title: Quality of handover in a pediatric postanesthesia care unit.
abstract: BACKGROUND
  The quality of anesthetic handovers to postanesthesia care units (PACU) is known to be poor in adults, and only very limited reports are available regarding the quality of handovers in pediatric anesthesia. In particular, it is not known which and in what quality information is communicated. This current study investigated, therefore, the presence of any handover component as well as its consistency in a pediatric postanesthesia care unit.
  
  
  METHODS
  This prospective observational study evaluated postoperative anesthetic handovers to a pediatric PACU using a detailed checklist, comprising 55 possible items. The main outcome measure was the proportion of information verbally transmitted in relation to the written documentation within the anesthesia record.
  
  
  RESULTS
  Four hundred and forty-three handovers were observed with two handovers excluded due to missing data. Type of surgery (93% [95% CI 91-95]) and any intra-operative regional anesthesia (89% [95% CI 85-94]) were most frequently communicated. Items such as ASA-PS (3% [95% CI 2-5]) and fluid management (4% of cases [95% CI 2-6]) were rarely handed over. Eleven of the 55 items contained within the checklist were communicated in more than 70% of patients.
  
  
  CONCLUSIONS
  The observed handovers to PACU staff were incomplete and missing important information. However, omission of essential information potentially compromises patient safety. A standardized universal mandatory handover protocol following pediatric anesthesia is required.
authors.affiliation: Medical Faculty of Health, Witten/Herdecke University, Witten, Germany.
authors.forename: Florian
authors.initials: F
authors.lastname: Piekarski
authors.affiliation: Department of Pediatric Anesthesiology, Children's Hospital of Cologne, Köln/Cologne, Germany.
authors.forename: Jost
authors.initials: J
authors.lastname: Kaufmann
authors.affiliation: Department of Pediatric Anesthesiology, Children's Hospital of Cologne, Köln/Cologne, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Laschat
authors.affiliation: Department of Anesthesiology and Intensive Care Medicine, Witten/Herdecke University, Köln/Cologne, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Böhmer
authors.affiliation: Department of Anaesthesia, Royal Aberdeen Children's Hospital, Aberdeen, UK.
authors.forename: Thomas
authors.initials: T
authors.lastname: Engelhardt
authors.affiliation: Department of Pediatric Anesthesiology, Children's Hospital of Cologne, Köln/Cologne, Germany.|Department of Anesthesiology and Intensive Care Medicine, Witten/Herdecke University, Köln/Cologne, Germany.
authors.forename: Frank
authors.initials: F
authors.lastname: Wappler
mesh_terms: D000762:Anesthesia Recovery Period; D057189:Checklist / Q000592:standards; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000706:statistics & numerical data*; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety / Q000592:standards; D010372:Pediatrics / Q000592:standards*; D011184:Postoperative Period; D011446:Prospective Studies; D011787:Quality of Health Care / Q000592:standards*
keywords: checklist; children; patient handover; postanesthesia care unit; risk management