Implementing Bedside Handoff in the Emergency Department: A Practice Improvement Project.

Area of Science:

• Nursing Practice
• Patient Safety
• Healthcare Communication

Background:

• Emergency departments are high-risk for medical errors during patient handoffs.
• A Midwestern trauma center implemented a practice improvement project to enhance nursing handoff effectiveness.
• The change mandated bedside handoffs using an adapted Situation, Background, Assessment, Recommendation (SBAR) tool.

Purpose of the Study:

• To evaluate the effectiveness of implementing bedside nursing handoff with an adapted SBAR tool.
• To assess the impact on patient safety culture and information transfer during shift changes.

Main Methods:

• Pre- and post-implementation nursing handoff questionnaires were used.
• Selected items from the Hospital Survey on Patient Safety Culture were administered.
• Nursing leadership conducted handoff observations to document adherence and tool usage.

Main Results:

• Questionnaire results showed improvement in 2 of 7 items related to handoff effectiveness.
• Patient Safety Culture scores improved between 2015 and 2016.
• Observations indicated a need for prompting bedside handoffs and limited use of electronic medical records (40%).

Conclusions:

• Nurses perceived the SBAR bedside report as user-friendly and effective in preventing patient information loss.
• Despite evidence supporting bedside handoffs, sustainability may be challenged by nurse resistance to process changes.