Standardized Bedside Handoff Report by Leah Barefoot RN

Standardized Bedside Handoff Report by Leah Barefoot, RN, CPN

Standardized Bedside Handoff Report § Purpose § Background § Evidence Based Practice § Implementation Guidelines § Impact § Compliance Monitoring § Lessons Learned § Suggested Improvements § Questions/Comments

Purpose § § § Improve Nursing Handoffs Improve Consistency of Information Increase Nurse to Nurse Accountability Decrease Distractions Promote Patient Safety Increase Patient Satisfaction (Popovich, 2011)

Background (Prior to Implementation) § Report at Nurses Station - Distractions § Audio Recording - No Opportunity to Ask Questions Lack of Standardization § Missing Information § -Writing while listening -Loss of significant data (Popovich, 2011)

Evidence Based Practice § Ineffective Handoff Communication -80% of serious medical errors -delays in treatment -inappropriate treatment -increased length of hospital stay (Joint Commission on Accreditation of Healthcare Organizations, 2012)

Evidence Based Practice § 2009 National Patient Safety Goal § Improve Effectiveness of Communication Among Caregivers -Standardized approach -Handoff effectively (Eldridge, 2009)

Implementation Guidelines § Effective October 1, 2010 § EPIC (Electronic Health Record) go live § At the bedside § Introduce oncoming nurse § Utilize SBAR handoff report in EPIC -history, medications, orders, results, & care plan -snapshot of prior 12 hours (VS’s, I&O’s, lines/drains, incisions)

Implementation Guidelines § Approximately 5 minutes per patient § Ensure patient privacy § Include the patient § Clean up orders -complete or discontinue orders as appropriate § Allow for any questions § Document handoff/transfer of care

Impact (Women’s & Children’s Dept. ) § Less time spent on report § Consistent & accurate report § Less writing (or no writing) § Visual assessment = no surprises -compare patient to report -quick assessment of environment -trace lines

Impact (Women’s & Children’s Dept. ) § Easily identified order discrepancies -Confirm IV fluid(s) & rate(s) -Confirm type & amount oxygen § Improved patient satisfaction scores -Overall communication up to 90% § Less call lights during shift change

Compliance Monitoring by Manager or Team Leader § Nurse observation -at least one shift change per week § Patient rounding/interviewing -every patient at least once during hospitalization

Lessons Learned/Observation Results § Inconsistent education process § Occurring at nurses station § Writing everything § Handoff tool not utilized § Patient not compared to report/orders § Performing complete assessment instead of quick visualization

Suggested Improvements § Standardized education -video demonstrating proper technique § Increased observation monitoring -develop observation tool § Revised protocol -clear consequences for each violation § Annual evaluation -SMART goals to include bedside handoff compliance

Questions? Comments?

References Eldridge, N. (2009). Joint commission national patient safety goals, 2009. Topics in Patient Safety, 9, 1 -4. Retrieved from http: //www. patientsafety. va. gov/docs/TIPS_Jan. Feb 09. pdf Joint Commission on Accreditation of Healthcare Organizations. (2012). Joint commission center for transforming healthcare releases targeted solutions tool for hand-off communications. Joint Commission Perspectives, 32, 1 -3. Retrieved from http: //www. jointcommission. org/assets/1/6/TST_HOC_Persp_08_12. pdf Popovich, D. (2011). Cultivating safety in handoff communication. Pediatric Nursing, 37, 55 -60. Retrieved from http: //www. medscape. com/viewarticle/746070_1