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Observational Study
. 2019 Mar;39(3):453-467.
doi: 10.1038/s41372-018-0305-6. Epub 2019 Jan 17.

Impact of patient handover structure on neonatal perioperative safety

D J France  1   2   3 , J Slagle  4   5   6 , E Schremp  4   5   6 , S Moroz  4   5   6 , L D Hatch  5   6   7 , P Grubb  7 , A Lorinc  4   5   6 , C U Lehmann  7   8 , J Robinson  8   9 , M Crankshaw  10 , M Sullivan  11 , T Newman  4   5   6 , T Wallace  12 , M B Weinger  4   5   6 , M L Blakely  9
Affiliations
Observational Study

Impact of patient handover structure on neonatal perioperative safety

D J France et al. J Perinatol. 2019 Mar.

Abstract

Objective: To compare the incidence, severity, preventability, and contributing factors of non-routine events-deviations from optimal care based on the clinical situation-associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates.

Study design: A prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children's hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative NICU care.

Results: The incidence of clinician-reported NREs was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. National Surgical Quality Improvement-Pediatric occurrences of major morbidity were significantly higher (p < 0.001) in direct team handovers than indirect nursing or mixed handovers.

Conclusions: NREs occur at a high rate and are of variable severity in neonatal perioperative care. NRE rates and contributory factors were homogenous across handover types. Surveyed clinicians recommend structured handovers for all patients at every transfer point regardless of acuity.

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Conflict of interest statement

Conflicts of interest: The authors have no conflicts of interests to report.

Figures

Figure 1.
Figure 1.
Direct and Indirect Perioperative Handovers
See this image and copyright information in PMC

References

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