22st of International Intensive Care Symposium, İstanbul, Türkiye, 3 - 04 Mayıs 2019
Improving cardiac operating room to intensive care unit handover using a standardised handover processDilek AltunDepartment of Anesthesiology and Reanimation, Acıbadem Mehmet Ali Aydınlar University, Vocational School of Health Sciences, Istanbul, Turkey
Transport of cardiovascular surgery patients from operating room to the cardiovascular intensive care unit (CICU) has many potential risks. The aim of this study was to evaluate problems we experienced during transport; precautions we have taken to minimize these problems, improve quality/safety of transport with the benefit of protocols carried out in our clinic with the aim of providing patients with least error by professional staff.
After approval of University Ethical Committee, we performed a retrospective review of prospectively collected data for patients undergoing cardiac surgery between 2015-2018.
Data collected before and after transport including hemodynamic parameters, periferic oxygen saturation, blood gas analysis.
After transfer, all complications encountered during transportation from beginning to the end of transport will be scanned.
Postcardiac surgery standardised written handover protocol has been started to use after 2016.
Before written protocol improvement, 317 patients were enrolled in the study protocol. Between 2016-2018, after written protocol improvement, 543 patients were enrolled in the study protocol (Table I).
The most common problem was hypocarbia and alkalosis.
No significant difference was found between hemodynamic parameters recorded in adult and pediatric patients at the beginning and as a result of transport (p>0.05) (Table II). When all complications were considered, there was no difference between adult and pediatric cases in terms of frequency of adverse events (p>0.05) (Table II).
Thirty-four surveys were collected with feedback from members of cardiac team participating in the handover initiative. These caregivers noted improvements in teamwork, content received, and patient care planning. (Table III).
According to the our study results, structured multidisiplinery handover process for transfer of patients was associated with an improvement in information transfer, reduction in postoperative complications and errors. Implementation of a structured handover process is associated with an improvement in information transfer, a decrease in specific complications.
Keywords: Handoff, safety, communication, cardiac intensive care unit, patient handover, teamwork