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Implementing Bedside Handoff in the Emergency Department: A Practice Improvement Project.
Journal of Emergency Nursing
|December 12, 2018
Summary
Implementing bedside nursing handoff using the Situation, Background, Assessment, Recommendation (SBAR) tool improved patient information transfer in the emergency department. While effective, sustainability requires addressing nurse resistance to this enhanced patient safety practice.
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.
Keywords:
Effective handoffEmergency departmentNursing bedside reportNursing handoffNursing reportObservationSelf-reportMore Related Videos
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