Handoff Communication

Abstract

Handoff communication is a high-risk process that causes errors that lead to ineffective care delivery and patient safety breaches. A failure modes and effects analysis was utilized to proactively evaluate handoff through a risk priority scoring process that focused the improvement plan on communication from shift to shift and between units. The electronic medical record was utilized to standardize the handoff tool in SBAR (situation, background, assessment, and recommendation) format for both nurses and patient care technicians. Key concepts of Jean Watson's caring model were incorporated into workflow, along with team huddles, to hardwire team communication and patient-centered care. Changes to the handoff process were piloted on the telemetry unit then launched on remaining nursing units over time. Data targeting patient satisfaction and nurse-sensitive outcomes were collected pre and post-implementation with notable gains. Sustaining change in light of care-related variables is a challenge leadership, quality, and patient care teams are committed to achieving.

Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review

“…Two before–after studies focused on patient hand-off between nursing shifts. 53 54 A reduction in the number of patient falls was reported in both studies. In addition, restrained patients rate and catheter-associated urinary tract infection rate decreased about one-third in one of these studies.…”

“…56 57 Other patient outcomes included methicillin-resistant Staphylococcus aureus (MRSA) bacteraemias 41 and catheter-associated urinary tract infection rates. 53 …”

Integrating hand-off communication into undergraduate nursing clinical courses

“…[27][28][29] As a result of the implementation of the SHOC tool, at the end of the first year of clinical rotations the nursing students had a better grasp of the background and rationale for an effective hand-off report. As a result, students began to recognize pertinent critical health information that needed to be communicated to their nurse mentor in a standardized manner.…”

Improving Client and Nurse Satisfaction Through the Utilization of Bedside Report

“…These factors were cited by Anderson and Mangino (2006) as driving forces behind the implementation of bedside report on a 32-bed surgical unit utilizing a client-centered care delivery model. Freitag and Carroll (2011) described an analysis of shift handoffs conducted on a 24-bed telemetry unit. Upon admission to the unit, clients received information regarding the expectations of bedside report.…”