Lost information during the handover of critically injured trauma patients: a mixed-methods study

Abstract

Trauma patient information was lost during handover from the ED to the ICU for multiple reasons. An interprofessional approach was proposed to improve handover through cross-unit familiarisation and use of communication tools is proposed. Going beyond traditional geographical and temporal boundaries was deemed important for improving patient safety during the ED to ICU handover.

Challenges of patient handover process in healthcare services: A systematic review

“…Most studies have focused on handover communication challenges;[10111213141516171819202122] other studies have also stated the importance of coordination between the incoming and outgoing nurses. [232425] Another research showed the importance of using a checklist in handover process and suggested that applying checklist could improve intrahospital transport of intensive care patient to other floors.…”

“…[23] There was also information that was written but not transmitted by the outgoing nurse to the incoming nurse, as well as the information transmitted but not recorded and often some information removed or not completed during transfer which could lead to the patient injury or damage the care process. [10171822] It is suggested that a standard protocol or policy and procedure should be used to ensure that both handover process management and communication are improved. [20] Carroll et al in their research found that incoming nurse wanted eye contact and opportunity for question, but these same features are experienced as interruptions and problems for the outgoing nurse who wants to transfer care and get to go home.…”

Staff perceptions of best practice for information transfer about multitrauma patients on discharge from the emergency department: a focus group study

“…A recent, similar study focussing on lost clinical information during the transfer of trauma patients from the ED to ICU found that injuries were missed in 24% of patients and that information discrepancies occurred in 48% of handovers (Zakrison et al . ). Causes of these discrepancies varied from patients having unknown medical histories, variability in handover structure, processes and quality, role discrepancy in relation to handover among disciplines, a lack of understanding of context between ED and ICU and flow disruptions in communication (Zakrison et al .…”

“…Causes of these discrepancies varied from patients having unknown medical histories, variability in handover structure, processes and quality, role discrepancy in relation to handover among disciplines, a lack of understanding of context between ED and ICU and flow disruptions in communication (Zakrison et al . ). Solutions focused on improving the whole process of handover between ED and ICU and a consideration of the impact of organisational system aspects, including culture (Zakrison et al .…”

“…Solutions focused on improving the whole process of handover between ED and ICU and a consideration of the impact of organisational system aspects, including culture (Zakrison et al . ). As such, it is essential to understand the process of information transfer for multitrauma patients from the perspective of the clinicians involved, which was an aim of this study.…”