Does Checklist Implementation Improve Quantity of Data Transfer: An Observation in Postanesthesia Care Unit (PACU)

Park, Lauren S.; Yang, Gloria; Tan, Kay See; Wong, Chen Khuan; Oskar, Sabine; Borchardt, Ruth A.; Tollinche, Luis

doi:10.4236/ojanes.2017.74007

Cited by 9 publications

(12 citation statements)

References 28 publications

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“…Process measures include the rate of adherence to a set handover outline or a tracking of handover score. 59 In their cardiac OR to cardiac SICU handover process implementation, the Mount Sinai Hospital in Toronto rated handover content, teamwork (eg, absence of interruptions, inclusion of readback), and patient care planning. 53 These metrics demonstrate the effectiveness of the roll-out and training sessions for a handover initiative.…”

Section: Implementation Of Standardized Handoversmentioning

confidence: 99%

Communication: Is There a Standard Handover Technique to Transfer Patient Care?

Methangkool

Tollinche

Sparling

et al. 2019

International Anesthesiology Clinics

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Effective communication is integral to patient safety, especially during high-risk periods where patients are transitioning to different care areas or to different providers. However, communication failures continue to occur; The Joint Commission (TJC) reports that the number one cause of anesthesia-related sentinel events is breakdown in communication. 1 The operating room (OR), the postanesthesia care unit (PACU), and the intensive care unit (ICU) are especially vulnerable to communication failures between providers; inadequate communication in the PACU has been shown to affect mortality and morbidity. 2,3 A review of 419 reports from the Anaesthetic Incident Monitoring Study (AIMS) indicated failure in communication as the second most common contributing factor to adverse events in recovery units. 4 Indeed, observational studies have shown a direct correlation between poor handover and patient harm. 5 Therefore, the handover process is critical to the safe care of the surgical patient. The handover is a transfer of not only information but also of professional responsibilities across teams. 6 Ideally, a handover report is attended by surgical and anesthesia staff, a nurse, and a PACU or an ICU clinician, and relays information on the patient's history, intraoperative events, and postoperative care plan. According to the American Society of Anesthesiologists, standard of care requires the presence of intraoperative anesthesia staff for monitoring during transport and verbal report. 7 However, beyond this, there is a lack of consistent guidelines; reports are vulnerable to omission of pertinent information. 8 A complete omission of information occurred in 57% of surgical malpractice claims 9 and has

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Section: Implementation Of Standardized Handoversmentioning

confidence: 99%

Communication: Is There a Standard Handover Technique to Transfer Patient Care?

Methangkool

Tollinche

Sparling

et al. 2019

International Anesthesiology Clinics

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“…This may mean that healthy patients remain in PACUs longer than necessary or patients in the PACU transferred to other wards if there was a shortage of beds. 33 …”

Section: Discussionmentioning

confidence: 99%

Assessment of Staffing and Service Provision in the Post-Anesthesia Care Unit of Hospitals Found in Amhara Regional State, 2020

Chekol¹,

Eshetie²,

Temesgen³

2021

DHPS

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Background Post-anesthesia recovery is a continuous process which is considered to be complete after the patient returns to their preoperative physiological state. Although all patients who have had an operation under anesthesia are in a potentially unstable physiological state, most patients recover safely without significant problems due to better and immediate post-anesthesia care. Therefore, this study aimed to assess the staffing and service provision in the post-anesthesia care unit. Methods A multicenter, institution-based cross-sectional study was conducted in post-anesthesia care units from November 28 to December 31, 2020. The data were collected using a questionnaire prepared from standards and guidelines of the American Society of Anesthesiologists, the American Association of Nurse Anesthetists, and the Royal College of Anesthetists by direct observation. Results Ten hospitals found in Amhara regional state were examined for their staffing of and service provision in their post-anesthesia care units. The total ratio of nurses assigned in post-anesthesia care units to post-anesthesia care unit beds was around 1:3, with a minimum and a maximum ratio of 1:8 and 1:2, respectively. The average number of patients admitted in post-anesthesia care units per week was 98. Eighty percent of the hospitals' post-anesthesia care units had no policy or caregivers for cardiac arrest management. Conclusions and Recommendations Standards, policies, and guidelines are not well prepared and posted so as to be visible to every caregiver. The majority of the hospitals have staff without special training for the management of possible complications in the post-anesthesia care unit. Generally, hospitals need to ensure standardized patient care in the post-anesthesia care unit for better and safer patient outcomes.

