Research output: Contribution to Journal/Magazine › Journal article › peer-review
Research output: Contribution to Journal/Magazine › Journal article › peer-review
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TY - JOUR
T1 - Interprofessional handover and patient safety in anaesthesia : observational study of handovers in the recovery room.
AU - Smith, Andrew F.
AU - Pope, C
AU - Goodwin, Dawn
AU - Mort, Maggie
PY - 2008/9
Y1 - 2008/9
N2 - Background: We aimed to describe how anaesthetists hand over information and professional responsibility to nurses in the operating theatre recovery room. Methods: We carried out non-participant practice observation and in-depth interviews with practitioners working in the recovery room of an English hospital and used qualitative methods to analyse the resulting transcripts. Results: We observed 45 handovers taking place between 17 anaesthetists and 15 nurses in the recovery room of the operating theatre suite. These took place in an environment that is event-driven, time-pressured, and prone to concurrent distractions. Anaesthetists and nurses often had differing expectations of the content and timing of information transfer. The point at which transfer of responsibility for the patient occurred during the handover process was variable and depended not only on the condition of the patient but also on the professional relationship between the nurse and doctor concerned. Handover also provided an ‘audit point’ in care where the patient’s intraoperative progress was reviewed and plans were made for further management. Here, as in the transfer of responsibility, we found evidence that nurses play a greater role in defining the limits of anaesthetists’ practice than might be expected. Conclusions: Patient handovers in the recovery room are largely informal, but nevertheless show many inherent tensions, both professional and organizational. Although formalized handover procedures are often advocated for the promotion of safety, we suggest that they are likely to work best when the informal elements, and the cultural factors underlying them, are acknowledged.
AB - Background: We aimed to describe how anaesthetists hand over information and professional responsibility to nurses in the operating theatre recovery room. Methods: We carried out non-participant practice observation and in-depth interviews with practitioners working in the recovery room of an English hospital and used qualitative methods to analyse the resulting transcripts. Results: We observed 45 handovers taking place between 17 anaesthetists and 15 nurses in the recovery room of the operating theatre suite. These took place in an environment that is event-driven, time-pressured, and prone to concurrent distractions. Anaesthetists and nurses often had differing expectations of the content and timing of information transfer. The point at which transfer of responsibility for the patient occurred during the handover process was variable and depended not only on the condition of the patient but also on the professional relationship between the nurse and doctor concerned. Handover also provided an ‘audit point’ in care where the patient’s intraoperative progress was reviewed and plans were made for further management. Here, as in the transfer of responsibility, we found evidence that nurses play a greater role in defining the limits of anaesthetists’ practice than might be expected. Conclusions: Patient handovers in the recovery room are largely informal, but nevertheless show many inherent tensions, both professional and organizational. Although formalized handover procedures are often advocated for the promotion of safety, we suggest that they are likely to work best when the informal elements, and the cultural factors underlying them, are acknowledged.
KW - anaesthesia
KW - recovery period
KW - communication
KW - education
KW - continuing
KW - interprofessional relations
KW - postoperative care
KW - recovery
KW - postoperative
UR - http://www.scopus.com/inward/record.url?scp=50949114149&partnerID=8YFLogxK
U2 - 10.1093/bja/aen168
DO - 10.1093/bja/aen168
M3 - Journal article
VL - 101
SP - 332
EP - 337
JO - British Journal of Anaesthesia
JF - British Journal of Anaesthesia
SN - 1471-6771
IS - 3
ER -