A Standardized Handoff Simulation Promotes Recovery From Auditory Distractions in Resident Physicians

作者：Matern Lukas H; Farnan Jeanne M; Hirsch Kristen W; Cappaert Melissa; Byrne Ellen S; Arora Vineet M^*

来源：Simulation in Healthcare-Journal of the Society for Simulation in Healthcare, 2018, 13(4): 233-238.

DOI：10.1097/SIH.0000000000000322

• Handoffs
• patient safety
• graduate medical education
• simulation

Introduction Despite the increasing use of training simulations to teach and assess resident handoffs, simulations that approximate realistic hospital conditions with distractions are lacking. This study explores the effects of a novel simulation-based training intervention on resident handoff performance in the face of prevalent hospital interruptions.
Methods After a preliminary educational module, entering postgraduate year 1 residents (interns) completed one of the following three handoff simulations: (1) no interruption, (2) hospital noise, or (3) noise and pager interruptions. Trained receivers rated interns using an evidence-based Handoff Behaviors Checklist and a previously validated Handoff Mini-Clinical Examination Exercise instrument.
Results Of 127 eligible interns, 125 (98.4%) completed an online preparatory module and a handoff simulation. Interns receiving auditory interruptions were less likely to be heard adequately (48.8% noise and 71.8% noise + pager vs. 100.0% uninterrupted, P < 0.001) and scored lower on establishing appropriate handoff settings (5.7 2.3 noise and 6.2 +/- 1.8 noise + pager vs. 8.0 +/- 0.8 uninterrupted, P < 0.001). Interns receiving noise only shared a written sign-out document more effectively (71.1% vs. 30.2% uninterrupted and 43.6% noise + pager, P < 0.001). There were no differences in averaged performance metrics on the Handoff Behaviors Checklist.
Discussion While common hospital interruptions created nonideal circumstances for the handoff, interns receiving interruptions were rated similarly and recovered effectively. However, interns exposed to noise only used the written sign-out form more actively. Our findings suggest that this intervention was successful in promoting handoff proficiency despite exposure to common but significant hospital interruptions.

• 出版日期2018-8