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

BACKGROUND The anesthesia recovery period after gastrointestinal surgery is a critical stage with a high risk of hypothermia, agitation, infusion failure, and other adverse events. Delayed or incomplete transfer of key information during handover may result in missed risks, inappropriate management, and compromised patient safety. Current handover practices vary widely and lack standardized, quantifiable indicators tailored to gastrointestinal surgery. This study was conducted to address these gaps by developing and validating a structured safety handover management system. The hypothesis was that a standardized indicator-based system would improve handover quality and reduce postoperative adverse events. AIM To construct and validate a safety handover indicator system for patients undergoing gastrointestinal surgery in the anesthesia recovery period. METHODS This observational study included 500 patients recovering from gastrointestinal surgery at a tertiary hospital from June 2024 to June 2025. A preliminary handover indicator system was developed through literature review, semi-structured interviews, and Delphi consultation. Indicator weights were determined using the analytic hierarchy process. The system was applied to 250 patients and compared with 250 patients receiving conventional handover. Outcomes included handover time, omission rate, complication incidence, adverse events, and staff satisfaction. Statistical analysis used χ 2 and t -tests. RESULTS Expert engagement in both Delphi rounds was 100%, with authority coefficients of 0.87 and 0.89, respectively. Kendall's harmony coefficient increased from 0.216 to 0.331 (both P < 0.01). The final system comprised three first-level, 12 second-level, and 38 third-level indicators. Compared with the control group, the experimental group showed longer handover time but markedly lower omission rate. Rates of hypothermia, agitation, and infusion failure were significantly reduced (all P < 0.05), and staff satisfaction scores were higher across all dimensions (P < 0.001). CONCLUSION The validated safety handover system standardizes postoperative transfer in gastrointestinal surgery, reduces errors and adverse events, and enhances patient safety and workflow efficiency, supporting its suitability for clinical implementation.