The pitfalls of postoperative theatre to intensive care unit handovers: a review of the current literature

Abstract

Postoperative handovers present a critical step in the management of intensive care unit (ICU) patients. There are many challenges in the transportation of unstable patients with complex medical histories from theatre to the ICU, and the subsequent transfer of responsibility for care from one group of caregivers to another. Communication between the providers of the handover report (anaesthetists, surgeons and theatre nursing staff) and receivers of the report (ICU physicians and ICU nursing staff) is often poor. The unstructured presentation of information, the noisy ICU environment, and discussions between healthcare workers from different disciplines at different levels of training adds to the burden of communication. The handover report may be seen as a sentinel event in the ICU patient’s stay. ICU staff use the handover process as an important source of information to coordinate management input from multiple disciplines. Despite its importance, the practice of a structured postoperative handover protocol in our region’s hospitals is non existent. The authors reviewed the current literature to better understand the challenges facing proper handover processes and suggest some interventional strategies.