305 - Collaboration in Perioperative Handover Communication
Description: Clinical IssueThe perioperative department had undergrown rapid growth from community hospital to level 2 trauma center. Increase in patient acuity made it necessary to develop a concise, comprehensive, written perioperative handover communication tool.Description of TeamPerioperative RNs from Pre-anesthesia, Pre-op, OR, and the Post Anesthesia Care Unit (PACU), a Quality Improvement RN, and a Surgical Educator comprised the Perioperative Communication Task Force formed in 2016.Preparation and PlanningThe task force met to review the existing written communication form, discuss barriers to use and possible changes. A survey was developed to solicit share holder input for perioperative nurses. Literature related to perioperative handover communication was reviewed. A Robust Process Improvement Study was implemented after IRB approval. AssessmentPreimplementation analysis of the existing written handover communication tool showed completion of 81% of available fields with extraneous writing on 97% on the handover communication forms. The survey netted minimal imput from stake holders. ImplementationUtilizing extraneous writing items and critical knowledge needed by perioperative team members as well as the minimal input from perioperative nursing surveys, the first draft of the written handover communication tool was put into place in surgical services in 2017.The reviesed form contained significantly more items, however, most fields were converted from free hand to check box or fill in the blank items. Nursing feedback increased significantly once the revised form was in place. Changes in OR protocols and nursing input, as well as several assessments of the revised tools were use to make continued revisions as needed.OutcomeWhile post-implimentation analysis of the revised handover communication tool showed a lower percentage of completion, the total number of items being communicated had increased by 35%. Some extraneous writing still prevailed which will be used in ongoing revisions. Nurse satisfaction with the revised written handover communication process was difficult to measure due to low survey participation. However, the revised Perioperative Handover Communication written tool has become the standard of care in perioperative services.Implications to Perioperative NursingThe written perioperative handover communication tool provides increased nursing satisfaction through ease of use and increase of comprehensive, concise information communicated between departments. Better communication enhances patient safety. Future development and implementation of a written intraoperative handover tool could increase commmunication during nurse to nurse relief within the Surgical Suite.