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{
    "pk": 13814,
    "title": "Prospective Observational Multisite Study of Handover in the Emergency Department: Theory versus Practice",
    "subtitle": null,
    "abstract": "Introduction:\n The handover process in the emergency department (ED) is relevant for patient outcomes and lays the foundation for adequate patient care. The aim of this study was to examine the current prehospital to ED handover practice with regard to content, structure, and scope.\nMethods:\n We carried out a prospective, multicenter observational study using a specifically developed checklist. The steps of the handover process in the ED were documented in relation to qualification of the emergency medical services (EMS) staff, disease severity, injury patterns, and treatment priority.\nResults:\n We documented and evaluated 721 handovers based on the checklist. According to ISBAR (Identification, Situation, Background, Assessment, Recommendation), MIST (Mechanism, Injuries, Signs/Symptoms, Treatment), and BAUM (Situation [German: Bestand], Anamnesis, Examination [German: Untersuchung], Measures), almost all handovers showed a deficit in structure and scope (99.4%). The age of the patient was reported 339 times (47.0%) at the time of handover. The time of the emergency onset was reported in 272 cases (37.7%). The following vital signs were transferred more frequently for resuscitation room patients than for treatment room patients: blood pressure (BP)/(all comparisons p < 0.05), heart rate (HR), oxygen saturation (SpO2) and Glasgow Coma Scale (GCS). Physicians transmitted these vital signs more frequently than paramedics BP, HR, SpO2, and GCS. A handover with a complete ABCDE algorithm (Airway, Breathing, Circulation, Disability, Environment/Exposure) took place only 31 times (4.3%). There was a significant difference between the occupational groups (p < 0.05).\nConclusion:\n Despite many studies on handover standardization, there is a remarkable inconsistency in the transfer of information. A “hand-off bundle” must be created to standardize the handover process, consisting of a uniform mnemonic accompanied by education of staff, training, and an audit process.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Emergency Medicine"
        },
        {
            "word": "emergency department"
        },
        {
            "word": "hand-over"
        },
        {
            "word": "hand-off"
        },
        {
            "word": "mnemonic"
        }
    ],
    "section": "Emergency Department Operations",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/9nn6t99p",
    "frozenauthors": [
        {
            "first_name": "Philipp",
            "middle_name": "",
            "last_name": "Ehlers",
            "name_suffix": "",
            "institution": "University Hospital Bonn, Department of Emergency Medicine, Bonn, Germany",
            "department": "None"
        },
        {
            "first_name": "Matthias",
            "middle_name": "",
            "last_name": "Seidel",
            "name_suffix": "",
            "institution": "University Hospital Bonn, Department of Emergency Medicine, Bonn, Germany",
            "department": "None"
        },
        {
            "first_name": "Sylvia",
            "middle_name": "",
            "last_name": "Schacher",
            "name_suffix": "",
            "institution": "Hospital Köln Kalk, Department of Emergency Medicine, Cologne, Germany",
            "department": "None"
        },
        {
            "first_name": "Martin",
            "middle_name": "",
            "last_name": "Pin",
            "name_suffix": "",
            "institution": "Hospital Florence Nightingale Düsseldorf, Department of Emergency Medicine, Düsseldorf, Germany",
            "department": "None"
        },
        {
            "first_name": "Rolf",
            "middle_name": "",
            "last_name": "Fimmers",
            "name_suffix": "",
            "institution": "University Hospital Bonn, Institute for Medical Biometry, Informatics and Epidemiology, Bonn, Germany",
            "department": "None"
        },
        {
            "first_name": "Monika",
            "middle_name": "",
            "last_name": "Kogej",
            "name_suffix": "",
            "institution": "University Hospital Bonn, Department of Emergency Medicine, Bonn, Germany",
            "department": "None"
        },
        {
            "first_name": "Ingo",
            "middle_name": "",
            "last_name": "Gräff",
            "name_suffix": "",
            "institution": "University Hospital Bonn, Department of Emergency Medicine, Bonn, Germany",
            "department": "None"
        }
    ],
    "date_submitted": "2020-04-23T16:04:11Z",
    "date_accepted": "2020-04-23T16:04:11Z",
    "date_published": "2021-01-12T08:00:00Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/13814/galley/7196/download/"
        }
    ]
}