Telemedicine for Interfacility Nurse Handoffs.

Area of Science:

• Nursing
• Health Informatics
• Pediatric Critical Care

Background:

• Interfacility patient transfers require effective nurse handoffs.
• Current methods like telephone may not optimize preparedness.
• Telemedicine offers a potential alternative for enhanced communication.

Purpose of the Study:

• To compare nurse preparedness and handoff quality during interfacility transfers using telemedicine versus telephone.
• To evaluate the feasibility of telemedicine for pediatric intensive care unit (PICU) patient handoffs.

Main Methods:

• Cross-sectional nurse survey linked with electronic medical record data.
• Multivariable, multilevel analysis of 106 handoffs from 55 nurses.
• Comparison of telemedicine (28%) versus telephone (72%) handoffs.

Main Results:

• Nurses reported higher preparedness after telemedicine handoffs (3.4 vs 3.1; p = 0.02), even for higher-acuity patients.
• No significant difference in overall handoff quality (Handoff Clinical Evaluation Exercise).
• Telemedicine handoffs showed trends toward better communication components, though not statistically significant in adjusted analysis.

Conclusions:

• Telemedicine is a feasible tool for nurse-to-nurse handoffs of critically ill pediatric patients.
• Telemedicine may enhance perceived and objective nurse preparedness.
• Further research is needed to confirm benefits in communication, adverse events, and satisfaction.