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).  

As I write this, I’m on my return flight from Nursing2013 Symposium in Las Vegas, Nevada. With each conference I attend, a highlight for me is developing new relationships and strengthening older ones with nursing colleagues from around the country and world. As nurses, we have an incredible amount of knowledge and experiences to share and getting away from our workplaces and joining together to talk and learn is exhilarating! By the nature of my work, so many of my relationships are “virtual” ones – communication via email, text, and social media is more the norm for me than face-to-face conversations, so it thrills me to connect in person with nurses that I’ve only “met” online.

I have quite a bit to share from this conference, but let me start with quotes that inspired & educated me during this event!

“Many times, a patient’s history leads to a diagnosis; the physical examination supports that diagnosis.”
Anne Dabrow Woods, MSN, RN, CRNP
Physical Assessment Skills for Adult Patients

“The most accurate way to take a blood pressure is by using the bell of the stethoscope.”
Anne Dabrow Woods, MSN, RN, CRNP
Physical Assessment Skills for Adult Patients

“It doesn’t take a title to be a leader.”
Jeff Doucette, MS, RN, CEN, FACHE, NEA-BC
Leading From Where You Are: Creating a Culture That Inspires

“Staff nurses are front-line leaders and often hold the key to resolving turnover drivers.”
Jeff Doucette, MS, RN, CEN, FACHE, NEA-BC
Leading From Where You Are: Creating a Culture That Inspires

“The best leaders are personal leaders.”
Charles Denham, MD
A Lifesaver for Lifesavers: How to Survive the Rough Seas of Patient Safety and Value-Based Purchasing Demands

“Human factors that contribute to the complexities of patient handoffs include too few nurses, fatigue, rushed report, memory, nursing turnover, emotion, and information/sensory overload.”
JoAnne Phillips, MSN, RN, CCRN, CCNS, CPPS
Effective Handoff Communication: A Key to Patient Safety

“Every time lactate increases by 2, the risk of death [from sepsis] increases by 20%.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“The mortality for sepsis equals that of an acute MI in 1960.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“For every organ system that fails, mortality [from sepsis] increases by 22%.”
Julie Miller, RN, BSN, CCRN
Sepsis: Nurses Implementing the Latest Guidelines

“Falls are an adverse drug reaction.”
Anne Dabrow Woods, MSN, RN, CRNP
Recognizing and Treating Adverse Drug Reactions

“Angioedema from ACE inhibitors is not dose dependent.”
Anne Dabrow Woods, MSN, RN, CRNP
Recognizing and Treating Adverse Drug Reactions

“Start with what you know best, maybe a case study, and start writing.”
Denise Drummond Hayes, MSN, RN, CRNP
Bylines and Deadlines: Writing for Professional Publication

“Our work is based on science and evidence, but we are best known for our caring side.”
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
Finding Your Nursing Voice

“The person with a strong nursing voice is an expert problem solver who is more proactive than reactive.”
Margaret A. Fitzgerald, DNP, FNP-BC, NP-C, FAANP, CSP, FAAN, DCC
Finding Your Nursing Voice

As many of the sessions were happening concurrently, I know there is so much that I missed and I look forward to listening to several of the presentations when they are available online. For those of you who attended this conference, please share what you learned and what inspired you too! 

Also, you can view some photos from the conference on our Facebook page!