Doctor of Nursing Practice
Post Master's DNP Completion
Year Degree Awarded
Month Degree Awarded
Handoff, Structured, Shift, Report, SBAR
Terrie Black DNP, MBA, CRRN, FAHA, FAAN
Background: Handoff is the transfer and acceptance of patient care responsibility achieved through effective communication. Patient-specific information moves from one caregiver to another, to ensure continuity and safety. Ineffective handoffs negatively impact patient safety, patient and staff satisfaction, adverse events, missed care, and treatment delays.
Purpose: To decrease adverse events associated with ineffective handoff and improve nurse satisfaction by implementing a structured, electronic handoff process, inclusive of a standardized handoff report in an outpatient setting.
Methods: This quality improvement project implemented an evidence-based, electronic, structured, handoff process, utilizing situation-background-assessment-recommendation (SBAR). A pre-implementation survey was created to identify intra-organization patient transitions and assess nurse satisfaction. Reporting to Improve Safety and Quality (RISQ™) data for handoff were also evaluated. Four weeks and eight weeks after implementing the new handoff process a repeat satisfaction survey was sent to the nursing staff, RISQ™ data was analyzed and use reports were initiated.
Results: Initiating this structured and standardized handoff process, inclusive of identifying the transitions requiring handoff, led to an increase in nurse satisfaction with statistical significance p<.001 in 87.5% of the satisfaction categories, a 42% decrease in adverse events associated with handoff and an increase in the use of a structured handoff process.
Conclusion: Structuring outpatient handoff for defined care transitions, utilizing a report derived from the electronic medical record can improve patient safety and increase nurse satisfaction.
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