Cardiac handover to PICU
Transfer of complex patients between different services has been identified as a risk area for patient care. This document aims to formalise the handover process, delegate responsibilities, and act as a template to ensure all vital patient information is handed over.
Transfer of complex patients between different services has been identified as a risk area for patient care.
This document aims to formalise the handover process, delegate responsibilities, and act as a template to ensure all vital patient information is handed over.
The 3 parts of the handover are:
Technology Transfer
Information Handover
Discussion and Plan
These are performed sequentially and each must be completed before going onto the next.
Technology Transfer
The team sets up the equipment
| 1. | Ventilation is configured, confirmed and turned on | Anaesthetist |
| 2. | Monitoring Tram is connected to PICU monitor | Technician |
| 3. | Visually check transducer level | Patient Nurse |
| 4. | Drains are connected to suction | Nurse 1 |
| 5. | Heat table (as required) is plugged in and turned on | Nurse 2 |
This is ALL that is done upon patient arrival in PICU unless immediate patient intervention is required
Safety Check
The Anaesthetist makes the following checks once the equipment setup is complete prior to verbal handover:
Equipment is appropriately configured and plugged in
The patient is appropriately ventilated
The patient is appropriately monitored
The patient's condition is stable
The receiving nurse and doctor have been identified and have confirmed their readiness to proceed
The handover of information or case-related discussions should not start until the safety check is satisfactorily completed.
Information Handover
The Anaesthetist speaks alone and uninterrupted, providing the relevant information according to the PICU Handover Checklist. The anaesthetist will confirm the transfer of information is complete
The Surgeon speaks alone and uninterrupted, providing any further relevant surgical information. The surgeon will confirm the transfer of information is complete
Safety check
The receiving nurse and doctor should use the PICU Handover Checklist to check that all necessary information has been obtained.
Discussion and Plan
The Surgeon, Anaesthetist and PICU Team should discuss the case as a group.
Anticipated problems should be identified
Anticipated recovery should be discussed from the following options:
Wake and wean
Review in 2-6 hours
Leave ventilated over night aiming for "stability"
ECMO high risk (pump circuit should be primed)
The PICU Team now have responsibility for patient care
The PICU Team reassess patient status:
Check that monitoring and support are appropriate
The patient plan is re-confirmed
Chest x-ray ordered and reviewed
Additional tests are done as appropriate
Complete handover tasks, e.g. zero pressure transducers, zero and detangle pumps, label chest drains
The PICU Consultant / Registrar (± Surgeon) or PICU Nurse update family
The patient care strategy should be reviewed at the evening ward round. Anticipated problems and pathway of recovery strategy should be set up for the night team.
PICU Handover Checklist
Download a printable copy of the PICU handover checklist here.