ICU handover procedure: the Greek perspective
Keywords:
Intensive Care Unit, Clinical handoverAbstract
Background: Passing the right information poses a challenge in clinical practice. This is the first study in Greece that tries to describe the handover procedure in an intensive care unit to a tertiary hospital.
Methods: A two phase study was conducted during a 155 days period. It included a blind and open observational study which examined the quality and content of clinical handover by night shift doctor to the medical team and a survey about the process. Retrospective cross-checking of the information handed over with one written down in the actual patient record was also conducted.
Results: A total of 800 set of patients’ daily records were examined. A structure of system-based approach of the handover was recorded, with system coverage varying from 21% (nutrition) to 86% (respiratory system) and good relation with the actual record in most areas of interest. Other areas, such as comorbidities, and relatives’ issue were poorly covered. Education meeting that was held between the two phases did ameliorate the content and the quality of information passed over, and in some areas, proved to have a positive effect on certain aspect of handover like e.g. frequency of interruptions, infection status, relatives’ issues and proposed management plan coverage.
Conclusions:Handoverprocess is vital for maintaining stability and quality of care in intensive care unit. Its continual efficiency reevaluation is at least as important as the handover itself for preserving it as a valuable tool in everyday practice.
References
Bonnie P, Mishkin An. Best practices in shift handover communication: Mars exploration rover surface operations. Proceedings of the International Association for the Advancement of Space Safety Conference sponsored by ESA, NASA, and JAXA, Nice, France, 25-27 October, 2005.
Lardner R. Effective Shift Handover, Offshore Technology report – Oto 96003, Health and Safety Executive 1996;1-19.
Northern Territory Magistrates Courts. Inquest into the death of Peter Limbunya. Darwin, NTMC 057, 2008.
National Patient Safety Agency. Safe handover: Safe patients. Guidance in clinical handover for clinicians and managers. London: BMA, 2004. Available at http://bma.org.uk/search?query=handover. Accessed October 2013.
Australian Medical Association. Safe handover: Safe patients. Guidance in clinical handover for clinicians and managers. Canberra: AMA, 2006 http://www.ama.com.au/node/4064 (accessed October 2013).
Royal College of Physicians. Acute care toolkit 1-Handover. London: RCP, 2011 http://www. rcplondon.ac.uk/resources/acute-care-toolkits (accessed October 2013).
Standards for clinical practice guide. Clinical handover. Royal Australian College of General Practitioners. Melbourne: RAGCP, 2010. http://www.racgp.org.au/your-practice/standards/ standards4thedition/practice-services/1-5/clinical-handover (accessed October 2013).
Australasian College for Emergency Medicine. Clinical Handover in the ED. Canbera: ACEM, 2010 http://www.acem.org.au/media/policies_and_ guidelines/Clinical_Handover_in_the_EM.pdf (accessed October 2013).
Cheung SD, Kelly JJ, Beach C, Berkeley RP, Bitterman RA, Broida RI, et al. Improving Handoffs in the Emergency Department. Ann Emerg Med. 2010;55:171-80.
Symons NR, Wong HW, Manser T, Sevdalis N, Vincent CA, Moorthy K. An observational study of teamwork skills in shift handover. Int J Surg. 2012;10:355-9.
Brenier G, Minville V, Fourcade O, Geeraerts T. Medical handovers in ICU: a snapshot of practice in the South West of France. Ann Fr Anesth Reanim. 2012;31:208-212.
Piscioneri F, Chong GC. Surgical handover in a tertiary hospital: a working model. Aust Health Rev. 2011;35:14-17.
Murphy JN, Ryan CA. Handover rounds in Irish hospitals. Ir J Med Sci. 2011;180:27-30.
Miller A, Scheinkestel C, Limpus A, Joseph M, Karnik A, Venkatesh B. Uni- and interdisciplinary effects on round and handover content in intensive care units. Hum Factors. 2009;51:339-53.
Thompson JE, Collett LW, Langbart MJ, Purcell NJ, Boyd SM, Yuminaga Y, et al. Using the ISBAR handover tool in junior medical officer handover: a study in an Australian tertiary hospital. Postgrad Med J. 2011;87:340-4.
Farhan M, Brown R, Woloshynowych M, Vincent C. The ABC of handover: a qualitative study to develop a new tool for handover in the emergency department. Emerg Med J. 2012;29:941-946.
Ilan R, LeBaron CD, Christianson MK, Heyland DK, Day A, Cohen MD. Handover patterns: an observational study of critical care physicians. BMC Health Serv Res. 2012;12:11.
Iedema R, Merrick ET, Kerridge R, Herkes R, Lee B, Anscombe M, Rajbhandari D, Lucey M, White L. Handover--Enabling Learning in Communication for Safety (HELiCS): a report on achievements at two hospital sites. Med J Aust. 2009;190:133-6.
Lyons M, Standley TDA, Gupta AK. Quality improvement of doctors' shift-change handover in neuro-critical care. Qual Saf Health Care 2010;19:1-7.
