Nursing Handoff: Implementing a Standard Handoff Communication Tool between Outpatient and Inpatient

Purpose: To implement a standardized and structured nursing handoff process between a pediatric outpatient hematology/oncology clinic and a pediatric inpatient hematology/oncology unit utilizing the SBAR communication tool to evaluate its impact on nurse perception of missed care and nurse satisfaction. The MISSEDCARE-pediatric survey was used to measure the frequency and severity of missed care. The satisfaction with handoff survey was used to measure nurse satisfaction and teamwork.

Method: Utilizing the plan-do-study-act (PDSA) process improvement model, nurses were educated on a standard and structured handoff process. Nurses completed surveys before and after the project intervention. All results were compared in the aggregate and reviewed for statistical significance. Results were reported as frequency and percent.

Results: There was a statistical difference identified between pre- and post- implementation groups in the area the area of communication (p = 0.0009) and nurse satisfaction (p = < 0.0001). There was a significant difference in urgent patient needs (p = 0.0224) and reassessment (p = 0.0011). There was no statically difference between pre- and post- implementation groups between demographics and job characteristics.

Discussion/implications: The handoff process utilized in this project required nurses to communicate in a structured way during admission from an outpatient clinic to an inpatient unit. It improved perception of communication, decreased the frequency and severity factor of missed care, and increased nurse satisfaction and teamwork. In order to further support the findings of this project, a longer monitoring period is needed and continued use of the SBAR tool during care transition needs to be monitored as well as organizational benchmarks regarding nursing care quality.