Literature Evaluation Table

Running head: FACILITATING HAND-OFFS 1

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FACILITATING HAND-OFFS

Facilitating Hand-Offs

Student’s Name

Institutional Affiliation

Facilitating Hand-Offs

PICOT Question

Among spinal patients who have received anesthesia for surgery (P), does the use of a physical checklist (I), compared to I-PASS Handover Bundle (C), improve handover communication (O) in Post Anesthesia Care Unit (PACU) within three hours? (T)

Defined elements of the above PICOT question are as follows:

P: spinal patients who have received anesthesia for a surgery

I: physical checklist

C: handover bundle

O: improved handover communication

T: three hours

Clinical Nursing Problem: Facilitating Hand-Offs; Improving Communication in the PACU

According to Methangkool et al. (2019), effective communication makes a critical part of patient safety at PACU, where there are high-risk periods. In the process of transitioning from one care area or provider in the operating room (OR) to a different area or provider in PACU, any failed communication can lead to a fatality. A communication breakdown primarily pushes a spinal patient who has received anesthesia for surgery to mortality and morbidity vulnerability. Methangkool et al. (2019) research revealed that communication failure is among the leading contributors to severe recovery departments' severe occurrences.

There is an existing direct relationship between poor handover communication and patient harm. In 2006, The Joint Commission (TJC) recommended a standardized handovers strategy as an integral part of patient safety Methangkool et al., (2019). As a result, a physical checklist became part of the standardized approach. Physical checklists are now depicting effectiveness in minimizing mortality and morbidity in PACU by reducing medical mistakes or errors. Bigham and colleagues' study revealed that a physical checklist reduced failures associated with handover communication by 69% yearly. In another Starmer's approach of "I-PASS Handover Bundle," the findings showed that this technique reduced general medical mistakes by 23% and 30% prevention of severe occurrences. In comparison, a physical checklist is more effective than the latter.

As a result of surgical patients passing via many care transitions, they need repetitive handing over from care specialists to care specialists, which demands effective communication to avoid medical errors. Methangkool et al., (2019) research that reviewed surgical error claims, at most 43% of communication barriers linked to injury of the patient took place due to miscommunication handovers. During handovers at PACU, the dominant challenges resulting in ineffective communication are personnel dynamics, disruptions, and repetitive transfers of information that lacks standardization. For instance, most handovers have up to 48% of communication disruptions such as irrelevant conversations, mobile calls, text messages alerts, and general noise (Methangkool et al., (2019). As a result, these distractions in PACU influence handover's quality and the level of satisfaction of delivering and receiving a doctor or nurse.

However, if this problem of poor or miscommunication in PACU is addressed by implementing a physical checklist to replace the current ineffective I-PASS Handover Bundle, the positive outcome will be a high decreased rate of morbidity and mortality. Also, the stay length of a patient in the PACU will automatically decrease from either five hour to at most two and a half hours (Holly, 2013). This shortened staying length implies that a patient's experience in the recovery room becomes positive. Overall, a patient's safety increases because, with a physical checklist, it is tough to experience any form of miscommunication, the omission of sensitive patient information, or having medical errors.

Conclusively, the handoff is a sensitive time for all spinal patients who have received anesthesia for surgery. As a result, nurses or healthcare providers at PACU should consider using an effective approach of handing over communication to prevent medical errors and other errors that lead to increased morbidity and mortality rates. The I-PASS Handover Bundle's replacement with a physical checklist will generally improve communication, thereby leading to a positive outcome for both patient and hospital.

References

Holly, C., & Poletick, E. (2013). A systematic review on the transfer of information during nurse transitions in care. Journal of Clinical Nursing, 23, 2387-2396. doi:10.1111/jocn.12365

Methangkool, E., Tollinche, L., Sparling, J., & Agarwala, A. V. (2019). Communication: Is There a Standard Handover Technique to Transfer Patient Care? International anesthesiology clinics, 57(3), 35.