Date of Award

12-2013

Degree Name

Nursing (M.S.N.)

Department

College of Nursing

Abstract

Problem: The hand off at the change of shift is a critical time for information exchange which can have significant impact on quality of care and patient safety. The end of shift hand off was identified as an area for improvement on a medical-surgical-acuity adaptable hospital unit. Literature review: Literature suggests that hand offs conducted at the patient’s bedside can help to decrease overtime, improve patient satisfaction scores, and address patient safety/quality issues. Evidence also supports the use of a standardized format for report. Protocol/Intervention: The first step is to provide better education to patients and families on admission regarding the standard for bedside report. Nurses will ask the patient/family if they wish to be awakened if they are sleeping to be included in the hand off. If the answer is yes, a card will placed on the patient’s door to alert staff of their wishes to be included in report. The second step is to create a report utilizing the SBAR (Situation, Background, Assessment, Recommendation) format. This tool would be laminated and affixed to the units work-stations-on-wheels (WOWs). The third step is to reinforce the unit standard of having Patient Care Assistants answer call lights during report time to limit interruptions. Benefits/Barriers: Anticipated benefits to better standardizing hand offs include: improved communication between nurses, improved communication between nursing and patients/families, a more efficient hand off process with less omission of information, and decreased time to conduct the hand offs. Perceived barriers include: potential costs, staff engagement, and compliance. Outcomes: Patient satisfaction, staff satisfaction, unit costs (related to decreased overtime), and patient length of stay will be targeted to improve with this protocol.

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