Implementation and adoption of SOAP-M and SBAR at a German anesthesiology department - a single-center survey study.

BACKGROUND: Checklists are a common tool used in order to mitigate risks caused by human factors and can facilitate the safe induction of anesthesia as well as handovers. SBAR (Situation, Background, Assessment, Recommendation) is a checklist recommended by the WHO and DGAI for handovers, while SOAP-M (Suction, Oxygen, Airway, Pharmaceuticals, Monitoring) is a checklist for the induction of anesthesia. This study investigates the implementation and adoption of these two checklists. METHODS: We conducted a single-center online survey one year after the implementation of SOAP-M and SBAR at a university hospital's anesthesiology department, using scales from three validated questionnaires to assess safety attitudes as well as the behavior of staff and the perceived usefulness of the checklists. RESULTS: Staff with a high score in general attitude towards patient safety, as determined by the safety attitudes questionnaire, considered both checklists useful additions to their work environment. Nurses and physicians (p = 0.102) as well as groups divided according to work experience (p = 0.077) showed no significant differences in using SOAP-M and SBAR. Perceived usefulness was significantly higher (p < 0.001) among users of the checklists, and the same goes for positive reinforcement (p < 0.001), social cues (p = 0.0215) and goal cues (p = 0.0252). CONCLUSION: SOAP-M and SBAR are perceived as useful checklists for patient handovers and anesthesia induction by tertiary referral hospital's employees with high score in general safety attitude and were therefore commonly used one year after their introduction. No significant difference in checklist adoption between occupations as well as groups divided according to work experience could be found. Perceived usefulness is significantly higher among users of the checklist, who feel using the checklists provides more support.

Enhancing inpatient glycemic education and management with a SMILE SBAR: A quantitative study.

AIM: To examine the effectiveness of a comprehensive diabetes education class on improving nurses' self-efficacy in glycemic management and physician communication, with a focus on using the SMILE (Sugar Trend, Medications, Intravenous fluid, Labs, and Eating) SBAR (Situation, Background, Assessment, Recommendation) as a communication tool. The secondary aim of this study was to investigate the translation of knowledge into practice, in this case, inpatient glycemic control. BACKGROUND: Inpatient glycemic management for patients living with diabetes can be challenging. Therefore, as patient advocates, nurses must be able to identify what clinical data warrants a call to the physician to facilitate timely decisions and interventions. METHODS: Data was collected from a purposive sample of 28 registered nurses from a single general medicine unit. A t-test was used to analyze nurses' pretest-posttest perceptions of self-efficacy in nine content areas. Kruskal-Wallis H analysis was also conducted on patients' median blood glucose values over four months (July-October 2023). RESULTS: The results suggest the class was effective in improving nurses' perceived knowledge and self-efficacy in all nine content areas, with the highest mean difference increase of 1.46 for I have sufficient knowledge regarding the SMILE SBAR and [will] use it as a tool for communicating with the physician, p < 0.05. A comparison of 403 patients' median blood glucose values were also statistically significantly different across four months, χ2(3) = 21.088, p < 0.0001. CONCLUSIONS: Continued efforts to prevent and manage inpatient glycemic control should focus on enhancing nurse-physician communication and teamwork with simple yet effective tools such as the SMILE SBAR.

Comparison of the SBAR method and modified handover model on handover quality and nurse perception in the emergency department: a quasi-experimental study.

