1. Research Implications Clinical Implications Practice Recommendations
Standardizing Nursing Shift Handoff Report
Kelcie Mendes, Senior Nursing Student
University of New Hampshire, Department of Nursing
Research Implications
A comparative study directly between the I-PASS tool and SBAR tool
Comparison of time spent on report during each form of handoff
Purpose
To address the following PICO question:
In adult medical-surgical patients, will standardizing shift handoff report using the I-PASS tool, as compared to individualized report, be effective in decreasing negative patient outcomes?
Current Literature
“Nurses in different settings have different perceptions about what is important to be conveyed…” (Friesen, White, & Byers, 2008)
“Incomplete transfer of medication information is recognized as a possible contributor to patient safety problems as patients are discharged from the hospital.” (Friesen, White, & Byers, 2008)
“65% of sentinel events occurred as a result of staff miscommunication.” (Ayala, 2017)
“I-PASS implementation was associated with improvements in verbal handoff communications, including inclusion of illness severity assessment, patient summary, to do list and an opportunity for the receiving nurse to ask questions.” (Starmer et al., 2017)
“The team (of Hackensack Meridian Health (HMH) in New Jersey) reported back during informal inquiries and frequent meetings that the I-PASS tool better allowed them to be specific, standardized, and all-inclusive during report.” (Clements, 2017)
Clinical Implications
Improved provider-to-provider communication
Decreased negative patient outcomes
Improved understanding of patient timeline
Decreased confusion among nursing staff regarding continuation of patient care
More consistent, quicker hand-off
Increased incidence of receiver questions
Increased time spent reporting on patients
(Figure 1)
Goal: Standardize nursing hand-off to improve overall patient outcomes and continuity of care
Practice Recommendations
A policy should be implemented standardizing information exchange between nursing staff. This researcher suggests the I-PASS tool as a basis for a comprehensive exchange of information between shift changes.
(Figure 2)