1. Section Editor(s): Davis, Charlotte BSN, RN, CCRN

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The American public's continued vote of confidence in the nursing profession, consistently listing nursing above law enforcement and even clergy in Gallup's annual most ethical professions poll, has been sustained because nurses utilize open communication and a patient- and family-centered holistic approach to care delivery. Open communication is essential for safe, quality patient care. When nurses use evidence-based communication techniques, such as bedside shift report, hourly patient/family rounding, and transition of care handoff reports, we're demonstrating our dedication to best practice and patient safety.

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One of the greatest risks that patients encounter in the healthcare setting is during the transition between healthcare providers or levels of care. Omitted information can have a detrimental impact on patient safety. For this reason, it's essential that all nurses utilize a communication tool or algorithm when transitioning care to prevent the omission of vital information. During transition of care handoff report, responsibility and accountability are transferred from one healthcare provider to another.


According to The Joint Commission, over 4,000 communication handoffs occur each day, or 1.6 million per year, in the average teaching hospital. During each one of these encounters, the chance for information to be conveyed inaccurately or omitted is ever present. The Joint Commission reports that 70% of sentinel events are due to communication breakdowns. The Institute for Safe Medication Practices (ISMP) directly links 80% of all medication errors to inadequate handoff communication between healthcare providers. The ISMP recommends that utilization of a standardized communication tool can help prevent these errors from occurring.


We must ensure that we perform our transition of care handoff reports face-to-face at the bedside using a standardized handoff communication tool to convey vital information in an organized and systematic manner. When we encourage patient and family involvement in the process, we gain their trust by showing our commitment to safe care transitions. To see what one Comprehensive Stroke Center is doing to increase safety for stroke patients transitioning into the community setting, see page 34.


Nurses are nationally recognized as patient safety advocates. The community sees your dedication to practice and they award you their vote of confidence. Congratulations, nurses, you're all amazing!

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