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Is it acceptable for a nurse anesthetist to give handoff reports to the PACU RN?

Monday May 21, 2012
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Question:

Dear Nancy,

Is it acceptable for a nurse anesthetist to give handoff reports to the PACU RN? We have a physician in our ambulatory surgical center who would like the RN in the room to bring the next patient into the OR, while the CRNA takes the last patient out and gives the report. I think the RN should go with the CRNA and give the handoff report to the PACU RN.

Ava



Nancy Brent replies:

Dear Ava,

A handoff of a patient, defined as any time there is a transfer of responsibility from one caregiver to another, in order to provide accurate and timely information about the patient's care plan, treatment, current condition and any recent or anticipated change, ("Patient Handoffs" by Lee Ann Runy, 2008, Hospital & Health Networks), is a critical aspect of patient care and patient safety. Indeed, the Joint Commission's National Patient Safety Goal 02.05.01 (2009) supports the importance of consistent and established protocols and policies for patient handoffs.

The Association of periOperative Registered Nurses, along with the U.S. Department of Defense Patient Safety Program, developed a Patient Hand Off Tool Kit for use in the perioperative department. The tool kit is available on the AORN website at www.aorn./org. Click on the Clinical Practice tab, then on Tool Kits from the drop-down menu. There is a wealth of information about handoffs that will be helpful. Also, the association's Perianesthesia Nursing Standards and Practice Recommendations for 2010-2012, would be helpful to you and to the other team members in your ambulatory center.

The association recommends that when a patient is transferred from the perioperative area to the PACU, the anesthesia provider, along with the OR nurse, should provide required information to the PACU RN. Moreover, the Joint Commission requires that in addition to information giving, the anesthesia provider and the OR nurse have the opportunity for discussion with the PACU RN (Kost and Odom-Forren, "Caring For The Postanesthesia Patient," CE module, located at ce.Nurse.com/Ce115-60/Caring-for-the-postanesthesia-patient/Coursepage, Accessed May 20, 2012, citations omitted).

In your situation, it seems the OR nurse and the CRNA should accompany the patient to the PACU. However, that handoff should not occur at the expense of the next patient coming into the surgical area. An OR nurse should be ready to take the information from the nurse who hands off that patient to him or her when that next patient comes into the area for surgery.

Attempting to change patterns of practice, or one or two team members' minds on this issue may be difficult, but having solid standards of practice for perioperative nurses in hand, along with any other standards for ambulatory surgery centers in your state, might help with needed changes in current practices about which you have concerns.

Regards,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.