title: Inter-professional clinical handover in post-anaesthetic care units: tools to improve quality and safety.
abstract: OBJECTIVE
  To examine quality and safety in inter-professional clinical handovers in Post Anaesthetic Care Units (PACUs) and make recommendations for tools to standardize handover processes.
  
  
  METHODS
  Mixed methods combining data from observations and focus groups.
  
  
  METHODS
  Three PACUs, one public tertiary hospital and two private hospitals.
  
  
  METHODS
  Observations were made of 185 patient handovers from anaesthetists to nurses. Eight focus groups were conducted with 62 staff (15 anaesthetists and 47 nurses) across the study sites.
  
  
  METHODS
  Inter-professional clinical handovers in PACU's.
  
  
  METHODS
  Characteristics of the structure and processes that support safe inter-professional PACU handover practice.
  
  
  RESULTS
  Characteristics of the process, content, activities and risks during anaesthetist to nurse patient handover into the PACU were integrated into four steps in the PACU handover process summarized by the acronym COLD (Connect, Observe, Listen and Delegate), a verbal communication tool (ISoBAR), a checklist of critical information for safe patient transfer into PACU and a matrix of factors perceived to increase handover risk.
  
  
  CONCLUSIONS
  The standard structure and checklists for optimal content of patient handovers were derived from existing practices and consensus, hence, expected to provide ecologically valid and practical resources to improve quality and safety during clinical handovers in the PACU.
authors.affiliation: Deakin University, Deakin Epworth Centre for Clinical Nursing Research, Burwood, Australia.
authors.forename: Bernice
authors.initials: B
authors.lastname: Redley
authors.affiliation: Deakin University, Deakin-Alfred Nursing Research Centre, Burwood, Australia.
authors.forename: Tracey K
authors.initials: TK
authors.lastname: Bucknall
authors.affiliation: Monash University, Centre for Research Excellence in Patient Safety, Prahran, Australia.
authors.forename: Sue
authors.initials: S
authors.lastname: Evans
authors.affiliation: Deakin University, Deakin Epworth Centre for Clinical Nursing Research, Burwood, Australia.
authors.forename: Mari
authors.initials: M
authors.lastname: Botti
mesh_terms: D000776:Anesthesiology; D057189:Checklist; D003266:Continuity of Patient Care / Q000592:standards*; D017144:Focus Groups; D006801:Humans; D019370:Observation; D062209:Patient Handoff / Q000592:standards*; D061214:Patient Safety / Q000592:standards*; D010360:Patient Transfer; D011182:Postoperative Care; D058996:Quality Improvement
keywords: anaesthesia; audit; health care; quality assurance; risk management; safety; standards