6557 Optimising neonatal handovers: have you done a STARS neonatal handover?

Objectives Issues with handover communication have been shown to be a significant factor leading to death and poor outcomes for mothers and babies in the UK.¹ A study found 52% of handovers were missing core clinical components, leading to potentially doubling the adverse outcomes.² We aimed to improve the telephone handovers that occur inter-professionally between midwives and the neonatal team, to better prepare the neonatal team for anticipated deliveries. Methods The neonatal doctors designed a google form to assess the deemed necessary information to know prior to attending an imminent delivery. Core components included gestation of baby (term or preterm), mode of delivery, risk factors for sepsis and whether senior support was required. Doctors carrying the delivery bleep were asked to complete a google form to assess if this information was given during the telephone handover. 20 forms were collected over 2 weeks. The neonatal team then designed a pneumonic-structured telephone handover tool for the use of the labour ward team, STARS, representing only the necessary information required prior to attendance of delivery. Teaching was given to the labour ward and neonatal teams for the use of STARS handover, and posters (figure 1) were placed around labour ward. The telephone handovers were re-assessed after 2 months of teaching, using a second google form with a similar format to the first assessment. 21 forms were collected over 2 weeks. We also collected verbal feedback from midwifery staff during our education sessions on labour ward. Results Overall, the results showed an improvement in key components of the neonatal handover, with an increase in the percentage of telephone handovers that included baby's gestation, risk factors for sepsis, and whether registrar attendance is required [tables 1 and 2]. The key component that did not show an improvement was 'type of delivery'. The verbal feedback from midwifery staff was positive – they felt that it would help junior staff, particularly students, know what information to handover to neonates via phone. They felt that a template would be helpful to prepare STARS information in advance. Conclusion We feel that the STARS handover is more tailored to maternity services than the standard SBAR handover. We are now introducing ''re-writable'' laminated posters [figure 2] for each delivery room, and plan to complete a second PDSA cycle to study the effect of this intervention. We are thankful for the support of our midwifery colleagues in this project. References Spranzi, F, Norton C. From handover to takeover: should we consider a new conceptual model of communication? British Journal of Midwifery 2020. Anoush, et al. Interdisciplinary handover between obstetric nursing and neonatal physician teams: an observational study. BMJ Paediatrics Open 2019.