Moni̇tori̇ng of postoperati̇ve pati̇ent handovers wi̇th information transfer and communication assessment tool for surgery

This research was conducted with methodological and qualitative approach in two stages, with the aim of monitoring patient handover by means of the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3) The sample of the first stage of the research was constituted by 296 postoperative handovers, the second stage was constituted by four anesthesists and six postoperative care unit nurses from Ege University Department of General Surgery, between March 27 and May 02, 2016. Informed consent forms, socio-demoraphic and occupational features forms and the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3) were used for data collection. The Information Transfer and Communication Assessment Tool For Surgery (ITCAS Checklist 3) (Appendix III), is a tool that is used to monitor the delivery of the patient from the operating room to the postoperative care unit after an operation. The necessary permissions to use the tool were obtained (Appendix V). In the first phase of the research to ensure the validity of the language of the tool, translation to Turkish language, back translation and pre-application were performed(n=10). After expert opinion was obtained, the data was analyzed via the Content Validity Index (CVI). In the assessment process, the acceptable score average of each item was calculated to be over 3. Its language validity having been done, the tool was used for post-operation patient handover at Ege University Medical Faculty Hospital Department of Surgery and the occupancy was assessed according to delivery dates and in its own right. In the second phase of the study, semi structured (in-depth) interviews were performed with Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3) users with a qualitative approach. For the in-depth interviews, four main themes and sub-themes for each main theme were ascertained. The first main theme consisted of the main theme 'patient handover before Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3)' and the sub-themes 'defective delivery, non-standard patient handover, lack of communication during delivery, and workload'. The second main theme was the positive aspects of the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3). The sub-themes for this main theme were 'improvment of communication, standardized patient handover, enhancement of patient safety, applications for the benefit of the nurse, decreased workload, what the post-operative care unit nurses should be handed over and the opportunity for the anesthesist to further monitor the patient after surgery'. The third main theme was the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3). This main theme had sub-themes which are 'being perceived as loss of time and extra workload, that the surgical team do not participate in patient handover and that the checklist should be more descriptive. The effectiveness of patient handover using the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3) was the fourth main theme. It was made up of the sub-themes 'standardizing the patient handover, increasing the communication among the team, the awareness of the nurses working in the post-operative care unit and the anesthesists about delivering the information about the patients and gaining continuity for this application' in terms of the surgeon, nurse, patient safety and familiarization with the patient beforehand. In conclusion, it was detected that patient handover using the Information Transfer and Communication Assessment Tool for Surgery (ITCAS Checklist 3) is effective. It was also found out that it is more effectual to perform the written patient handovers via chairside checklists. Keywords: Patient handover, ITCAS checklist 3, Surgical patient