This paper examines nurse-to-nurse hand-off communication within the same hospital unit, focusing on the risks that arise when critical patient information is not properly transferred at shift change. Using the TeamSTEPPS framework, the paper proposes a three-phase approach — assessment, planning/implementation, and sustainment — supported by four specific communication strategies: verbal handoffs, whiteboard postings, chart documentation, and computer-based information sharing. The paper outlines both an implementation plan and a communication plan, emphasizing leadership commitment and minimal training requirements. Together, these strategies aim to reduce medication errors, care gaps, and patient safety breaches caused by ineffective handoffs.
The objective of this paper is to present four strategies addressing nurse-to-nurse hand-off communication on the same unit, using the TeamSTEPPS approach to provide a clear and thorough description of each strategy.
Hand-off communication is a problem common in nursing departments, and the failure to properly pass along patient information at shift change creates significant risks to patient health. This problem is specific to nurse-to-nurse communication within the same unit. Friesen et al. report that an effective handoff of communication between nurses serves to support "the transition of critical information and continuity of care and treatment" (p. 1). Problems associated with handoffs are identified to include the increasing specialization of healthcare and the larger number of clinicians involved in delivering care in today's health system. The results of ineffective handoffs are reported to include "gaps in patient care and breaches or failures on patient safety, including medication errors, wrong-site surgery and patient deaths" (Friesen et al., n.d., p. 1). Ensuring that effective hand-offs occur requires specific and proven methods to facilitate proper communication exchanges between nurses on the same unit.
Nursing communication is critical for ensuring patient safety and the best possible patient care. For this reason, TeamSTEPPS was developed as an approach to ensuring effective and timely nurse-to-nurse communication. The TeamSTEPPS approach is comprised of three phases: Phase I (assessing the need), Phase II (planning, training, and implementation), and Phase III (sustainment).
First, the TeamSTEPPS intervention must be defined. For the purpose of this study, the intervention is related to nurse-to-nurse communication at shift change. Second, there must be a plan for determining the intervention's effectiveness. For the purpose of this study, effectiveness will be determined by surveying nursing staff regarding nurse-to-nurse communication at shift change.
"Four communication methods and leadership commitment"
"Staff training and four-method information exchange plan"
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