patient handovers

[cully24]

We are trying to implement a "handover" in our perianestheisia areas. This involves the Pre op staff, OR staff, anesthesia and PACU staff. I am inquiring if any other hospitals are incorporating a handover in the perioperative routine, how is it working and better yet, how did you get the staff to "buy in" to this idea?

[PaKuRN]

Well, this was a tough sell for the OR nurses, who now have to get report from the unit RN, and then have to give the PACU RN report. We used to get report from anesthesia.(and OR nurses did not get involved in any report) PACU RN's also had a bit of struggle with this process, we relied on Anesthesia for report. But, with some standard forms on a single piece of paper, (not part of the chart), the RN in OR gets the basic info, anesthesia adds to it upon arrival to PACU, and then we put it all together. There are some OR RN's that have a strain in their voice as they give report, i guess feeling like a fish out of water, but we worked it out... This is called a "hands off" report, and we must document in our chart that "report was received from ... RN", and "report given to ...,RN" on discharge, using the nurses first and last name. When mock rounds are made in preperation for the JOINT, we are asked this information and where it is charted. So, it has become an important part of the continous legal paper work.We had no choice but to "buy" it. We were told that this is what the JOINT looks at for continuity of care and we had to do it. It has been over a year now, and it is the norm, report is expected PRIOR to patient coming into the PACU. No report,,, then don't bring the patient in here. It gives accountability to each professional, it's a good practice. Go for it!

[thezenmonk]

it is the norm, report is expected PRIOR to patient coming into the PACU. No report, then don't bring the patient in here. It gives accountability to each professional, it's a good practice.

We have implemented this policy in our hospital too, but our OR is very busy, with a high patient turnover. My OR nurses find it really tough to fill in the forms prior to shifting the post-op patient to the PACU, at a time when they have to get the OR cleaned up and the next patient mobilized too..

But documentation is important as you have said, and it speeds up things in the PACU as all the orders are already written. Safer for the patients too, as there's no communication gap.