BACKGROUND: Effective information transfer during nursing shift handover is a crucial component of safe care in the emergency department (ED). Examining nursing handover models shows that they are frequently associated with errors. Disadvantages of the SBAR handover model include uncertainty of nursing staff regarding transfer of responsibility and non-confidentiality of patient information. To increase reliability of handover, written forms and templates can be used in addition to oral handover by the bedside. AIMS: The purpose of this study is to compare the 'Situation, Background, Assessment, Recommendation (SBAR) method and modified handover model on the handover quality and nurse perception of shift handover in the ED. METHODS: This research was designed as a semi-experimental study, with census survey method used for sampling. In order to collect data, Nurse Perception of Hanover Questionnaire (NPHQ) and Handover Quality Rating Tool (HQRT) were used after translating and confirming validity and reliability used to direct/collect data. A total of 31 nurses working in the ED received training on the modified shift handover model in a one-hour theory session and three hands-on bedside training sessions. This model was implemented by the nurses for one month. Data was analyzed with SPSS (version 26) using paired t-tests and analysis of covariance. RESULTS: Results indicated significant difference between the modified handover model and SBAR in components of information transfer (P < 0.001), shared understanding (P < 0.001), working atmosphere (P = 0.004), handover quality (P < 0.001), and nurse perception of handover (P < 0.001). The univariate covariance test did not show demographic variables to be significantly correlated with handover perception or handover quality in SBAR and modified methods (P > 0.05). CONCLUSIONS: The results of this study can be presented to nursing managers as a guide in improving the quality of nursing care via implementing and applying the modified handover model in the nursing handover. The resistance of nurses against executing a new handover method was one of the limitations of the research, which was resolved by explanation of the plan and goals, as well as the cooperation of the hospital matron, and the ward supervisor. It is suggested to carry out a similar investigation in other hospital departments and contrast the outcomes with those obtained in the current study.

Implementation and Evaluation of the SBAR Communication Model in Nursing Handover by Pediatric Surgery Nurses.

PURPOSE: Situation, Background, Assessment, Recommendations (SBAR) is recommended as a standardized model to improve communication between health professionals and increase patient safety. Correct use of the SBAR model reduces communication errors, facilitates rapid decision-making, and increases patient safety. Therefore, effective use of the SBAR model among health care professionals contributes to safer patients. This study examines the implementation and evaluation of the SBAR communication model in nursing handover by pediatric surgical nurses. DESIGN: The study had a pretest-post-test semi-experimental design. METHODS: Data were collected between April 1 and June 30, 2022 from 24 nurses, who worked at two pediatric surgery units of a training research hospital in Turkey. Ethical approval and written informed consent were obtained prior to the study. FINDINGS: The mean age of the nurses was 26.00 ± 3.43 years and 75% were female. The mean score obtained from the handover rating scale was 60.33 ± 11.11 (18 to 70). The pretest and post-test scores obtained from the SBAR communication model questionnaire were 60.00 ± 20.64 (20 to 90) and 92.50 ± 9.89 (60 to 100), respectively. 66.7% of the nurses answered no to the statement "Using the SBAR communication model did not contribute positively to the handover." The majority answered yes to the items other than this statement, the ratio of those who answered yes and no to the statement "The SBAR communication model caused me to waste time during the handover" was equal, and the majority completed the SBAR handover form. CONCLUSIONS: Some of the nurses felt that the SBAR communication model made a positive contribution to shift performance, while others felt that it did not. Although half of the nurses considered the SBAR communication model to be a waste of time, it was observed that no negative events occurred during the use of the model and that the nurses were willing to use the SBAR communication model. Therefore, it is recommended that in-service training programs be organized to increase the use of the SBAR communication model and that the use of SBAR should be continuously reviewed and improved.

Transferring critical pediatric patients from emergency department to intensive care: A quality improvement initiative.

BACKGROUND: Transfer of care, moving hospitalized patients between care areas, is a critical point of vulnerability for healthcare organizations. Patient information handoff is an essential activity occurring frequently in hospital environments. Poor communication has been linked with adverse events and poor patient outcomes. This evidence-based quality project aimed to enhance the handoff process between the Emergency Department (ED) and Pediatric Intensive Care Unit (PICU) by standardizing transfer of care steps. This was accomplished through customizing a reporting tool to contain all the information the receiving department deemed necessary for safe patient care. METHODS: A customized situation, background, assessment, recommendation (SBAR) form handoff tool was developed for ED to PICU transfers. This SBAR tool included information that PICU nurses identified as critical to transfer of care. Nurse perceptions were surveyed pre- and post-implementation. Patient safety event reports were tracked to evaluate events related to transfer of care before and after the practice change. FINDINGS: An increased number of PICU nurses agreed the customized handoff tool was complete and organized. Additionally, more nurses agreed that handoff gave all information needed to safely care for critically ill patients transferred from the ED. Lastly, bedside patient checks increased, and patient safety events related to transfer of care decreased. DISCUSSION: This project demonstrated that implementation of a standardized transfer of care process coupled with a customized handoff tool increased PICU nurse perceptions that handoff was organized, and all information needed to safely care for critically ill patients was conveyed. APPLICATION TO PRACTICE: Transfer of care processes between the ED and PICU should be standardized. The use of customized tools may improve information exchange between nurses and ensure that all vital patient information is communicated.

Effectiveness of the SBAR-Based training program in self-efficacy and clinical decision-making of undergraduate anesthesiology nursing students: a quasi-experimental study.

BACKGROUND: Structured Situation, Background, Assessment, and Recommendation (SBAR) training technique have been widely utilized in clinical and educational settings. Therefore, the current study investigated the effectiveness of an SBAR-based educational program in students' self-efficacy and clinical decision-making skills. METHODS: This quasi-experimental study was conducted using a pretest and posttest design and a control group at Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. A total of 70 three- and fourth-year students were recruited for the study using the census method. The students were randomly assigned to the intervention and control groups. The intervention group participated in an SBAR-based educational course consisting of eight sessions held in 4 weeks. Differences in the levels of self-efficacy and clinical decision-making skills before and after participation in the SBAR course were assessed and compared. Data were analyzed using descriptive tests, the Mann-Whiney U test, paired and independent t-tests, and the Wilcoxon test. RESULTS: The intervention group demonstrated significantly higher levels of self-efficacy with a mean score of 140.66 ± 22.43 (P < 0.001) and clinical decision-making with a mean score of 75.31 ± 7.72 (P < 0.001); while in the control group, the mean score of self-efficacy and clinical decision-making skills was 85.34 ± 18.15 and 65.51 ± 4.49, respectively. Moreover, the Mann-Whitney U test showed that the levels of students' clinical decision-making skills were promoted to the next level after the intervention (P < 0.001); it means the distribution of the level of intuitive-interpretive skill was upgraded from 0 to 22.9%. CONCLUSION: The SBAR-based training programs can promote the self-efficacy and clinical decision-making skills of anesthesiology nursing students. Considering the weakness of the anesthesiology nursing curriculum at the undergraduate level in Iran, it can be expected that the SBAR-based training course should be included as an educational intervention in the curriculum of anesthesiology nursing students.

Exploring interprofessional communication during nursing home emergencies using the SBAR framework.

Communication breakdowns during emergencies threaten patient safety. In nursing homes (NHs) vulnerable residents may experience emergencies at any time. Concerns over clinical complexity and diverse communication styles among interprofessional practitioners heighten the need for standardized methods to improve practitioners' communication skills. This study explores communication structures among 32 practitioners in four NHs using in-depth interviews following a formalized Situation-Background-Assessment-Recommendation (SBAR) framework. Network analysis, a deductive approach to qualitative data analysis, and case analysis were performed for a comprehensive understanding of interprofessional communication in 48 emergency cases identified during interviews. Findings identified the flow of information, messaging, and management strategies that were expected of receivers during interprofessional communication. These results could help develop training regimens or guidelines to improve cooperative interprofessional communication, allowing practitioners to provide appropriate emergency care for NH residents.

The effect of distraction on the quality of patient handoff: a randomized study.

OBJECTIVE: The number of patient handoffs has increased in recent years. In addition, technology has advanced in the medical field, leading to most providers carrying smartphones at work. Little is known about the effect of mobile devices and quality of patient handoffs. The objective of this study was to determine whether distraction affects the quality of sign-out among obstetrical providers. DESIGN: A randomized, prospective study was conducted. SETTING: Hospital. PARTICIPANTS INTERVENTION: Obstetrical providers listened to a recorded sign-out vignette. Provider groups either were or were not exposed to a distraction while listening to the vignette. All providers had been told that they would be participating in a trial of two methods of sign-out, although in actuality they were all assigned to a single method. In the distraction arm, the participants were exposed to a 'distracting event' (a phone ring, which was answered by the proctor and followed by a brief conversation) that occurred midway through the vignette. MAIN OUTCOME MEASURE: Providers answered a 14-question survey testing recall of facts included in the vignette. The results of each group were analyzed using Fisher's exact test and Student's t-test. RESULTS: Eighty-eight providers were randomized, 44 in the distraction group and 44 in the non-distracted group. The average scores on the survey were similar between groups (11.0 and 10.8, P = 0.57). In addition, the average scores for questions that occurred after the distraction did not differ between the distracted and non-distracted groups (6.4 vs 6.2, P = 0.42). CONCLUSIONS: We observed that a phone ring and brief response did not affect the obstetrical providers' recall of details of a standardized sign-out. More studies are warranted to determine if more frequent or longer distractions would change results.

