Our Summary

This research paper focuses on the transfer of patient care among doctors, specifically for pediatric heart surgery patients. The study examined a specific process, called ‘handover’, that involves passing the necessary information about a patient from one clinician to another, usually when a patient is moved from one area of the hospital to another. This process can often lead to medical errors.

The researchers wanted to test if a standardized ‘protocolized’ handover process, using a checklist, could reduce these errors and also if this improved process could be maintained over time. The study was conducted at a children’s hospital in the US, where the researchers observed the handovers of 119 patients being moved from the operating room to the intensive care unit after heart surgery.

The study found that the number of technical errors and missed information significantly reduced when using the checklist in the handover process. Importantly, this improvement was still seen in the ‘sustainability phase’ of the study, showing that this improved process can be effectively maintained over time.

In simpler terms, the study found that using a checklist when transferring kids from heart surgery to intensive care can help reduce mistakes. Plus, doctors kept on using this improved process over time, which is good news for patient safety.

FAQs

  1. What is the ‘handover’ process in pediatric heart surgery patient care?
  2. How can a standardized ‘protocolized’ handover process improve patient safety?
  3. Did the study find that the improvement in the handover process was maintained over time?

Doctor’s Tip

Therefore, a helpful tip a doctor might tell a patient about pediatric cardiac surgery is to ensure that all medical staff involved in the care of their child use a standardized checklist during the handover process. This can help ensure that important information is not missed and reduce the risk of errors during the transfer of care. It is important for parents to advocate for their child’s safety and ask about the use of checklists during handovers to help prevent medical errors.

Suitable For

Pediatric cardiac surgery patients are typically recommended for surgery if they have congenital heart defects, acquired heart conditions, or other heart-related issues that require surgical intervention. These patients may include infants, children, and adolescents with conditions such as:

  • Ventricular septal defects
  • Atrial septal defects
  • Tetralogy of Fallot
  • Transposition of the great arteries
  • Hypoplastic left heart syndrome
  • Coarctation of the aorta
  • Pulmonary stenosis
  • Aortic stenosis
  • Coronary artery anomalies
  • Cardiomyopathy
  • Arrhythmias

These patients may experience symptoms such as difficulty breathing, poor feeding, cyanosis (bluish skin color), fatigue, chest pain, or palpitations. Pediatric cardiac surgery is recommended to improve the patient’s quality of life, prevent complications, and reduce the risk of long-term heart damage.

It is important for pediatric cardiac surgery patients to be evaluated by a multidisciplinary team of pediatric cardiologists, cardiac surgeons, anesthesiologists, and other specialists to determine the best treatment plan. The decision to recommend surgery is based on the specific diagnosis, the severity of the condition, the patient’s age and overall health, and the potential benefits and risks of surgery.

Timeline

Before pediatric cardiac surgery:

  • Patient is diagnosed with a heart condition and recommended to undergo surgery
  • Preoperative assessment and preparation, including medical history review, physical examination, and tests such as blood work and imaging
  • Consultation with pediatric cardiologist, cardiac surgeon, and anesthesiologist to discuss the surgery and potential risks
  • Consent for surgery obtained from parents or legal guardians
  • Patient admitted to the hospital on the day of surgery

After pediatric cardiac surgery:

  • Patient undergoes surgery in the operating room under general anesthesia
  • Transfer to the intensive care unit (ICU) for postoperative care and monitoring
  • Handover process where information about the patient’s surgery, condition, medications, and care plan is passed on from the surgical team to the ICU team
  • Continuous monitoring of vital signs, pain management, and assessment for any complications
  • Gradual recovery and transition to a regular hospital room
  • Rehabilitation and follow-up care with the pediatric cardiologist and cardiac surgeon
  • Discharge from the hospital with instructions for at-home care and follow-up appointments

Overall, the timeline for a pediatric cardiac surgery patient involves thorough preoperative preparation, the surgical procedure itself, postoperative care in the ICU, and ongoing monitoring and follow-up to ensure a successful recovery.

What to Ask Your Doctor

Some questions a patient should ask their doctor about pediatric cardiac surgery include:

  1. What is the specific procedure you will be performing on my child’s heart?
  2. What are the potential risks and complications associated with this surgery?
  3. How experienced are you and your team in performing pediatric cardiac surgeries?
  4. How long will the recovery process be for my child?
  5. What follow-up care will be needed after the surgery?
  6. Are there any long-term effects or lifestyle changes my child may need to make after the surgery?
  7. How will pain management be handled for my child after the surgery?
  8. What is the success rate of this type of surgery in pediatric patients?
  9. Are there any alternative treatment options to consider?
  10. Can you explain the handover process and how information about my child’s care will be communicated between doctors and nurses during the transfer from the operating room to the intensive care unit?

Reference

Authors: Chenault K, Moga MA, Shin M, Petersen E, Backer C, De Oliveira GS Jr, Suresh S. Journal: Paediatr Anaesth. 2016 May;26(5):488-94. doi: 10.1111/pan.12878. Epub 2016 Mar 21. PMID: 26997082