ABSTRACT
OBJECTIVE: To compare the incidence, severity, preventability, and contributing factors of non-routine events-deviations from optimal care based on the clinical situation-associated with team-based, nurse-to-nurse, and mixed handovers in a large cohort of surgical neonates. STUDY DESIGN: A prospective observational study and one-time cross-sectional provider survey were conducted at one urban academic children's hospital. 130 non-cardiac surgical cases in 109 neonates who received pre- and post-operative NICU care. RESULTS: The incidence of clinician-reported NREs was high (101/130 cases, 78%) but did not differ significantly across acuity-tailored neonatal handover practices. National Surgical Quality Improvement-Pediatric occurrences of major morbidity were significantly higher (p < 0.001) in direct team handovers than indirect nursing or mixed handovers. CONCLUSIONS: NREs occur at a high rate and are of variable severity in neonatal perioperative care. NRE rates and contributory factors were homogenous across handover types. Surveyed clinicians recommend structured handovers for all patients at every transfer point regardless of acuity.
Subject(s)
Intensive Care Units, Neonatal , Patient Handoff/statistics & numerical data , Patient Safety , Perioperative Care/standards , Quality Improvement/organization & administration , Cross-Sectional Studies , Female , Hospitals, Pediatric , Humans , Infant, Newborn , Male , Prospective StudiesABSTRACT
The purpose of this forum was to discuss with consumers having spinal cord injury what their research priorities would be for the field of functional electrical stimulation (FES) and to explore the impact of technology in the lives of people with disabilities. Both FES users and nonusers were included on the panel. The format for the discussion was primarily question and answer, with each participant giving his or her personal response to the moderator's question. Consumer research priorities depended on the individual and his or her personal priorities, preferences, background, history, and level of injury. Common themes that emerged were independence, ease of movement, ease of control, and spontaneity. From the consumers' perspective, the focus of research to restore function ought to be based on the needs and desires of the consumer, not just on the scientifically intriguing aspects of a particular technology.
