Impact of patient handover structure on neonatal perioperative safety

D. J. France, J. Slagle, E. Schremp, S. Moroz, L. D. Hatch, P. Grubb, A. Lorinc, C. U. Lehmann, J. Robinson, M. Crankshaw, M. Sullivan, T. Newman, T. Wallace, M. B. Weinger, M. L. Blakely

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Objective: To 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 design: A 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. Results: The 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. Conclusions: NREs 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.

Original languageEnglish (US)
Pages (from-to)453-467
Number of pages15
JournalJournal of Perinatology
Volume39
Issue number3
DOIs
StatePublished - Mar 1 2019

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology

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