Handoff Communication: A Survey Study of What Anesthesia Providers need to Know

Abstract

Purpose: The transfer of patient care between healthcare providers commonly referred to as handoff is a complex process that may lead to serious adverse consequences for patients or institutions if not conducted properly. The purpose of this scholarly project was to determine the knowledge level of Certified Registered Nurse Anesthetists (CRNAs) relating to best practices during patient handoffs, and to develop a PowerPoint Presentation intended to close knowledge gaps relating to best practices for patient handoffs. To achieve this objective, a survey of CRNAs was performed. Survey results were used to determine if CRNAs are in settings that facilitate their ability to practice within the American Association of Nurse Anesthetists’ (AANA) Standards of Practice (SOP) with regards to handoffs and their knowledge regarding The Joint Commission (TJC) recommendation on effective handoff procedures. Barriers that prevent CRNAs for performing an effective and efficient handoff were investigated. Methods: This project utilized an online survey. The development and electronic mailing of a questionnaire was distributed via Qualtrics®, to practicing CRNAs. The survey questionnaire was anonymous and comprised of 26 questions. CRNAs responded to questions regarding their knowledge and awareness of handoff recommendations, tools available for handoffs, tools currently utilized, and standards of practice regarding handoffs. The survey questions were meant to elicit CRNAs understanding of the current handoff practices, identify information thought to be crucial to communicate to enhance efficient handoff from one provider to another, and assess for knowledge gaps among the CRNAs in handoff processes. A review of the literature was performed. Information obtained from the literature review and survey results was utilized to develop a power point presentation to enhance knowledge and awareness. Results: Production pressure/time constrains was the most cited factor hindering CRNAs from performing appropriate handoffs (25.3%). 30% of the respondents strongly agreed that they were in environments that allowed them to practice according to the AANA standards of practice. 31.8% were not aware if their department had a handoff policy/procedure. 66.2% of the respondents strongly agreed that for a handoff to be safe and effective it should be, incorporated in the Electronic Medical Record (EMR), use a checklist, and allow time for questions and answers. Conclusions: Effective communication among caregivers is critical to seamless handoffs that result in safe, high quality care through analyzing key processes from the perspective of both the sender and the receiver. Survey results suggests there is room for improvement in CRNAs knowledge regarding the handoff process. Poor communication and abbreviated or incomplete handoff resulted in poor patient outcomes. Awareness of the SOP was below 65%, with nearly 26% respondents reporting they had never reviewed the SOP. This indicates a need to close the knowledge gap among the CRNAs on the standards regarding transfer of care. Data Sources: ProQuest, Medscape, PubMed, Cochrane Library, CINAHL, Joint Commission websites, and Google Search. Keywords: Anesthesia Handoffs, JC recommendations, Handoff tools, Standardized Checklist, Standards of Practice.