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“…Of these 144 articles, we identified 19 articles [78][79][80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95][96] that fit our eligibility criteria. Of these studies, 12 involved checklist use in the surgical setting [78-79, 81-84, 86, 92-96] , 5 involved checklist use in the anaesthesia/critical care setting [78,86,[88][89][90] , 2 involved checklist use in the medical setting [81,91] . All studies involved comparison of participant groups with checklist usage against participant groups without checklist usage.…”

Section: Study Characteristicsmentioning

confidence: 99%

“…All studies involved comparison of participant groups with checklist usage against participant groups without checklist usage. Two of the 19 studies were randomized controlled trials [80,91] , 10 studies utilized a pre/post intervention study design [78,79,83,85,86,90,92,93,95,96] , while seven studies adopted a retrospective or prospective observational study design [81,82,84,87,88,89,94] .…”

Section: Study Characteristicsmentioning

confidence: 99%

Impact of checklists on inpatient safety: A review of recent literature

Wani,

Kaur,

Chew

et al. 2023

Int. J. Appl. Res.

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Background: Increase in public education and demands for patient-centred care prompt further research into transparent, organized and, above all, safe medical care. The checklist appears capable in theory to resolve some of the issues of patient safety, however its relevance and value in current practice has been questioned and adoption remains low among medical communities worldwide. Objective: to conduct a systematic review of articles of the current effect of checklists on patient safety in terms of improving patient outcomes and reducing medical errors in the inpatient setting. Methods: Search was conducted using Google Scholar with no language or study design restrictions and included keywords 'checklist', 'impact' and 'patient safety'. Publications before January 2016 were excluded to more closely reflect its impact in current medical practice. Only studies on quantitative measures of impact were included. Case reports, editorials, letters, commentaries, reviews, overviews and conference abstracts were excluded. Studies with checklists employed as part of a 'bundle', impact assessed in a simulated setting, involved outpatient setting were excluded. Titles that obviously did not match the review's aim were also excluded. Main Results: 114 articles were identified, of which 19 satisfied the eligibility criteria. Articles evaluated checklist impact in terms of patient outcomes (mortality, adverse events, length of hospital stay) and staff adherence to standard guidelines. Studies reported mixed results of checklist impact in patient related outcomes, however uniformly found statistically significant improvements in staff adherence (mean number of items completed 8.7 (SD=1.5) without checklist to 10.9 (SD=1.1) items with checklist out of 12 items, p<0.0001). Several studies also reported significant effects when completed checklists are compared with patient related outcomes (20.0% when checklist not completed vs 11.3% when checklist completed, p=0.026). Conclusion:The studies concluded a possible contribution of the checklist in patient-related outcomes, with much inconsistency in findings among different studies. The few articles reporting on staff adherence however provided significant uniform improvement following checklist implementation. There is a need for more high-quality quantitative studies to effectively conclude its impact in patient safety. As for now, the checklist remains relevant and should be applied at a broader scale, with research priority on checklist design and quality indicators to be included.

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Does Checklist Implementation Improve Quantity of Data Transfer: An Observation in Postanesthesia Care Unit (PACU)

Cited by 9 publications

References 28 publications

Communication: Is There a Standard Handover Technique to Transfer Patient Care?

Communication: Is There a Standard Handover Technique to Transfer Patient Care?

Assessment of Staffing and Service Provision in the Post-Anesthesia Care Unit of Hospitals Found in Amhara Regional State, 2020

Impact of checklists on inpatient safety: A review of recent literature

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