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Intensive Care Medicine
Published in: Intensive Care Medicine 4/2015

Open Access 01-04-2015 | Systematic Review

Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge

Authors: Nelleke van Sluisveld, Gijs Hesselink, Johannes Gerardus van der Hoeven, Gert Westert, Hub Wollersheim, Marieke Zegers

Published in: Intensive Care Medicine | Issue 4/2015

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Abstract

Purpose

To systematically review and evaluate the effectiveness of interventions in order to improve the safety and efficiency of patient handover between intensive care unit (ICU) and general ward healthcare professionals at ICU discharge.

Methods

PubMed, CINAHL, PsycINFO, EMBASE, Web of Science, and the Cochrane Library were searched for intervention studies with the aim to improve clinical handover between ICU and general ward healthcare professionals that had been published up to and including June 2013. The methods for article inclusion and data analysis were pre-specified and aligned with recommendations outlined in the PRISMA guideline. Two reviewers independently extracted data (study purpose, setting, population, method of sampling, sample size, intervention characteristics, outcome, and implementation activities) and assessed the quality of the included studies.

Results

From the 6,591 citations initially extracted from the six databases, we included 11 studies in this review. Of these, six (55 %) reported statistically significant effects. Effective interventions included liaison nurses to improve communication and coordination of care and forms to facilitate timely, complete and accurate handover information. Effective interventions resulted in improved continuity of care (e.g., reduced discharge delay) and in reduced adverse events. Inconsistent effects were observed for use of care, namely, reduction of length of stay versus increase of readmissions to higher care. No statistically significant effects were found in the reduction of mortality. The overall methodological quality of the 11 studies reviewed was relatively low, with an average score of 4.5 out of 11 points.

Conclusions

This review shows that liaison nurses and handover forms are promising interventions to improve the quality of patient handover between the ICU and general ward. More robust evidence is needed on the effectiveness of interventions aiming to improve ICU handover and supportive implementation strategies.
Appendix
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Metadata
Title
Improving clinical handover between intensive care unit and general ward professionals at intensive care unit discharge
Authors
Nelleke van Sluisveld
Gijs Hesselink
Johannes Gerardus van der Hoeven
Gert Westert
Hub Wollersheim
Marieke Zegers
Publication date
01-04-2015
Publisher
Springer Berlin Heidelberg
Published in
Intensive Care Medicine / Issue 4/2015
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-015-3666-8

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