1. Developing a Bedside Handoff Process for Postpartum Patients Kelli Benson, BSN, RN, RNC-MNN Ferris State University
Plan
Study
Act
Repeat staff survey
Repeat patient survey
Bedside handoff audits
Bedside staff volunteers
Ongoing feedback
Revisions of standardized handoff tool
Revisions of bedside handoff process
Project goals:
To improve the handoff process between the labor and delivery (L&D), postpartum, and antepartum departments.
To improve patient involvement in handoff report.
Problems addressed:
No patient involvement in handoff
No face to face handoff
Needed use of Situation, Background, Assessment, Recommendation structure (SBAR) for handoff
Support:
Bedside handoff has been shown to improve:
Patient outcomes, engagement, and satisfaction
Staff communication, accountability, and satisfaction
Root Cause Analysis:
Environment: different models of care
Management: different managers, styles, and experience levels
Equipment: unreliable phone system, not using electronic medical record for handoff
Process: phone handoff, transfer time inconsistent
People: patient and family not involved, patient transferred by nursing assistant, lack of understanding of each other’s roles
New Handoff Process
Labor and delivery calls receiving unit to give 15 minute “heads up” to transfer
Receiving nurse available at bedside
Handoff occurs at bedside
Patient and family included
Standardized Handoff Tool
Developed by staff
Initiated in labor and delivery
Used at bedside
SBAR format
References
Groves, P. S., Manges, K. A., & Scott-Cawiezell, J. (2016). Handing off safety at the bedside. Clinical Nursing Research, 25(5), doi: /
Holden, A. C. (2012). Commitment to putting new mothers first: Implementing bedside report in a family birthing center. Journal of Obstetric, Gynecologic & Neonatal Nursing, 41(1), s60-s61. doi: /j x
Jeffs, L., Acott, A., Simpson, E., Campbell, H., Irwin, T., Lo, J.,…Cardoso, R. (2013). The value of bedside shift reporting: Enhancing nurse surveillance, accountability, and patient safety. Journal of Nursing Care Quality, 28(3), doi: /NCQ.0b013e f46
Mardis, T., Mardis, M., Davis, J., Justice, E. M., Riley Holdinsky, S., Konnelly, J.,…Riesenberg, L. A. (2016). Bedside shift-to-shift handoffs. Journal of Nursing Care Quality, 31(1), doi: /NCQ
Maxson, P. M., Derby, K. M., Wrobleski, D. M., & Foss, D., M. (2012). Bedside nurse-to-nurse handoff promotes patient safety. MedSurg Nursing, 21(3), 140. Retrieved from
Olson-Sitki, K, Weitzel, T., & Glisson, D. (2013). Freezing the process: Implementing bedside report. Nursing Management, 44(7), doi: /01.NUMA af
Olvera, L. & Campbell Bliss, M. (2010). Perfecting the patient handoff: Improving the process for patients and nurses. Nursing for Women’s Health, 14(6), Retrieved from
Spinks, J., Chaboyer, W., Bucknall, T., Tobiano, G., & Whitty, J. A. (2015). Patient and nurse preferences for nurse handover-using preferences to inform policy: a discrete choice experiment protocol. British Medical Journal, online. doi: /bmjopen
Vines, M. M., Dupler, A. E., Van Son, C. R., & Guido, G. W. (2014). Improving client and nurse satisfaction through the utilization of beside report. Journal for Nurses in Professional Development, 30(4), doi: /NND Do
Staff Involvement:
Requesting volunteers from all departments
Utilized to help develop the handoff tool and staff survey questions in order to increase success of the new procedure
Standardized Tool:
Developed to provide handoff that provided the information needed by all departments
Ensure the patient would be appropriately updated
Patient Survey:
Determine patient perspective of involvement
Before and after the change in practice
Staff Survey:
Elicit staff opinions related to handoff
Before and after the change
Acknowledgements
The author acknowledges Emily Jackson, MSN, CNM who provided extensive support, guidance, and expertise during this project.