«HANDOVER» Kvalitet og sikkerhet knyttet til formidling av informasjon i overføringssituasjoner etter kirurgi. En prospektiv observasjonsstudie.

Background. Effective clinical handover ensures continuity of patient care. During the last decade interventions to improve handover has increased. Current research has identified numerous safety risks related to patient handovers after surgery. Purpose. Examine and analyze the handover challenges in a local setting, and document current practice. Material and methods. Three qualitative semi structured focus group interview was conducted with 13 registered nurses to describe the current practice. Using a checklist including 23 items, the information transfer during 100 post-operative handovers was documented, and subsequently compared with patient medical records. Results. The focus group interviews indicate that sender and receiver often have different opinions about what items should be included in the verbal handover. In the observed handover situations, two items were transferred in all cases, patient name and type of surgery. Items regarding the post-operative period was transferred in only 72 % of the handovers. Items rarely transmitted were plan for lines and drains, postop investigations, antibiotic therapy, feeding plan, regular medication and patient's relatives. Conclusions. This study demonstrates that current practice in post-operative handover is incomplete. A standardized handover appears useful to optimize the handover process. Relevance. Postoperative handover involves staff across professional group and skill sets, each with their own different yet important priorities of what information must be transferred. Incomplete information transfer may have a negative impact on patient safety. Before safety solutions can be considered is it important to analyze the challenges in the local setting and customized the solutions to fit the specific context in which the handover takes place