Developing a standardized safety handover system for post-anesthesia patients in gastrointestinal surgery: Construction and validation

Table 1 Level 1 and level 2 indicators and weights of the safety handover management system

Primary indicator and weight	Secondary indicator and weight	Composite weight
A1: Pre-handover preparation (0.3512)	B1: Completeness of patient information preparation (0.4015)	0.1411
	B2: Preparation of drugs/supplies/equipment (0.3287)	0.1155
	B3: Environment and personnel readiness (0.2698)	0.0948
A2: Handover process execution (0.4635)	B4: Accurate patient identification (0.2150)	0.0997
	B5: Completeness of intra-operative status transfer (0.1832)	0.0849
	B6: Handover of vital signs and level of consciousness (0.1714)	0.0794
	B7: Tubing check and secure fixation (0.1555)	0.0721
	B8: Fluid balance and medication summary (0.1349)	0.0625
	B9: Skin integrity and belongings transfer (0.0751)	0.0348
	B10: Special issues and key medical orders (0.0649)	0.0301
A3: Post-handover verification (0.1853)	B11: Information recheck and clarification of doubts (0.6328)	0.1172
	B12: Mutual signature and documentation (0.3672)	0.0681

Table 2 Importance scores and weights for selected level 3 indicators

Level 2 indicator	Level 3 indicator	Importance score (mean ± SD)	Weight
B4: Accurate patient identification	Use at least two methods to verify identity (name, hospital ID)	4.95 ± 0.22	0.402
	Check wristband information	4.85 ± 0.37	0.318
	Verify operative site and procedure	4.75 ± 0.44	0.280
B7: Tubing check and secure fixation	Name, insertion depth, and fixation of each tube (drains, NG, CVC, etc.)	4.90 ± 0.31	0.256
	Confirm drain patency and characteristics/volume of drainage	4.95 ± 0.22	0.294
	IV access patent; insertion site without leakage or swelling	4.80 ± 0.41	0.235
	Oxygen catheter/mask patent and properly secured	4.60 ± 0.50	0.215
B11: Information recheck and clarification of doubts	Receiving nurse repeats key data (blood loss, special drugs, allergies)	4.75 ± 0.44	0.421
	Handover staff confirm or correct the repeated information	4.70 ± 0.47	0.342
	Both parties immediately clarify any discrepancies and reach agreement	4.85 ± 0.37	0.237

IV: Intravenous; CVC: Central venous catheter; NG: Nasogastric; SD: Standard deviation.

Table 3 Baseline data comparison between the two patient groups, n (%)

Group	n	Sex		Age (years)	Surgery time (minutes)	ASA			Types of surgery
		Male	Female			II	Ⅲ	IV	Open-abdominal surgery	Laparoscopic
Experimental	250	142 (56.80)	108 (43.20)	58.76 ± 8.23	182.54 ± 35.63	48 (19.20)	152 (60.80)	50 (20.00)	95 (38.00)	155 (62.00)
Control	250	139 (55.60)	111 (44.40)	57.95 ± 9.14	178.96 ± 35.26	52 (20.80)	146 (58.40)	52 (20.80)	88 (35.20)	(64.80)
χ2/t	-	0.073		1.091	1.239	0.218			0.456
P value	-	0.787		0.276	0.216	0.897			0.500

ASA: American Society of Anesthesiologists.

Table 4 Expert consultation results

Round	Questionnaires distributed	Valid responses	Valid response rate	Expert authority coefficient	Kendall’s W	χ2 value	P value
1	20	20	100	0.87	0.216	135.24	< 0.001
2	20	20	100	0.89	0.331	207.51	< 0.001

Table 5 Comparison of handover quality indicators between the two patient groups

Group	n	Handover time (minutes)	Information omission rate (%)
Experimental	250	9.86 ± 1.83	3.28 ± 1.57
Control	250	8.52 ± 2.15	15.86 ± 4.34
t-value	-	8.624	45.217
P value	-	< 0.001	< 0.001

Table 6 Comparison of complication and adverse event incidence during the anesthesia recovery period, n (%)

Group	n	Hypothermia	Agitation	Nausea/vomiting	Respiratory depression	Unplanned extubation	Infusion failure	Pressure ulcer
Experimental	250	35 (14.00)	28 (11.20)	33 (13.20)	5 (2.00)	0 (0.00)	4 (1.60)	1 (0.40)
Control	250	68 (27.20)	55 (22.00)	42 (16.80)	8 (3.20)	2 (0.80)	15 (6.00)	3 (1.20)
χ2 value	-	15.789	11.429	1.563	0.714	2.008	7.143	1.026
P value	-	< 0.001	0.001	0.211	0.398	0.156	0.008	0.311

Table 7 Comparison of handover satisfaction among medical staff in the two groups

Group	n	Process clarity	Information completeness	Work efficiency	Overall security	Total score
Experimental	30	90.22 ± 5.35	93.66 ± 4.14	85.45 ± 6.83	92.51 ± 5.02	90.43 ± 4.56
Control	30	76.43 ± 8.26	72.81 ± 9.58	70.69 ± 10.14	75.27 ± 8.75	73.88 ± 7.64
t-value	-	7.892	11.234	6.543	9.876	10.123
P value	-	< 0.001	< 0.001	< 0.001	< 0.001	< 0.001