Strengthening handover communication in pediatric cardiac intensive care

Abstract

Objective: To evaluate knowledge transfer and perceptions using a structured handover process for the postoperative pediatric cardiac patient being admitted to intensive care. The hypothesis being that knowledge transfer could be optimized by the implementation of this handover structure.

Aim: To investigate the effects of the implementation of a structured handover in the intensive care unit, including preadmission cardiac reports and operating room information.

Background: Patient handover following pediatric cardiac surgery involves a multidisciplinary team and a potentially unstable patient, which may create multiple cognitive demands for the treating team. This may lead to an increased risk of information error with potentially significant sequelae for the patient.

Methods: A prospective interventional study in a tertiary pediatric hospital providing both general and cardiac intensive care in the United Kingdom was undertaken in the postoperative cardiac group. Twenty-one preintervention and 22 postintervention handovers were observed by a trained independent observer. Three phases of the handover, prepatient readiness, prehandover readiness, and information conveyed, were assessed as well as attentiveness, organization of the team, and flow of information during the handover. The duration and number of interruptions were also recorded. Staff perceptions of the handover were also assessed.

Results: All three phases of the handover were significantly improved with the handover intervention. The observer scores were also significantly improved as were the perceptions of the staff following the implementation of the handover tool. There was no significant increase in the duration of the handover.

Conclusions: Communication between the operating room and intensive care staff, regarding postoperative pediatric cardiac patients, significantly improved with the implementation of a structured handover.