Semester

Fall

Date of Graduation

2022

Document Type

Problem/Project Report

Degree Type

DNP

College

School of Nursing

Department

Anesthesiology

Committee Chair

Aaron Ostrowski

Committee Co-Chair

William Lewis

Abstract

Standardization of handoff reporting has been proven to increase the quality of information being transferred and improve patient safety. Poor quality handoff between providers increases morbidity and mortality, hospital length of stay, healthcare costs, as well as decreases patient satisfaction The aim of this Doctor of Nursing Practice quality improvement (QI) project was to implement the situation, background, assessment, recommendation (SBAR) handoff reporting tool in the postanesthesia care unit (PACU) at a hospital in Western Maryland. There was no standardized handoff process in place between certified registered nurse anesthetists (CRNAs) and PACU registered nurses (RNs) at the facility. The participants in this project consisted of 17 CRNAs, 17 PACU RNs, and 3 nurse anesthetist students. The project took place over 13 weeks and involved a pre and post implementation survey, an education session with implementation of the SBAR handoff tool, handoff assessment forms, and a one- day adherence follow-up. Data was collected by the project designer using online and paper surveys and paper handoff assessment forms. All results remained anonymous. Statical analysis of the results revealed a statistically significant improvement (P value < 0.05) in staff perception on patient handoff following implementation of the handoff tool in the areas of staff expectations, responsibility for safe patient care, and the opportunity to answer additional questions at the end of handoff report. The participants expressed their likes and dislikes on the current handoff process through open-ended questions in the pre/post-implementation surveys. Use of the SBAR handoff tool improved completeness in reporting of patient and procedure identification (87.6% to 94.4%), allergies (82.5% to 83.3%), intake and output (77.3% to 94.4%), airway assessment (50.5% to 69.4%), and lines and catheters (28.9% to 66.7%). The project designer concluded an overall improvement in provider perception on handoff reporting as well as improvement in completeness of report with the use of SBAR handoff reporting tool. Use of standardized handoff reporting is recommended to improve provider satisfaction and patient safety.

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