OR Manager - February 2020 - 17

Periop nursing
* IPASS-Illness severity, Patient
summary, Action items, Situation
awareness and contingency planning,
Synthesis by receiver (http://
www.ipassstudygroup.com).
Dr Lane-Fall notes that clinicians
need to know what they are expected
to provide for each section of
the
mnemonic. A 2017 study of the use
of SBAR for intraoperative handoffs
found that on average, each handoff
addressed only 67% of the four components,
with the frequency of SBAR
components used differing by role type.
Spruce recommends that OR leaders
ensure that the handoff process
includes the following:
* assigning the roles and responsibilities
of team members
* individualizing the handoff for the
specific patient population (eg, child,
adult) and level of acuity (eg, severity
of symptoms, complexity of surgery,
comorbid conditions)
* notifying the receiving team member
that the patient is being transferred
and citing the potential equipment
needs before the patient's arrival
* completing urgent tasks before starting
the handoff
* limiting the handoff conversation to
patient-specific discussions
* allowing only one person to speak at
a time
* keeping distractions and interruptions
(such as personal conversations)
to a minimum, with only urgent
clinical interruptions allowed
* using supporting documentation
such as laboratory test results
* providing an opportunity for participants
to voice concerns and ask
questions.
Putting good handoff practices in
place helps OR leaders meet regulatory
requirements and can improve the bottom
line by bolstering efficiency. But the
most important purpose of the handoff
is at the heart of what leaders, physicians,
and staff alike want to achieve-
quality patient care. ✥
www.ormanager.com
Cynthia Saver, MS, RN, is president of
CLS Development, Inc, Columbia, Maryland,
which provides editorial services to
healthcare publications.
References
Agarwala A, Lane-Fall M, Greilich P E,
et al. Consensus recommendations
for the conduct, training, implementation,
and research of perioperative
handoffs. Anesth Analg.
2019;128(5):e71-e78.
Agarwala A, Lane-Fall M. The evidence
base for optimal conduct
of handoffs. Anesthesia Patient
Safety Foundation Newsletter.
2017;32(2):36-39.
Chatterjee S, Shake J G, Arora R C,
et al. Handoffs from the operating
room to the intensive care unit after
cardiothoracic surgery: From the
Society of Thoracic Surgeons WorkTools
in action
Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center in Nashville,
Tennessee, uses a flow sheet to ensure that all team members clearly understand
the handoff process.
" The recommendations are one of the most important parts of SBAR [Situation,
Background, Assessment, Recommendation], " says Amanda Lorinc, MD, assistant
professor in the division of pediatric anesthesiology. " They are focused on 'what
should we expect,' 'what should we be worried about,' and 'what do you want us to do
or not to do.' " Without SBAR, it's easy to miss those key points.
This checklist is one of the tools used by the OR and neonatal ICU teams.
Check List
1. ICU MD/NP
 Patient ID/armband check
 Pertinent History
 End Organ Dysfunction
 Abnormal labs
 Most worried about....
 NPO Status
 Ht/Wt (Dosing & Actual)
 Allergies
2. Bedside RN (continued)
 Infusions
 Access
 Airway
 Meds due
 Drains, tubes
 Anyone have any questions?  Family (concerns, location)
2. Bedside RN
3. OR RN
 Consent/H&P
4. Anesthesia MD
 Post-operative plan, Questions?
Source: Monroe Carell Jr Children's Hospital at Vanderbilt University Medical Center.
Used with permission.
force on Critical Care. Ann Thorac
Surg. 2019;107(2):619-630.
Hawthorne H, Cohen T, Common W.
Assessing SBAR during intraoperative
handoff. Periop Care Operating
Room Manag. 2017;6:7-10.
Joint Commission. Sentinel Event
Alert: Inadequate hand-off communication.
2017. https://
www.jointcommission.org/assets/1/18/SEA_58_Hand_off_
Comms_9_6_17_FINAL_(1).pdf.
Patterson
E S, Roth E M, Woods D
D, et al. Handoff strategies in settings
with high consequences for
failure: Lessons for health care
operations. Int J Qual Health Care.
2004;16:125-132.
Terekhov M A, Ehrenfeld J M, Dutton R
P, et al. Intraoperative care transitions
are not associated with postoperative
adverse outcomes. Anesthesiology.
2016;125(4):690-699.
OR Manager | February 2020 17

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OR Manager - February 2020

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