Transitioning Nurse Handoff to the Bedside: Engaging Staff and Patients

The emergency department is a complex environment in which reliable communication is vital for safe patient care. Communication during nurse shift report can be risky without an effective report process in practice. Reliability improves with the use of a standardized, patient-centered nurse handoff process. Quality improvement methods were used to promote reliable information exchange during nurse shift handoff through the implementation of a standardized, patient-centric bedside report process. Forty-six hospital-based emergency nurses participated in the project. Outcomes were measured through observation of bedside report process, nurse, and patient surveys. Of 13 handoffs observed, 92% occurred at the bedside and 54% of patients actively participated in the report process. The offgoing nurses adopted most elements of the handoff process, while the oncoming nurses were less successful. Nurses believed that the new process influenced their ability to respond to patient needs and patients were more satisfied with nurses. A structured, patient-centered bedside handoff process can reduce safety risk and promote satisfaction with care through reliable information exchange. This implementation template for bedside handoff engages staff and patients while translating best practice.