Background: Handover is a process of transferring patient’s clinical data to another person and can occur at the time of shift changes of doctors and nurses working in Intensive care unit. Ineffective handover process can cause adverse patient outcome.
Methods: Handover processes from doctor to doctor at the time of shift change were recorded in intensive care unit. They were evaluated using modified ISOBAR checklist. Data were collected for mentioned and missed out items in different components of checklist during handover procedures, time duration of handover procedures and distracters during handover procedures.
Results: Patient’s name and MRD number were not mentioned in all the 50 handover procedures. Problem of patient was mentioned in all handover procedures but, its time of occurrence and severity were mentioned in 35 (70%) and 30 (60%) handovers, respectively. Observation for vital parameters was missing in average of 49.6% handover procedures. Only 54% handover procedures mentioned about treatment to date. Physical examination findings, investigation findings, pending results, current diagnosis and about contact person for any problem were discussed in 42, 70, 22.7, 84 and 2% handover procedures, respectively. Overall, recommendations were missing in majority of handover procedures except recommendation for need of other tests for patients (80.9%). Handover procedure was completed in average of 69.6 seconds duration. Distractions were present in 16 (32%) handover procedures. Phone and people were the common distracters. Posing of questions by incoming resident doctor was noted in 18 (36%) handover procedures, only.
Conclusion: Clinical staff working in ICU of our hospital requires training for proper handover procedures. They should be made aware of standard communication checklist and encouraged to use that checklist during handover procedures.
Keywords: Handover procedure, Intensive Care Unit, ISOBAR, Shift change, doctors.
Wednesday, September 13, 2017