After critical appraisal, eight articles were chosen and included in this review. These tools were used to evaluate research and non-research evidence and determine quality of such in relation to this topic. These eight articles had over 230 references combined; one article searched literature on the subject for the past 25 years. Critical appraisal of this information led to many positive findings in relation to implementation of a standardized handoff process in relation to many positive outcomes. However, studies also addressed that findings may not be conclusive enough to offset possible financial burdens incurred with introduction of standardized handoffs at organizational levels. Compliance of providers with use of the handoff process was also a concern. Through a detailed appraisal of the eight chosen articles, positive and negative findings were identified and …show more content…
In many of the studies, there is an observer who monitored the handoff processes and this may contribute to observer bias, especially if the observer has an interest in a positive outcome (Agarwala et al., 2015). This observer could also contribute to the “presence of a Hawthorne effect, namely that the quality of handoffs was affected by the mere presence of observers” (Agarwala et al., 2015, p. 103). Raiten, et al. (2015) address the financial considerations of standardizing the handoff process; although an improved handoff process could help prevent medical errors, and save millions of dollars every year, there is still not sufficient data to support this. Robbins and Dai (2015) explain that limiting the number of handoffs in a hospital setting is difficult due many factors including nursing shifts, operating room schedules, work hours, and the multiple patient handoffs encountered in this setting. Often in the operating room setting, the anesthesia provider who begins the case is often not the same provider who ends the case and transports the patient to the PACU; information is especially particular to degradation in these situations with multiple providers (Robins & Dai, 2015).