Search

There should be a named lead consultant for the PACU (see Glossary).¹⁸⁵

Processes for the communication and implementation of patient safety alerts should be in place.

Patients should be transferred to the ward, the postoperative care environment or the critical care unit accompanied by two members of staff, at least one of whom should be suitably trained to locally agreed standards.²⁰¹ The anaesthetic record, recovery and prescription charts together with the postoperative plan, should accompany the patient and be clearly communicated to the receiving ward nurse.

Handover, including on moving to the postoperative care environment or to the ICU, should always be to a member of staff who is competent to care for the patient at that time, and this should be clearly documented.²⁰²

All handovers should be structured to ensure continuity of care.^8,203

Staff should complete urgent tasks before information transfer, limiting conversations while performing these tasks (adopting a ‘sterile cockpit’ approach see Glossary).^204,205

If responsibility for care is transferred from one anaesthetist to another, a ‘handover protocol’ should be followed, during which all relevant information concerning the patient’s medical history, medical condition, anaesthetic status, and plan should be communicated.¹⁸²

Standardisation of the handover process can improve patient care by ensuring information completeness, accuracy and efficiency (the use of checklists should be considered). Staff should comply with the local standardised handover processes.^192,206

There should be an established policy to ensure clear communication of continuing requirements at discharge (e.g. analgesia) to include communication with primary care. This should include written information about common concerns (restarting medication, driving, etc.) and how to contact the hospital when required post discharge. Surgical teams will ordinarily be responsible for most of this process.

The particular needs of children should be considered at all stages of perioperative care. Children should receive an appropriate preassessment from staff with appropriate paediatric experience.²⁰⁷