The importance of how well nurses communicate with each other, physicians, nursing assistants, pharmacy staff, and janitorial staff makes the difference in patient care and safety and the patient’s attitude toward healthcare and compliance with their plan of care Baggs et al. (1992) have observed improved communication and collaboration results in more positive patient outcomes, higher satisfaction, and lower readmission rates. If nurses are at the heart of the communication process, and are carrying out this process efficiently, then it’s safe to say that the client is more likely to have increased positive patient outcomes and higher satisfaction with the care being provided. Evidence suggests that communication improves when nursing handoff involves the patient and is carried out using a structured reporting format (Mascioli et al 2009, Tucker et al 2009). The World Health Organization (2007) recommends the use of the SBAR (Situation, Background, Assessment, and Recommendation) tool to standardize handoff communications. The hospital where our research was conducted has a policy in place that states using the SBAR tool when giving hand off information combined with bedside report. Bedside Reporting, which is what our study facility participates in, is only effective when done properly and even then has its drawbacks. A simple drawback is the “inclusion-exclusion” of patient’s from their care. The RN’s may be in the patient’s room, but the focus is on discussing the case to the next RN on duty in terminology that the patient does not understand. This creates a “parallel” perception of RN care from the patient, which is better than no perception, but can still be improved upon for better patient outcomes. Hannah Chitkara; Kiristan Dials; Kati Schuh; Nick Thompson; Celena Wagner; Mrs. White, MSN, RN NURB 361 Introduction to Nursing Research, Baccalaureate Nursing Program Introduction Literature Review A PROTOCOL TO ENHANCE NURSE-TO-NURSE COMMUNICATION DURING PATIENT HANDOFF Policy Alterations The objective of this project is to observe, analyze, and ascertain nurse to nurse communication methods within a moderate sized, urban, teaching hospital within Kentucky and propose recommendations to increase the effectiveness of nurse to nurse hand-off and nurse telecommunications for better patient outcomes. Improved communication techniques will ultimately lead to higher quality, holistic nursing care and therefore increase rates of patient safety and satisfaction. This will be completed by conducting nurse discussions, observing nurse implementation, and analyzing hospital policy to uncover barriers to efficient communication. Further research and analysis upon the hospital’s current policy revealed obstacles to efficient patient handoff. Discussion with nurses on the unit revealed negativity regarding the current practice of bedside reporting. Observation of 13 weeks within the hospital revealed variance from the policy by staff members. Delving into current evidence based practice techniques, a modification was proposed. Nurse shift reports and nurse handovers are two of the most critical processes in patient care that can support patient safety and reduce medical errors in the United States (Gregory, 2014). A timely, efficient patient handoff is of vital importance to the beginning of a shift adhering to patient-care, and the focus of this project was conducted upon this premise. Clinical Implications Adherence to the hospital’s handoff communication policy regarding the use of Situation Background Assessment Recommendation (SBAR) when passing on specific relevant information from one team member to another for the purpose of ensuring the continuity and safety of the patient. Proposed model creates a more meaningful, time saving method of patient handoff therefore increasing both nurse and patient participation. Patient Satisfaction Survey results will improve thereby increasing hospital reimbursement. More meaningful time spent with patient- rather than discussing case in parallel to patient speaking in medical jargon, Nurse would be speaking directly to them in understandable terms. Less HIPAA violations. Having an effective patient handoff would lead to more holistic nursing care, leading to less morbidity and mortality. Patient Satisfaction Survey Proposed Patient Hand-Off Modification Increased Hand-Off Report Efficiency Less Morbidity and Mortality Less HIPAA Violations Higher Patient Satisfaction More Hospital Reimbursement 80% 52% 72% 75% 49% 65% NURSES "ALWAYS" COMMUNICATED WELL PATIENT'S WHO "STRONGLY AGREE" THAT THEY UNDERSTOOD CARE WHEN LEAVING HOSPITAL PATIENT'S WHO GAVE THEIR HOSPITAL A RATING OF 9 OR 10 National Average Urban Teaching Hospital Current Policy 30 minute complete bedside report SBAR Proposed Modification 15 minute RN to RN patient handoff in designated area 15 minute patient rounding Patient Centered Care Increased Nurse Participation Positive Patient Satisfaction Surveys References Agency for Healthcare Research and Quality (2013). Nurse bedside shift report and implementation handbook. Retrieved from http://www.ahrq.gov/profressionals/systems/hospital/engagingfamilies/stragegy3/index.html Baggs, J., Ryan, S., Phelps, C., Richeson, J., & Johnson, J. (1992). The association between interdisciplinary collaboration and patient outcomes in medical intensive care. Heart Lung, 21, 18–24 Casey, A., & Wallis, A. (2011). Effective communication: Principle of nursing practice E. Nursing standard, Vol. 25, pp. 35-37 Christie, P., & Robinson, H. (2009) Using a communication framework at handover to boost patient outcomes. Nursing Times. 105, 47, 13-15. Holzmueller, C., Timmel, J., Kent, P., Schulick, R., & Pronovost, P. (2009). Implementing a team based daily goals sheet in a non-ICU setting. Joint Commission Journal of Quality Patient Safety, 35, 384–388. Mascioli S, Laskowski-Jones L, Urban S, & Moran S (2009) Improving handoff communication. Nursing 2009. 39, 2, 52-55. World Health Organization (2007) Communication During Patient Hand-Overs. http://bit.ly/ecCnXg (Last accessed: March 22 2011.) Benefits of Modification