Handoffs are a known “trouble spot” when it comes to patient safety. As nurses, we participate in handoffs any time we transfer care to another provider, whether at change of shift, transfer to another floor or unit, or transfer to another facility. Errors that occur during these times can result from a variety of barriers, many of which are human factors, ranging from understaffing and interruptions to fatigue and information or sensory overload.
The Joint Commission requires a standardized approach to patient handoffs; it is one of the National Patient Safety Goals (2006 National Patient Safety Goal 2E). During her presentation “Effective Handoff Communication: A Key to Patient Safety” at Nursing2013 Symposium, JoAnne Phillips, MSN, RN, CCRN, CCNS, CPPS, shared several acronyms that can be used to help guide a well-organized transfer of information and minimize errors and omissions during patient handoffs.
SBAR + 2 (See also The Art of Giving Report and The impact of SBAR.)
Introduction
Situation
Background
Assessment
Recommendation
Question & Answer
5 P’s Model
Patient
Plan
Purpose
Problems
Precautions
PACE
Patient/Problem
Assessment/Actions
Continuing/Changes
Evaluation
I PASS the BATON
Introduction
Patient
Assessment
Situation
Safety Concerns
the
Background
Actions
Timing
Ownership
Next
What is the standard for nursing handoffs where you work?
References:
Cairns, L., Dudjak, L., Hoffman, R., & Lorenz, H. (2013). Utilizing Bedside Shift Report to Improve the Effectiveness of Shift Handoff. Journal of Nursing Administration, 43(3).
Riesenberg, L., Leisch, J., Cunningham, J. (2010). Nursing Handoffs: A Systematic Review of the Literature. American Journal of Nursing, 110(4).
Schroeder, S. (2006). PATIENT SAFETY: Picking up the PACE: A new template for shift report. Nursing2006, 36(10).
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