Standardized Post Anesthesia Handovers by Certified Registered Nurse Anesthetists: An Exploration of Barriers to Implementation

Abstract

Introduction: Numerous studies show benefits to the standardization of a post anesthesia handover process, yet little research has investigated the degree Certified Registered Nurse Anesthetists (CRNAs) incorporate them into their daily practice nor identified obstacles that may prevent their implementation.

Purpose: To explore the extent CRNAs use standardized post anesthesia handovers in the Post Anesthesia Care Unit (PACU) and to investigate barriers to implementation.

Methods: The study used a quantitative descriptive research design. A denovo data collection tool (titled ‘Standardized Post-anesthesia Handover Procedures Assessment Tool’) was developed and validated for survey distribution to 3000 CRNA members of the American Association of Nurse Anesthetists (AANA). Surveys were disseminated between February-March2019.

Results: A total of 243 CRNAs completed the survey. Utilization of a mandated standardized post anesthesia handovers was 30.4% (n=73); 17.5% (n=42) indicated their facility post anesthesia handover was mandated but non-standardized while 52.1% (n=125) had no mandated handover in place. Significantly more CRNAs utilized their standardized post anesthesia handover procedure 100% of the time compared to the non-standardized group (p=0.001). Barriers to post anesthesia handover implementation that emerged from the research included: disagreement with handover adequacy (p=0.005), disagreement to likelihood of using handover with incentives provided (p=0.008), disagreement to easy access (p=0.005), disagreeing to handover that is easy/simple to use (p

Conclusions: Despite evidence-based research promoting handover standardization, a notable amount of CRNAs have no mandated post anesthesia handover (standardized or non-standardized) in place at their current facility. This study highlights key implementation barriers and provides recommendations to aid future handover standardization initiatives. Further research needs to examine the barriers and facilitators of handover implementation.