Date of Award
Doctor of Nursing Practice (DNP)
Julia Feczko, DNP, CRNA
Mark Deshur, MD
Pamela Schwartz, DNP, CRNA
Background: Despite numerous studies and agencies recommending the standardization of handovers to improve the quality and safety of patient care, intraoperative anesthesia handovers have remained unstandardized at many institutions.
Objectives: The purposes of this study were to 1) develop the preliminary Anesthesia Handover Report (AHR) and evaluate its accessibility, layout, and content using feedback from an Expert Sampling Group; 2) create the finalized AHR and evaluate the impact it had on the perceived quality of handover among anesthesia providers; and 3) to assess the uptake of the finalized AHR.
Methods: This study was implemented at NorthShore University Health System (NSUHS), Evanston, Highland Park and Glenbrook locations. In Phase 1, an Expert Sampling Group of ten experienced anesthesia providers evaluated the preliminary AHR for its accessibility, layout and content using the Expert Sampling Group Questionnaire. In Phase 2, using feedback from this questionnaire, the finalized AHR was created and all 140 anesthesia providers at the three study locations were invited to utilize and evaluate the AHR during intraoperative anesthesia handover, additionally, during Phase 3 the use of the AHR was queried every two weeks for the duration of Phase 2 to assess uptake.
Results: Five anesthesia providers completed the Expert Sampling Group Questionnaire in Phase 1. Changes made to the preliminary AHR in response to feedback from the Expert Sampling Group Questionnaire included the removal of redundant information, more appropriate layout of information in the sidebar, the addition of total drug dose given in the medications panel, an additional hyperlink to anesthesia nerve block reports, and corrections to wrong information being pulled into the AHR. During Phase 2, 21 anesthesia providers completed the Anesthesia Handover Survey. The overall mean Likert score for handover conduct was 3.72 with a SD of .475 (minimum 2, maximum 4), this indicated that overall the majority of the respondents perceived that the AHR improved the conduct component of handover. The overall mean Likert score for teamwork was 3.76, with a SD of .432 (minimum 3, maximum 4), which indicated that respondents felt the AHR improved teamwork during handover. Lastly, the mean Likert score for the handover quality was 3.64 with a SD of .611 (minimum 1, maximum 4), this indicated respondents felt the AHR improved overall handover quality. Results of Phase 3 indicated the uptake did not increase as expected over the six-week monitoring window, but rather peaked during week four and quickly dropped off thereafter. The mean number of times the “Anesthesia Handoff” event button was clicked each week was 3.17.
Conclusions: Use of the AHR improved the perceived conduct, teamwork, and quality of intraoperative anesthesia handovers. The use of the AHR did not improve over time. Overall, use of the AHR improved the perceived quality of anesthesia handovers. Future studies should be done to determine if use of the AHR would result in the standardization of anesthesia handovers.
Lindsay, Amber Kristine and Rue, Elisa, "A Standardized Electronic Handover Report for Anesthesia Providers" (2017). College of Science and Health Theses and Dissertations. 214.