Increasing Patient Safety in Hemodialysis Units by Improving Handoff Communication.

This quality improvement project aimed to increase patient safety by preventing errors through improving staff handoff communication in an outpatient hemodialysis unit. Lewin's theory of planned change was applied. Staff familiarity with the situation-background-assessment-recommendation (SBAR) communication format was assessed. Education regarding SBAR format and supporting tools was provided to staff prior to implementing the SBAR handoff format. Safety incidences were compared pre- and post-implementation. Data analysis supported a statistically significant improvement in reported error rates post implementation (p = 0.000). Implementing a standardized handoff communication form provided a mechanism for improving patient safety.

[Structured patient handovers in perioperative medicine : Rationale and implementation in clinical practice]. / Strukturierte Patientenübergabe in der perioperativen Medizin : Rationale und Umsetzung in der klinischen Praxis.

Clear and consistent communication is pivotal for well-functioning teamwork, in operating theatres as well as intensive care units. However, patient handovers significantly vary between specialties and locations. If communication is not well structured, it might increase the risk for mishaps and malpractice. Therefore, implementing structured handover protocols is pivotal. The perioperative setting is a high-risk environment that is prone to communication failures due to operational design (frequent change of shift due to working time restrictions) and a high work load and multitasking (operating room management, short surgery times, concurrent emergencies). Hence teamwork in the operating room and intensive care unit requires clear and consistent communication. In the perioperative setting, the patient is transferred several times: from the ward to operating room, to recovery, intermediate care/intensive care unit and back to normal ward. This necessitates multiple handovers. Since 2005, the World Health Organization (WHO) requests a structured handover concept that processes all relevant information in a predefined order. The SBAR concept (situation, background, assessment, recommendation) is an intuitive communication concept that can improve quality of patient handovers. This underlines the clinical relevance of a structured handover concept that leads to improved outcomes for every patient.In this review, basic measures for a clear and consistent communication are presented. These are pivotal for an effective teamwork and for ensuing patient safety. Furthermore, we will focus on possibilities to implement structured approaches but also on potential barriers of implementation. Communication failure among different health care providers can be identified more easily and hopefully can be eliminated.

Structured Handover in the Pediatric Postanesthesia Care Unit.

PURPOSE: To establish a structured handover in the pediatric postanesthesia care unit. DESIGN: An observational prequality and postquality improvement design was used. METHODS: Convenience samples of 52 preimplementation and 51 postimplementation handover interactions (N = 103) were observed and compared to a 42-item Introductions, Situation, Background, Assessment, Recommendations, & Questions checklist. Patient care team members' satisfaction was assessed using voluntary electronic surveys. Data were analyzed for descriptive measures and differences in the pre- and postchecklist, and satisfaction total scores were compared using a two-sample t test. FINDING: The implementation of the handover checklist resulted in a statistically significant increase in the percentage of items discussed during five of six handover phases (P < .001). Overall, a significant increase in provider satisfaction was demonstrated from preimplementation to postimplementation (P < .01). The average duration of handover (in minutes) was not significantly different from pre (mean = 5.80 ± 3.80) to post (mean = 6.80 ± 2.30), P = .15. CONCLUSIONS: A structured handover checklist is associated with increased communication of handover content information and improved provider satisfaction. No statistically significant effect on handover duration time was found.

The effect of simulation on skill performance: a need for change in pediatric nursing education.

BACKGROUND: This study sought to determine if student's performance of safety skills improved following a simulated educational experience. METHODS: Further analysis of data from a quasi-experimental design (n=73) was examined to identify if student's skill performance improved following a simulated educational intervention. RESULTS: Students did show an improvement in skill performance, but even after the intervention over half the students did not assess patient identification, over half did not administer medications safely, and students struggled with communicating nursing recommendations. CONCLUSION: Further research needs to focus on skill performance and assessing students' ability to provide safe nursing care.

The development and implementation of an inter-professional simulation based pediatric acute care curriculum for ward health care providers.

