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Evidence-Based Practice Briefs: The Art of Effective Handoffs: What Is the Evidence?
Sheila M. Gephart BSN, RN
Jacqueline McGrath

$3.95 		Advances in Neonatal Care
February 2012 
Volume 12  Number 1
Pages 37 - 39
 
  PDF Version Available!

ABSTRACT
Over a decade ago, the Institute of Medicine released its landmark report To Err Is Human, reporting that nearly 100 000 lives a year are lost in the United States because of preventable medical errors.1 Errors in the neonatal intensive care unit (NICU) are often serious, yet many are preventable. Vulnerable infants are at a particularly high risk for preventable errors because of their size and immaturity. If they experience adverse drug events or nosocomial infections, their risk for negative long-term complications increases dramatically.2-2 In the NICU, more than half of adverse drug events occur in infants born at 24 to 27 weeks' gestation, in contrast to a mere 3% in term infants.5 Furthermore, the lowest-gestation infants remain at high risk simply because they stay longer in the hospital and the opportunity for errors related to communication breakdowns is greater with increasing length of stay.6If the quality of health care is to improve, communication between providers must improve whether they are nurses, physicians, respiratory therapists, or professionals interacting across disciplines.7 When care is "handed off" at shift change, when patients are transferred, or when those responsible for caring for a patient change because of a change in acuity or scheduling, opportunities for communication breakdowns occur. Several researchers have found that when information degrades because of ineffective handoffs, it strongly increases the opportunity for medical errors and up to two-thirds of sentinel events are related to communication breakdowns.7-2 The Agency for Healthcare Research and Quality (AHRQ) reports that nearly half of hospital staff (N = 176 811) indicate that patient information is lost during shift handoffs.11 They recommend that handoffs be structured, include an opportunity for questions and answers, and be supplemented by readily available medical records preferably in an electronic form.11Handoffs are a standard procedure in the NICU and affect

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