01.03 Shift change and Patient handoff

Overview

1. What is the patient handoff?
   1. Report of information
      1. Nurses
      2. Providers
   2. Transfer of care

Nursing Points

General

1. Goal of patient handoff
   1. Promotes patient safety
      1. Prevention of medical errors
      2. Timely treatment
   2. Team building
   3. Coaching/teaching

Assessment

1. Standardized handoff reports
   1. Guidelines to follow
      1. Prevents
         1. Treatment delays
         2. Missing information
         3. Knowledge deficits
   2. Examples
      1.  SBAR
         1. Situation
            1. Name
            2. Unit
            3. Patient
            4. Problem
         2. Background
            1. Admission diagnosis
            2. Pertinent history
            3. Current treatments
         3. Assessment
            1. Current vital signs
            2. Physical assessment
            3. Test results
         4. Requests
            1. Further testing
            2. Transfer
      2. I-PASS
         1. Illness severity
            1. Summary of patient acuity
         2. Patient summary
            1. Patient’s diagnosis and treatment plan
         3. Action list
            1. To-do items
         4. Situation awareness/contingency plan
            1. Directions to follow in event of patient change
         5. Synthesis
            1. Receiver asks questions
2. Important with handoff
   1. ALWAYS document who report was given to
      1. 1. “SBAR report given to…”
            1. Legally shows transfer of care

Therapeutic Management

1. Handoff issues
   1. Without standarized reporting
      1. Linked to adverse events
      2. Breaks in communication
      3. Like the game “telephone”

Nursing Concepts

1. Clinical judgement
2. Communication
3. Safety
4. Teamwork and Collaboration