An interprofessional, simulation based, acute care course for ward health care providers was developed and implemented with the objectives of teaching identification of deteriorating patients, practicing crisis resource management and basic life support skills, and using the SBAR (Situation Background Assessment Recommendation) communication tool. Thirty-eight physicians and 51 nurses attended the four separate courses. Nine questions on a 5-point Likert scale and two open-ended questions revealed that over 95% of respondents strongly agreed/agreed that facilitators encouraged active participation, lectures were presented in an interesting manner, and that simulations were useful for practical skills and for practicing communication. Open-ended questions revealed that participants felt more confident, understood the importance of communication, roles, teamwork and valued the day. Based on this evaluation, the program was regarded as feasible and acceptable to all health care providers.

Situation, Background, Assessment, and Recommendation-Guided Huddles Improve Communication and Teamwork in the Emergency Department.

PROBLEM: Thousands of people die annually in hospitals because of poor communication and teamwork between health care team members. Standardized tools and strategies help increase the amount and quality of communication. Two structured communication methods include implementing huddles and the use of the situation, background, assessment, and recommendation (SBAR) communication framework. METHODS: To improve communication among nurse practitioners and registered nurses within a pediatric emergency department, a performance-improvement project with the structured processes of a joint patient evaluation and huddle was implemented. Data were gathered from 32 nurses and 2 nurse practitioners using structured observation and pre- and post-implementation surveys. The following outcomes were measured: presence or absence of joint patient evaluation and SBAR-guided huddle, verbalization of treatment plan, communication, teamwork, and nurse satisfaction. RESULTS: Eighty-three percent of patient encounters included a joint evaluation. A huddle structured with SBAR was conducted 86% of the time. Registered nurses and nurse practitioners verbalized patients' treatment plans in 89% of cases and 97% of cases, respectively. Improved teamwork, communication, and nursing satisfaction scores were demonstrated among the nurse practitioners and registered nurses. IMPLICATIONS FOR PRACTICE: This project showed the feasibility of a simple and inexpensive joint nurse practitioner-registered nurse patient evaluation followed by a structured huddle, which improved communication, teamwork, and nurse satisfaction scores. This performance-improvement project has the potential to enhance efficiency by reducing redundancy, as well as to improve patient safety through the use of structured communication techniques.

Effect of empathy nursing combined with SBAR communication system on the negative emotions and nursing quality of children with tracheotomy.

BACKGROUND: Situation, Background, Assessment, and Recommendation (SBAR) is a structured method for communicating critical information that requires immediate attention and action. OBJECTIVE: To study the effects of empathy nursing combined with the SBAR communication system on the negative emotions and nursing quality of children undergoing tracheotomy. METHODS: This is a clinical observational study. A total of 100 tracheotomy patients who were cared for in the pediatric intensive care unit (subsequent treatment in the tracheotomy clinic or otolaryngology ward) of our hospital from September 2021 to June 2022 were recruited and assigned at a ratio of 1:1 either into a control group (empathic care) or an observation group (empathic care combined with SBAR) using a randomized method. Further, the postoperative anxiety self-rating scale scores, negative emotions, hope index, and nursing quality were compared between the two groups. RESULTS: After nursing, the psychological resilience scale score of the observation group was higher than that of the control group, whereas the anxiety self-rating scale score was significantly lower than that of the control group (all P< 0.05). Basic and special nursing, knowledge awareness, and safety management of the two groups of patients improved significantly, with higher results in the observation group than in the control group (P< 0.05). CONCLUSION: Empathy nursing combined with the SBAR communication system considerably improves postoperative negative emotions and enhances the quality of nursing care for patients undergoing tracheotomy.

Evaluation of a training program using the SBAR communication tool for caregivers managing acute respiratory distress in lung cancer patients: A pilot randomized controlled trial protocol.

Background: Family-based caregivers are increasingly important in the management of non-hospitalized lung cancer patients. However, lack of training can negatively impact care including diagnostic errors that can lead to delays in providing appropriate medical treatment. Acute respiratory failure (ARF) is common symptom of lung cancer and requires urgent intervention as well as adequate communication with healthcare professionals (HCPs) to enable appropriate decision-making and improve patient outcomes. Standardized tools such as the Situation, Background, Assessment, Recommendation (SBAR) tool and its French adaptation SAED, standing for Situation, Antécédent, Évaluation et Demande, are designed to facilitate communication among (HCPs).Additionally, digital interventions, such as serious games, are increasingly used to train HCPs though its use for caregivers has not been studied. This pilot study aims to assess an innovative serious game training using the SAED tool combined with standard instructions on self-efficacy for family-based caregivers of lung cancer patients when facing a simulated situation of ARF. The study also aims to examine caregivers' emotional state, quality of life, satisfaction and knowledge about the SBAR tool. Methods: A monocentric, randomized, controlled, open-label, superiority, parallel-arm trial will be conducted for 18 months with 3 mid-study assessments (NCT05839353). Family caregivers of lung cancer patients will be recruited at the University Hospital Center of Saint Pierre, Reunion Island, France. Participants will be randomized (1:1) into two groups: the experimental group receiving training using the SBAR/SAED tool and standard instructions for managing respiratory distress/dyspnea, and the control group, receiving standard instructions only. The primary outcome will be to determine perceived self-efficacy as measured by the Generalized Self-Efficacy Scale. Discussion: This study will present a preliminary assessment of training family caregivers in using the SBAR/SAED tool in simulated episodes of ARF in lung cancer patients. Our findings may provide valuable insights into effective training methods for caregivers in critical home care situations and could be widely used for lung cancer management.

A survey on the effects of patient safety training programs based on SBAR and FMEA techniques on the level of self-efficacy and observance of patient safety culture in Iran hospital, Shiraz in 2022-2023.

BACKGROUND AND OBJECTIVE: Patient safety and medical personnel self-efficacy are among the main factors involved in providing quality health services. Moreover, safety culture in an organization is considered one of the most critical factors regarding patients' safety. Therefore, the present study aimed to determine the effects of patient safety programs based on Situation, Background, Assessment, Recommendation (SBAR) and Failure Model Effects Analysis (FMEA) techniques on self-efficacy and patient safety culture in Iran Hospital of Shiraz in 2022-2023. MATERIALS AND METHODS: This two-stage quasi-experimental study was conducted in 2022-2033. Considering inclusion criteria, the present study included 80 nurses working in Iran Hospital. The participants were divided into groups of SBAR (40 participants) and FMEA (40 participants). All the data were collected using a Hospital Survey on Patient Safety Culture questionnaire and Sherer General Self-Efficacy Scale. Then, the collected data were analyzed using SPSS 13, Fisher's exact test, paired t-test, and independent t-test with a significant level of P < 0.05. RESULTS: The mean score of total patient safety culture between the two groups was insignificant before the intervention (P = 0.58). However, it was more significant in the FMEA group than the SBAR group after the intervention (P < 0/05). In addition, the mean self-efficacy score between the two groups was insignificant before the intervention (P = 0.80). However, after the intervention, the mean score of the FMEA group was significantly higher than the SBAR group (P < 0.05). CONCLUSION: According to the findings of this study, there is a meaningful relationship between patient safety training programs based on SBAR and FMEA techniques on patient safety and self-efficacy of nurses; however, FMEA training has more positive effects on self-efficacy and patient safety compared to other techniques. As a result, these techniques, along with other plans, are recommended to authorities in order to help improve patient safety.

Improved recall of handover information in a simulated emergency - A randomised controlled trial.

Background: Handovers during medical emergencies are challenging due to time-critical, dynamic and oftentimes unorderly and distracting situations. We evaluated the effect of distraction-reduced clinical surroundings during handover on (1) the recall of handover information, (2) the recall of information from the surroundings and (3) self-reported workload in a simulated in-hospital cardiac arrest scenario. Methods: In a parallel group design, emergency team leaders were randomly assigned to receive a structured handover of a cardio-pulmonary resuscitation (CPR) either inside the room ("inside group") right next to the ongoing CPR or in front of the room ("outside group") with no audio-visual distractions from the ongoing CPR. Based on the concept of situation awareness, the primary outcome was a handover score for the content of the handover (0-19 points) derived from the pieces of information given during handover. Furthermore, we assessed team leaders' perception of their surroundings during the scenario (0-5 points) and they rated their subjective workload using the NASA Task Load Index. Results: The outside group (n = 30) showed significant better recall of handover information than the inside group (n = 30; mean difference = 1.86, 95% CI = 0.67 to 3.06, p = 0.003). The perception of the surroundings (n = 60; mean difference = -0.27, 95% CI = -0.85 to 0.32, p = 0.365) and the NASA Task Load Index (n = 58; mean difference = 1.1; p = 0.112) did not differ between the groups. Conclusions: Concerning in-hospital emergencies, a structured handover in a distraction reduced environment can improve information uptake of the team leader.

