To Improve the Quality of Paediatric Handovers by Introducing a New Safety Handover Tool and using Modified SBAR Based Handovers

Background: This Quality Improvement project was conducted with a view to improve the quality of morning handovers in a high turnover paediatric environment. The national recommendations suggest inclusion of a “sick” handover prior to the main handover to allow for a system risk assessment¹. Our aim was to create a new safety tool, and to introduce a new Modified SBAR (Situation, Background, Assessment, Recommendations) method to increase handover efficiency.

Objectives: The objectives were to increase the usage of new safety tool and Modified SBAR and in the morning handovers in the paediatric unit.

Methods: We conducted a pre-intervention questionnaire to assess the deficiencies in the existing SBAR based handovers. We then devised a new pre-handover safety tool called “SSSS” to discuss the number of Sick patients, Spacing, Staffing levels and Similar sounding names. Also, a new Modified SBAR handover method to include only relevant details of the patients was introduced. The senior trainees were trained in the use of the new handover tools. Two study cycles were conducted which involved modifications to the existing handover sheet. Post-intervention staff survey was done to see the results.

Results: The uptake of the SSSS tool was 85% and that of the Modified SBAR handover was 100% at the end of the study period. All the parameters to assess handover safety increased. Handover effectiveness increased from 81% to 95%.

Conclusions: We believe SSSS tool and modified SBAR based handovers are a new way to handover sick paediatric patients. This will also help to minimise errors and improve patient safety. We recommend their use in emergency and acute paediatrics settings for the future.

¹https://www.rcpch.ac.uk/sites/default/files/2018-03/facing_the_future_standards_for_acute_general_paediatric_services.pdf