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Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information retention among receivers: a prospective interventional study of postoperative handovers
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.
Uppsala universitet.
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap. Uppsala universitet.ORCID-id: 0000-0003-1185-061X
Högskolan i Gävle, Akademin för hälsa och arbetsliv, Avdelningen för hälso- och vårdvetenskap, Medicin- och vårdvetenskap.
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2016 (Engelska)Ingår i: European Journal of Anaesthesiology, ISSN 0265-0215, E-ISSN 1365-2346, Vol. 33, nr 3, s. 172-178Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

BACKGROUND: Communication errors cause clinical incidents and adverse events in relation to surgery. To ensure proper postoperative patient care, it is essential that personnel remember and recall information given during the handover from the operating theatre to the postanaesthesia care unit. Formalizing the handover may improve communication and aid memory, but research in this area is lacking.

OBJECTIVE: The objective of this study was to evaluate whether implementing the communication tool Situation-Background-Assessment-Recommendation (SBAR) affects receivers' information retention after postoperative handover.

DESIGN: A prospective intervention study with an intervention group and comparison nonintervention group, with assessments before and after the intervention.

SETTING: The postanaesthesia care units of two hospitals in Sweden during 2011 and 2012.

PARTICIPANTS: Staff involved in the handover between the operating theatre and the postanaesthesia care units within each hospital.

INTERVENTION: Implementation of the communication tool SBAR in one hospital.

MAIN OUTCOME MEASURES: The main outcome was the percentage of recalled information sequences among receivers after the handover. Data were collected using both audio-recordings and observations recorded on a study-specific protocol form.

RESULTS: Preintervention, 73 handovers were observed (intervention group, n = 40; comparison group, n = 33) involving 72 personnel (intervention group, n = 40; comparison group, n = 32). Postintervention, 91 handovers were observed (intervention group, n = 44; comparison group, n = 47) involving 57 personnel (intervention group, n = 31; comparison group, n = 26). In the intervention group, the percentage of recalled information sequences by the receivers increased from 43.4% preintervention to 52.6% postintervention (P = 0.004) and the SBAR structure improved significantly (P = 0.028). In the comparison group, the corresponding figures were 51.3 and 52.6% (P = 0.725) with no difference in SBAR structure. When a linear regression generalised estimating equation model was used to account for confounding influences, we were unable to show a significant difference in the information recalled between the intervention group and the nonintervention group over time.

CONCLUSION: Compared with the comparison group with no intervention, when SBAR was implemented in an anaesthetic clinic, we were unable to show any improvement in recalled information among receivers following postoperative handover.

TRIAL REGISTRATION: Current controlled trials http://www.controlled-trials.com Identifier: ISRCTN37251313.

Ort, förlag, år, upplaga, sidor
2016. Vol. 33, nr 3, s. 172-178
Nyckelord [en]
postoperative care, postanaesthesia care, communication, Situation-Background-Assessment-Recommendation, SBAR
Nationell ämneskategori
Anestesi och intensivvård
Identifikatorer
URN: urn:nbn:se:hig:diva-20602DOI: 10.1097/EJA.0000000000000335ISI: 000369548100003PubMedID: 26760400Scopus ID: 2-s2.0-84957092321OAI: oai:DiVA.org:hig-20602DiVA, id: diva2:871871
Projekt
KPATillgänglig från: 2015-11-17 Skapad: 2015-11-17 Senast uppdaterad: 2018-03-13Bibliografiskt granskad
Ingår i avhandling
1. Communication and Patient Safety: Transfer of information between healthcare personnel in anaesthetic clinics
Öppna denna publikation i ny flik eller fönster >>Communication and Patient Safety: Transfer of information between healthcare personnel in anaesthetic clinics
2016 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Communication errors are frequent during the perioperative period and cause clinical incidents and adverse events. The overall aim of the thesis was to study communication – the transfer of information, especially the postoperative handover – between healthcare personnel in an anaesthetic clinic and the effects of using the communication tool SBAR (Situation-Background-Assessment-Recommendation) from a patient safety perspective.

The thesis is based on studies using a correlational (Paper I), quasi-experimental (Paper II and III) and descriptive (Paper IV) design. Data were collected using digitally recorded and structured observations of handovers, anaesthetic records, questionnaires, incident reports and focus group interviews.

The results from baseline data showed that lack of structure and long duration of the verbal postoperative handover decreased how much the receiver of postoperative handover remembered; the item most likely not to be remembered by the receiver was anaesthetic drugs. The variation in remembered information showed that there were room for improvement (Paper I). Implementing the communication tool SBAR increased memorized information among receivers following postoperative handover. Interruptions were frequent during postoperative handover, which negatively affected memorized information (Paper III). Furthermore, after implementation of SBAR, the personnel’s perception of communication between professionals and the safety climate improved, and the proportion of incident reports related to communication errors decreased in the intervention group (Paper II). The results of the focus group interviews revealed that the nurse anaesthetists, anaesthesiologists and post-anaesthesia care unit nurses had somewhat different focuses and views of the postoperative handover, but all professional groups were uncertain about having all information needed to secure the quality of postoperative care (Paper IV).

The findings indicate that using a predictable structure during postoperative handover may improve the information memorized by the receiver, perception of communication between professionals and perception of safety climate. Incidents related to communication errors may also decrease. Long duration of the handover and interruptions may negatively affect the information memorized by receiver. To ensure high quality and safe care, there is a need to achieve a shared understanding across professionals of their work in its entirety.  

Ort, förlag, år, upplaga, sidor
Uppsala: Acta Universitatis Upsaliensis, 2016. s. 70
Serie
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 1186
Nyckelord
anaesthesiologist, anaesthetic clinic, communication, handover, incident reports, information transfer, interruption, memory, nurse, operating theatre, patient safety, post-anaesthesia care unit, safety attitudes, SBAR
Nationell ämneskategori
Omvårdnad Anestesi och intensivvård
Forskningsämne
Vårdvetenskap
Identifikatorer
urn:nbn:se:hig:diva-21387 (URN)978-91-554-9489-6 (ISBN)
Disputation
2016-04-20, Museum Gustavianum, Akademigatan 3, Uppsala, 13:00 (Svenska)
Opponent
Handledare
Projekt
Kommunikation och patientsäkerhet (KPA)
Tillgänglig från: 2016-04-07 Skapad: 2016-04-05 Senast uppdaterad: 2018-03-13Bibliografiskt granskad

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Randmaa, MariaMårtensson, GunillaHögberg, HansEngström, Maria

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