Navigating the Path to a Sustainable "PACU Pause" and Standardized Perioperative Handoff: A Quality Improvement Project

J Perianesth Nurs. 2022 Feb;37(1):44-47. doi: 10.1016/j.jopan.2021.06.104. Epub 2021 Nov 19.


Purpose: The purpose of this project was to develop and implement a pause and standardized perioperative handoff to improve the quality of the handoff and the satisfaction of the perioperative team in the postanesthesia care unit (PACU) setting.

Design: The Iowa Model for Evidence-Based Practice guided this evidence-based practice-quality improvement project.

Methods: A team was formed of key nurses and other perioperative members to execute the project. The outcome of the evidence review, appraisal, and synthesis supported the change to a pause and standardized perioperative handoff. The project team educated perioperative staff on the practice change and new process. Baseline, 3-month and 1-year data were collected for adherence to the PACU PAUSE and handoff critical elements, and baseline and 3-months for satisfaction.

Findings: PACU PAUSE adherence was 42.30% prepractice change, 92.3% postchange and 96.10% at 1-year. Adherence to the 17 critical elements in the standardized handoff was 40.16% prepractice change, 77.36% postchange and 71.78% at 1-year. Nurse satisfaction with the PACU PAUSE and handoff increased 59% and 50% respectively from pre to postpractice change. Operating room nurse and anesthesia provider satisfaction with PACU PAUSE and handoffs was greater than 85% at baseline and increased 14% and 8% respectively.

Conclusions: The PACU PAUSE allows for increased nurse concentration during the handoff and this can improve patient safety. Using a standardized handoff in situation, background, assessment, response format can decrease information loss and miscommunication, improve the quality of the handoff and the perioperative team members satisfaction with the handoff, and may mitigate patient safety events.

Keywords: OR patient handoff; patient handoffs; patient handovers; perioperative handover; postanesthesia handover.

MeSH terms

  • Anesthesia*
  • Anesthesiology*
  • Humans
  • Patient Handoff*
  • Patient Safety
  • Quality Improvement