Implementing situation-background-assessment-recommendation in an anaesthetic clinic and subsequent information retention among receivers A prospective interventional study of postoperative handovers

摘要

BACKGROUNDCommunication errors cause clinical incidents and adverse events in relation to surgery. To ensure proper postoperative patient care, it is essential that personnel remember and recall information given during the handover from the operating theatre to the postanaesthesia care unit. Formalizing the handover may improve communication and aid memory, but research in this area is lacking.OBJECTIVEThe objective of this study was to evaluate whether implementing the communication tool Situation-Background-Assessment-Recommendation (SBAR) affects receivers' information retention after postoperative handover.DESIGNA prospective intervention study with an intervention group and comparison nonintervention group, with assessments before and after the intervention.SETTINGThe postanaesthesia care units of two hospitals in Sweden during 2011 and 2012.PARTICIPANTSStaff involved in the handover between the operating theatre and the postanaesthesia care units within each hospital.INTERVENTIONImplementation of the communication tool SBAR in one hospital.MAIN OUTCOME MEASURESThe main outcome was the percentage of recalled information sequences among receivers after the handover. Data were collected using both audio-recordings and observations recorded on a study-specific protocol form.RESULTSPreintervention, 73 handovers were observed (intervention group, n=40; comparison group, n=33) involving 72 personnel (intervention group, n=40; comparison group, n=32). Postintervention, 91 handovers were observed (intervention group, n=44; comparison group, n=47) involving 57 personnel (intervention group, n=31; comparison group, n=26). In the intervention group, the percentage of recalled information sequences by the receivers increased from 43.4% preintervention to 52.6% postintervention (P=0.004) and the SBAR structure improved significantly (P=0.028). In the comparison group, the corresponding figures were 51.3 and 52.6% (P=0.725) with no difference in SBAR structure. When a linear regression generalised estimating equation model was used to account for confounding influences, we were unable to show a significant difference in the information recalled between the intervention group and the nonintervention group over time.CONCLUSIONCompared with the comparison group with no intervention, when SBAR was implemented in an anaesthetic clinic, we were unable to show any improvement in recalled information among receivers following postoperative handover.TRIAL REGISTRATIONCurrent controlled trials http://www.controlled-trials.com Identifier: ISRCTN37251313.