Browsing Doctor of Nursing Practice (DNP) Projects by Subject "Situation, Background, Assessment, Recommendation"
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Implementation and Evaluation of a Patient Handoff Tool to Improve Nurses CommunicationProblem & Purpose: Poorly conducted handoffs are implicated in 80% of preventable adverse events in healthcare facilities. Within a sub-acute and rehabilitation facility in Maryland, observational reports revealed that nurse handoffs were poorly conducted and lacked the use of a standardized evidence-based tool, resulting in miscommunication and nurse dissatisfaction with the handoff process. Situation, Background, Assessment, Recommendation (SBAR) is an evidence-based tool recognized by The Joint Commission, Agency for Healthcare Research and Quality (AHRQ), and the World Health Organization (WHO) as an effective tool in improving handoff communication, reducing adverse events, and promoting patient safety. The purpose of this quality improvement (QI) project was to implement and evaluate an SBAR patient handoff tool to improve nurse communication. Methods: Nurses were educated on the SBAR method and tool prior to using the tool. A Handover Evaluation Scale (HES) survey was distributed pre-implementation and again at the end of the 15-week implementation period. Weekly observation audits were conducted to determine nurse compliance with use of the SBAR handoff tool. Results: Findings indicated that nurse compliance with use of the SBAR patient handoff tool was 86% by Week 7, and 100% by Week 13. Comparison of pre and post-HES survey mean responses showed modest improvements in all items relating to the key variables: quality of information, interaction, and efficiency of handoffs. Conclusion: Use of the SBAR tool improved the quality of information, interaction, and efficiency of patient handoffs between nurses, thereby improving communication. Further QI projects are recommended to evaluate the effectiveness of SBAR in reducing adverse patient events and improving patient care outcomes.