1. White River Junction VAMC
Shift into G.E.A.R.
STACEY R. COLLINS RN BSN
White River Junction VAMC
Introduction
Methods
G.E.A.R.
Discussion
Shift into G.E.A.R is a quality improvement project that aims in developing a medical-surgical standardized report for end of shift handoff. Handoff report, also referred to as end of shift report, is an essential part to the nursing process. At this time, nurse’s relay information to the oncoming nurses that is critical in providing safe patient care.
In 2006, a Joint Commission standard was to “Implement a standardized approach to “hand-off” communications, including an opportunity to ask and respond to questions¹.”
“Shift into G.E.A.R” aims to increase specific patient data during handoff report to improve patient safety and continuity of care. The goal was for nurses to “Shift into G.E.A.R.
A literature review was completed using EBSCO with various search terms including but not limited to “handoff,” “shift report,” “nursing report,” and “change of shift report.”
The search results were narrowed to twenty research articles which were used through the quality improvement project.
A six question pre-survey through Survey Monkey was conducted to gather the perspective of the inpatient medical surgical nursing staff.
The pre-survey data collected from both medical surgical units supported the research literature.
1. To gather patient specific in patient using a standard tool
2. To exchange and explain the information to the oncoming nurse
3. To provide a time for nurses to ask questions
4. To recommend a plan of care and respond to the information received.
Individual and group discussions at change of shift were conducted.
Positive and negative feedback was obtained. The report sheet was adjusted to make improvements including but not limited to adding information specific to the medical surgical units.
Multiple patient sheets are being trialed now.
Future suggested plans are to make the handoff report sheet into a template on CPRS for nursing progress notes, where nurses can then print out their notes.
Implementation
Recommendations
Figure #1
Ideas for further research include researching into the location of where report is conducted and the timing of report
Goals
To increase the amount of patient specific data transferred from nurse to nurse
To improve the flow of report
To standardized report on both medical surgical units
Update Nursing Service Policy
Bibliography
A standardized report sheet was created and trialed on the medical surgical unit 1 West. Feedback is continuing to be collected on the unit from staff to make improvements.
Patient safety primers.(2014).  In: AHRQ PSNet [Web site].  Rockville (MD): Agency for Healthcare Research and Quality (AHRQ).  Available from: