述与患者病情和情境相关的术后交接报告和任务，以确定最佳实践的促进因素。
术后环境中的高质量交接对于患者安全和护理连续性至关重要。需要探讨与患者病情和其他影响因素相关的交接质量。
观察性混合方法收敛设计。
观察术后患者交接，收集定量（n=109）和定性数据（n=48）。定量数据使用术后交接评估工具（PoHAT）和评估患者病情的评分系统收集。定性数据使用自由文本字段注释和观察指南收集。该研究遵循 GRAMMS 报告混合方法研究的指南。
观察到的交接中信息遗漏范围为 1-13（中位数为 7）。生命体征稳定且舒适的患者的交接报告中信息遗漏更多。共有 50 次交接（46%）受到干扰，检查表的遵守率较低（13%，n=14）。对定性数据的主题分析确定了三个主题：“交接的适应”、“信息传递策略”和“背景和个体因素”。促进最佳实践的因素与根据患者病情和情境调整交接、结构化口头报告、提供患者评估以及在交接团队中进行对话有关。
观察到的交接中报告的项目和执行的任务的变化与患者病情、情境和检查表遵守率低有关。根据患者病情和情况调整交接、结构化报告、团队内的对话以及患者评估有助于提高交接质量。
重要的是要认识到交接质量不仅仅与信息传递有关。本研究描述了与患者和情况相关的因素如何影响交接质量。
