Exploring patients’ handover process between operating room team members and post anesthesia care unit nurse: a case of University Teaching Hospital of Butare Rwanda

Abstract

Background: Handover failures are common in healthcare settings and lead to different adverse patient outcomes and complications. The complexity of perioperative environment and the condition in which surgical patients are handed over to postanesthesia care (PACU) nurses make surgical patients the most vulnerable to handover failures and associated complications. Problem statement: Lack of standardized process, irrelevance or absence of core team members, noise, distractions and interruptions threaten the quality of handovers. The aim of this study was to explore the process of patient care handover between the OR team and PACU nurses, staff compliance with tasks and information transfer to the PACU nurse at CHUB. Methods: A prospective observational study using cross-sectional design was conducted on patients and staff involved in admission to the PACU of the University Teaching Hospital of Butare (CHUB), south Rwanda. A sample of 109 admissions was calculated using Yamane‟s formula and a checklist adopted from the one developed validated and utilized in two hospitals of London. A single researcher observed handover and completed the checklist accordingly. Data was analyzed through SPSS version 21 Statistics and presented in tables and charts showing percentages. Results: Only 89% patients were handed over, the team handing over was complete in only 0.9%, and tasks execution and attentiveness of the staff complied 15.6% with the protocol. Most of the essential information items were conveyed in less than 60% however all pieces of surgical related information was conveyed less than 10%. Conclusion: Postoperative Patients handovers practice in CHUB was noted to have gaps that pose risks. There is no standardized process, the staff rely on memory and information transfer was characterized by heterogeneity and incompleteness, whereby Recommendations: Standardization of the process, use of postoperative handover checklist, staff trainings researches on postoperative patient handover are essential to improve quality and safety of postoperative patient care at CHUB.