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Impact of patient handover structure on neonatal perioperative safety
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نویسنده
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France D. J. ,Slagle J. ,Schremp E. ,Moroz S. ,Hatch L. D. ,Grubb P. ,Lorinc A. ,Lehmann C. U. ,Robinson J. ,Crankshaw M. ,Sullivan M. ,Newman T. ,Wallace T. ,Weinger M. B. ,Blakely M. L.
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منبع
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journal of perinatology - 2019 - دوره : 39 - شماره : 3 - صفحه:453 -467
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چکیده
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Objectiveto compare the incidence, severity, preventability, and contributing factors of non-routine events—deviations from optimal care based on the clinical situation—associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates.study designa prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children’s hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative nicu care.resultsthe incidence of clinician-reported nres was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. national surgical quality improvement—pediatric occurrences of major morbidity were significantly higher (p < 0.001) in direct team handovers than indirect nursing or mixed handovers.conclusionsnres occur at a high rate and are of variable severity in neonatal perioperative care. nre rates and contributory factors were homogenous across handover types. surveyed clinicians recommend structured handovers for all patients at every transfer point regardless of acuity.
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آدرس
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Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Vanderbilt University Medical Center, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA. University of Utah, Department of Pediatrics, Division of Neonatology, USA, University of Utah, Department of Pediatrics, Division of Neonatology, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, University of Utah, Department of Pediatrics, Division of Neonatology, USA. Vanderbilt University Medical Center, Department of Biomedical Informatics, USA, Vanderbilt University Medical Center, Department of Biomedical Informatics, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatric Surgery, USA, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Neonatal Intensive Care Unit, USA, Vanderbilt University Medical Center, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Nationwide Children’s Hospital, Neonatal Intensive Care Unit, USA, Vanderbilt University Medical Center, Department of Anesthesiology, USA. Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatrics, Division of Neonatology, USA, Monroe Carell Jr. Children’s Hospital at Vanderbilt, Department of Pediatric Surgery, USA
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Authors
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