Implementation of a Standardized Handoff During Transition of Care from the ED to the ICU

2.50
Hdl Handle:
http://hdl.handle.net/10755/621338
Category:
Full-text
Format:
Text-based Document
Type:
Poster
Title:
Implementation of a Standardized Handoff During Transition of Care from the ED to the ICU
Author(s):
Abbring, Melinda
Lead Author STTI Affiliation:
Zeta Epsilon
Author Details:
Melinda Abbring, RN
Abstract:
Session presented on Saturday, March 18, 2017: ABSTRACT: Patient safety and communication are crucial to the nursing handoff. Emergency department (ED) patients transferring to the intensive care unit (ICU) have life-threatening impairments. Stabilization of critically ill patients may not occur until after the handoff has occurred. Often, vital patient information may be omitted. EDs can be chaotic with numerous distractions that adversely affect the nursing handoff. The Institute of Medicine published two groundbreaking patient safety publications highlighting handoffs: To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2004). In 2006, the Joint Commission recognized handoffs by adding transition of care with the National Patient Safety Goal 2E (2014). The purpose of this evidence-based practice project is to implement a standardized handoff from the ED to the ICU to improve nursing communication and patient safety. The review of literature supported implementation of a standardized handoff. Melnyk and Fineout-Overholt's (2001) hierarchy of evidence ranked 15 separate sources: Two level III, one level IV, five level V, four level VI, and three level VII. The Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines revealed six high quality sources and nine good quality sources. The Stetler Model provided guidance and direction during implementation of this project. Rogers' Diffusion of Innovation was used to assess nurses' willingness to adopt the handoff intervention. A 205-bed, non-profit, Midwestern hospital was the setting for this intervention. The ED and ICU managers, the nurse educator, and the Chief Nursing Officer all understood and supported the proposal. Education of the standardized handoff occurred over a one week period during staff meetings and change of shift in the ED and ICU. A PowerPoint presentation was given and questions from nurses in both the ICU and ED were answered. At that time, a demographics form was completed as well as a pre-intervention questionnaire asking nurses about the current handoff practice. This handoff implementation continued for eight weeks. At the end of the implementation phase, ED and ICU nurses will complete a post-implementation questionnaire. Communication and patient safety will be compared from the two months prior to implementation of the standardized handoff to the two months during implementation using a paired t test. Descriptive statistics will compare pre-intervention and post-intervention questionnaires regarding nursing attitudes and communication on a Likert Scale along with completeness of the handoff items. The time patients spend in the ED waiting for an ICU bed prior to arrival to ICU and MIDAS risk reports will be audited and compared to the two months prior to implementation of a standardized handoff. It is anticipated that implementation of a standardized handoff will improve both nursing communication and patient safety. Learning Objectives: The learner will be able to name the six steps involved in the implementation of a standardized handoff from ED to ICU found in the review of literature and discuss their importance as related to nursing communication and patient safety. The learner will be able to name at least one of the three institutions that published findings highlighting the importance of nursing handoff as a safety measure. Publications from these three institutions preceded the implementation of this evidence-based practice project regarding ED to ICU handoff.
Keywords:
Nursing Handoff; Intensive Care Units; Emergency Department (ED)
Repository Posting Date:
3-Mar-2017
Date of Publication:
3-Mar-2017
Other Identifiers:
CHWE17PST48
Conference Date:
2017
Conference Name:
Creating Healthy Work Environments 2017
Conference Host:
Sigma Theta Tau International, the Honor Society of Nursing
Conference Location:
Indianapolis, Indiana, USA
Description:
Creating Healthy Work Environments 2017: Best Practices in Clinical and Academic Settings. Held at the JW Marriott, Indianapolis, Indiana, USA

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePosteren
dc.titleImplementation of a Standardized Handoff During Transition of Care from the ED to the ICUen
dc.contributor.authorAbbring, Melindaen
dc.contributor.departmentZeta Epsilonen
dc.author.detailsMelinda Abbring, RNen
dc.identifier.urihttp://hdl.handle.net/10755/621338-
dc.description.abstractSession presented on Saturday, March 18, 2017: ABSTRACT: Patient safety and communication are crucial to the nursing handoff. Emergency department (ED) patients transferring to the intensive care unit (ICU) have life-threatening impairments. Stabilization of critically ill patients may not occur until after the handoff has occurred. Often, vital patient information may be omitted. EDs can be chaotic with numerous distractions that adversely affect the nursing handoff. The Institute of Medicine published two groundbreaking patient safety publications highlighting handoffs: To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm (2004). In 2006, the Joint Commission recognized handoffs by adding transition of care with the National Patient Safety Goal 2E (2014). The purpose of this evidence-based practice project is to implement a standardized handoff from the ED to the ICU to improve nursing communication and patient safety. The review of literature supported implementation of a standardized handoff. Melnyk and Fineout-Overholt's (2001) hierarchy of evidence ranked 15 separate sources: Two level III, one level IV, five level V, four level VI, and three level VII. The Johns Hopkins Nursing Evidence-Based Practice Model and Guidelines revealed six high quality sources and nine good quality sources. The Stetler Model provided guidance and direction during implementation of this project. Rogers' Diffusion of Innovation was used to assess nurses' willingness to adopt the handoff intervention. A 205-bed, non-profit, Midwestern hospital was the setting for this intervention. The ED and ICU managers, the nurse educator, and the Chief Nursing Officer all understood and supported the proposal. Education of the standardized handoff occurred over a one week period during staff meetings and change of shift in the ED and ICU. A PowerPoint presentation was given and questions from nurses in both the ICU and ED were answered. At that time, a demographics form was completed as well as a pre-intervention questionnaire asking nurses about the current handoff practice. This handoff implementation continued for eight weeks. At the end of the implementation phase, ED and ICU nurses will complete a post-implementation questionnaire. Communication and patient safety will be compared from the two months prior to implementation of the standardized handoff to the two months during implementation using a paired t test. Descriptive statistics will compare pre-intervention and post-intervention questionnaires regarding nursing attitudes and communication on a Likert Scale along with completeness of the handoff items. The time patients spend in the ED waiting for an ICU bed prior to arrival to ICU and MIDAS risk reports will be audited and compared to the two months prior to implementation of a standardized handoff. It is anticipated that implementation of a standardized handoff will improve both nursing communication and patient safety. Learning Objectives: The learner will be able to name the six steps involved in the implementation of a standardized handoff from ED to ICU found in the review of literature and discuss their importance as related to nursing communication and patient safety. The learner will be able to name at least one of the three institutions that published findings highlighting the importance of nursing handoff as a safety measure. Publications from these three institutions preceded the implementation of this evidence-based practice project regarding ED to ICU handoff.en
dc.subjectNursing Handoffen
dc.subjectIntensive Care Unitsen
dc.subjectEmergency Department (ED)en
dc.date.available2017-03-03T16:42:30Z-
dc.date.issued2017-03-03-
dc.date.accessioned2017-03-03T16:42:30Z-
dc.conference.date2017en
dc.conference.nameCreating Healthy Work Environments 2017en
dc.conference.hostSigma Theta Tau International, the Honor Society of Nursingen
dc.conference.locationIndianapolis, Indiana, USAen
dc.descriptionCreating Healthy Work Environments 2017: Best Practices in Clinical and Academic Settings. Held at the JW Marriott, Indianapolis, Indiana, USAen
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