Abstract
The perioperative environment is complex, it encompasses multiple teams of health professionals and numerous transitions of patient care, requiring effective teamwork and communication to avoid negative patient outcomes. Clinical handover provides the critical bridge between professionals; it is an important ritual which, not only provides a sense of professional achievement and personal satisfaction for the nurse, it ensures a safe transition of care for the patient.
Aim of the study
The aim of this research was to identify current practice in handover from the theatre nurse to the post anaesthetic care nurse in the New Zealand perioperative setting.
Research design and method
A quantitative research design was chosen using descriptive statistics, to gain a broad understanding of perioperative handover in New Zealand, about which little is known. Data collection via an online self-completed questionnaire elicited the opinion, observations and experiences of perioperative nurses from a wide a range of surgical hospitals throughout New Zealand. Interest in the study was solicited through communication with the New Zealand Perioperative Nurses College.
Findings and Recommendations
One hundred and thirty survey responses met the study’s criteria and were included in the data analysis. The results illustrate that perioperative nurses in New Zealand are experienced, adaptable in their practice and regularly engage in face-to-face verbal handover. It is also clear that most perioperative nurses are satisfied with nurse-to-nurse handover.
Barriers to effective verbal handover in the perioperative environment were identified, with the receiving post anaesthetic care nurse being required to multitask, and therefore not actively listening highlighted. In addition, collegiality between nurses and a ‘handover pause’ for verbal handover were important to nurses, and factors identified that enabled the safe transfer of information.
International literature has a plethora of suggestions on how to overcome communication barriers and how to mitigate error, with many of those suggestions being integrated into the New Zealand health care system. Indeed, that a culture of patient safety exists to some extent in the New Zealand perioperative environment is the overriding impression from the survey results. There appear to be systems, such as, standardised models to guide verbal handover, and an awareness of appropriate nurse behaviours which results in nurses working together to achieve safe transitions in patient care.
One recommendation to come from this study was for a formal ‘handover pause’ to be instigated in the post anaesthetic care unit, so all the health professionals involved in handover can actively engage in the communication process. Additionally, in the interests of patient safety, face-to-face verbal handover in combination with a written framework of documentation is recommended. Provision of education on how to conduct effective nurse-to-nurse handover also needs to occur.
The results of the current study have identified numerous opportunities for future research, both in New Zealand and internationally. It is clear there is a dearth of literature specifically on nurse handover in the New Zealand perioperative setting, with this study providing the foundation from which future research can occur.