Implementation of a Standardized Handoff Report for Nurse Anesthetists in the Intra- Operative Setting: A Quality Improvement Project

Abstract

The anesthetic period is a dynamic moment in patient care, and the role of anesthesia providers during anesthesia handoff carries a tremendous amount of responsibility. The operating room environment offers an additional layer of complexity and distractions during anesthesia handoff. The purpose of this Doctor of Nursing Practice project was to assess anesthesia providers' perceptions of adequacy of the PATIENT mnemonic to facilitate standardized handoffs of anesthetized patients. The goal was to gain a better understanding of CRNA perceptions of this method in order to assess its usefulness as a handoff checklist in the transfer of care. This quality improvement project was conducted in the operating rooms of an outpatient surgery center located in the southeastern region of the United States. A pre-and post-survey design was used to complete a single plan, do, study, act cycle to assess perceptions of a standardized anesthesia handoff checklist among a nonrandomized convenience sample of CRNAs who volunteered to participate in the project. The CRNAs reported in the post-implementation survey that the PATIENT mnemonic was easy to use but not more efficient, comprehensive, or appropriate in length compared to their personally used handoff methods. There was a net neutral response regarding whether the tool was more time consuming, lent itself to errors, and overall satisfaction using the mnemonic. Limitations included a small sample size and number of survey responses. Recommendations for future study involve CRNA collaboration in the creation of an anesthesia handoff checklist as well as anesthesia handoff project champions.