Standardization of Postoperative Communication with Application of the Written Handoff Anesthesia Tool

Abstract

Purpose. The purpose of this doctoral project was to improve communication between anesthesia providers and postoperative care registered nurses through utilization of a standardized checklist. The aim was to evaluate anesthesia providers perception of the checklist and its impact during the communication process.Background. Communication handoff between anesthesia providers and postoperative care registered nurses in the postoperative period can cause information loss leading to adverse patient outcomes. Providers employ differing methods to give postoperative report including verbal report from memory, handwritten report, and checklists. Implementation of a formal handoff checklist to structure the handover process improves knowledge transfer, increases accuracy, and decreases the omission of pertinent patient medical information. The use of standardized checklists improves the conveyance of crucial information during handoffs while reducing high-risk patient events and lowering the rate of errors. Methods. An educational presentation, including a PowerPoint, was presented to anesthesia providers at a large academic hospital in Tucson, Arizona. A Written Handoff Anesthesia Tool (WHAT) badge card was handed out to participants to be utilized after the presentation. Participants were asked to complete an email survey via Qualtrics after utilizing the checklist for 4 weeks. Results. Thirty-six Certified Registered Nurse Anesthetists (CRNAs) were recruited to participate in the project; twenty-three CRNAs received information via the educational presentation and a total of 13 CRNAs completed the post-survey. The checklist was found to be useful by 92.3% (n=12) of providers while 100% (n=13) of providers found the tool easy to use. The tool was determined simple to learn by 100% (n=13) of providers. Overall satisfaction was measured at 100% (n=13) of CRNAs. Open ended questions found an increase in provider’s perception of improvement of handover reporting and perceived patient safety with tool usage. Conclusion. The data gathered suggests that CRNAs found the Written Handoff Anesthesia Tool to be effective, improve communication, easy to use, quick to learn, and overall satisfactory. Respondents emphasized the tool’s impact on improvement of patient safety. This DNP project helped identify an opportunity for improvement of information transfer during the postoperative transition period.