Improving the Accuracy of the Gynaecology Handover Process: An Effective Quality Improvement Project at a University Hospital in the United Kingdom.

Objectives The objective of this study was to introduce a new system of handover in the gynaecology department and ensure its effectiveness with dynamic improvement measures. This was launched as a quality improvement project in a district general hospital in the United Kingdom. The primary aim was to start and consolidate a new system of a separate gynaecology handover in the presence of consultants, registrars (incoming and outgoing), senior house officers (incoming and outgoing) and gynaecology nurses. Design The strategy for consolidation included a daily quality review on the basis of a fixed proforma, identifying the obstacles faced, and improvising dynamic solutions. A new quality check proforma was introduced which took into account: (i) Presence of team members, (ii) Following of proper SBAR (Situation, Background, Assessment, Recommendation) format in the handover, (iii) Updating of patients awaiting surgeries with every detail on the list, (iv) Proper handing over of pending referrals, (v) Mention of sick patients with proper importance, and (vi) Proper handing over of new admissions. A pilot study was done to evaluate the baseline performance of the unit regarding the gynaecology team handover on the basis of the same proforma. The result of the baseline study was noted as the reference. Each day the team receiving the handover was interviewed for the next five months about the quality of each of the parameters on the predesigned proforma and the responses were noted. The answers were designed in binary form (Yes/No). These results were compiled at the end of each month. The result from each individual month was reviewed and the problems were identified and practical solutions were applied. These changes were noted and plotted graphically as a bar diagram. The monthly audit results were tabulated in an Excel sheet (Microsoft Corporation, Redmond, Washington, United States). Results Pilot study results and final month results were compared with the help of the Mcnemar test and statistically significant improvement was noticed in seven out of eleven parameters. There was a steady and gradual improvement in the responses. The possible limitations of the study were also noted at the same time. Conclusion The quality improvement project was highly effective in improving the quality of handover and increased patient safety to a large extent.

Surgical Handover Core Outcome Measures (SH-CORE): a protocol for the development of a core outcome set for trials in surgical handover.

BACKGROUND: Surgical handover is associated with a significant risk of care failures. Existing research displays methodological deficiencies and little consensus on the outcomes that should be used to evaluate interventions in this area. This paper reports a protocol to develop a core outcome set (COS) to support standardisation, comparability, and evidence synthesis in future studies of surgical handover between doctors. METHODS: This study adheres to the Core Outcome Measures in Effectiveness Trials (COMET) initiative guidance for COS development, including the COS-Standards for Development (COS-STAD) and Reporting (COS-STAR) recommendations. It has been registered prospectively on the COMET database and will be led by an international steering group that includes surgical healthcare professionals, researchers, and patient and public partners. An initial list of reported outcomes was generated through a systematic review of interventions to improve surgical handover (PROSPERO: CRD42022363198). Findings of a qualitative evidence synthesis of patient and public perspectives on handover will augment this list, followed by a real-time Delphi survey involving all stakeholder groups. Each Delphi participant will then be invited to take part in at least one online consensus meeting to finalise the COS. ETHICS AND DISSEMINATION: This study was approved by the Royal College of Surgeons in Ireland (RCSI) Research Ethics Committee (202309015, 7th November 2023). Results will be presented at surgical scientific meetings and submitted to a peer-reviewed journal. A plain English summary will be disseminated through national websites and social media. The authors aim to integrate the COS into the handover curriculum of the Irish national surgical training body and ensure it is shared internationally with other postgraduate surgical training programmes. Collaborators will be encouraged to share the findings with relevant national health service functions and national bodies. DISCUSSION: This study will represent the first published COS for interventions to improve surgical handover, the first use of a real-time Delphi survey in a surgical context, and will support the generation of better-quality evidence to inform best practice. TRIAL REGISTRATION: Core Outcome Measures in Effectiveness Trials (COMET) initiative 2675.  http://www.comet-initiative.org/Studies/Details/2675 .