• Login
    View Item 
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    •   UMB Digital Archive
    • School of Nursing
    • Doctor of Nursing Practice (DNP) Projects
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of UMB Digital ArchiveCommunitiesPublication DateAuthorsTitlesSubjectsThis CollectionPublication DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    Display statistics

    Implementing a Standardized Nursing Handoff between the Emergency Department and Inpatient Departments

    • CSV
    • RefMan
    • EndNote
    • BibTex
    • RefWorks
    Thumbnail
    Name:
    Foltz_NursingHandoff_2019.pdf
    Size:
    822.7Kb
    Format:
    PDF
    Download
    Author
    Foltz, Kimberly A.
    Advisor
    Quattrini, Veronica
    Date
    2019-05
    Type
    DNP Project
    
    Metadata
    Show full item record
    Other Titles
    Standardized Nursing Handoff
    Abstract
    Background It is estimated that 80% of serious medical errors have a component of miscommunication between caregivers when a patient is being transferred. Ineffective handoffs can lead to delays in, or inappropriate treatments, and increased length of stay. Approximately half of hospital staff indicate information related to the patient is lost during handoffs. For a handoff to be successful, the following is needed: (1) standardized content, forms, tools, and methods; (2) the opportunity to ask questions; (3) staff accountability and monitoring; and (4) education and coaching. Additionally, the electronic health record should be used to enhance handoffs between senders and receivers. Local Problem The purpose of this quality improvement project was to implement and evaluate evidence-based patient-centered handoff from the emergency department to inpatient medicine departments within an urban, academic medical facility based in Maryland. Prior to this project, there was not a handoff report which contained all of the critical elements, an easy way for the inpatient nurse to contact the emergency department nurse with questions, and/or the ability to document that handoff was complete. Interventions Lewin’s change theory was used as the framework. The interventions were: (1) create a new report in the electronic health record, which contained all elements noted to be critical content by The Joint Commission, and (2) add a field to the electronic health record which the inpatient nurse completed after the report has been reviewed. The inpatient nurse was able to document ‘Chart reviewed, no questions’, ‘Chart reviewed, questions answered’, or ‘Other’ with the ability to add a comment. Results There was a reduction of handoff related patient safety events from four preimplementation to two post-implementation. Though the theme of all of the events was communication, there was a difference in miscommunication versus lack of communication. The percentage of compliance with the new process was 48.6%. Not all of the responses to the preimplementation and post-implementation survey questions are statistically significant; however, there was a statistically significant difference in ‘I am satisfied with the process for emergency department to inpatient handoff’ on both the inpatient (pre-data (M=2.3, SD=1.1) and post-data (M=3.3, SD=1.3); t=-2.8, p=0.006) and emergency department (pre-data (M=3.3; SD=1) and post-data (M=4.4, SD=0.7); t=-3.9; p=0.0003) surveys. Nurse satisfaction with the handoff process has increased. Conclusions The project decreased patient safety events, and increased overall nurse satisfaction related to handoff from the emergency department to inpatient medicine units. As all transfers from the emergency department to non-intensive care inpatient areas followed the same process pre-implementation, expanding the use of the new process into those areas is recommended. The emergency department to intensive care unit process is currently a verbal handoff with no specific format. In the future, it will be guided by the new electronic health record report. There are opportunities to implement an improved handoff process in other areas of the medical center. Patients are transferred between units, procedural areas, and from one clinician to another frequently. The model used in this project could be the foundation for improvements in those handoffs.
    Keyword
    Patient Handoff--standards
    Quality Improvement
    Identifier to cite or link to this item
    http://hdl.handle.net/10713/9838
    Collections
    Doctor of Nursing Practice (DNP) Projects

    entitlement

     
    DSpace software (copyright © 2002 - 2023)  DuraSpace
    Quick Guide | Policies | Contact Us | UMB Health Sciences & Human Services Library
    Open Repository is a service operated by 
    Atmire NV
     

    Export search results

    The export option will allow you to export the current search results of the entered query to a file. Different formats are available for download. To export the items, click on the button corresponding with the preferred download format.

    By default, clicking on the export buttons will result in a download of the allowed maximum amount of items.

    To select a subset of the search results, click "Selective Export" button and make a selection of the items you want to export. The amount of items that can be exported at once is similarly restricted as the full export.

    After making a selection, click one of the export format buttons. The amount of items that will be exported is indicated in the bubble next to export format.