NHS Virtual Poster Session: Spring 2013

Thank you for visiting the Chatham University Nursing Honor Society’s first virtual poster session. We hope you enjoy and engage in active discussions as you review the posters presented below. In order to assist us with future programs, we ask that you leave us a few comments that address the following three questions and also ask that you participate in active discussions for each poster you view:

  • What content will you take away from the poster?
  • How will you apply this content to practice?
  • Share the amount of time you spent reviewing the poster’s content?

We appreciate your input and look forward to hearing from you.

Sincerely, The NHS Board Members

Promoting Patient Safety With Perioperative Handoff Communication

Click the poster image below to view a larger version

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  1. Nancy Leighton Robinson says:

    Objectives
    Discuss the components of effective handoff communication in the perioperative setting
    Apply the principles of Lean Six Sigma to perioperative handoff communication

    Abstract

    Effective perioperative handoff communication is essential for patient safety. The purpose of this quality improvement project was to demonstrate how a structured handoff tool and standardized process could increase effective perioperative communication of essential clinical information, improve perioperative patient safety outcomes, increase compliance with regulatory standards for handoff communication, and improve nurse satisfaction. A team-based pilot project used the Iowa Model of Evidence-Based Practice and the principles of LEAN Six Sigma to implement a standardized framework for handoff communication and Perioperative PEARLS a perioperative specific handoff communication tool. The implementation of a structured handoff tool and standardized process supports compliance with regulatory standards of care and eliminates waste from the handoff process. Practice change effectiveness was measured pre-post implementation using a five-point Likert scale nurse satisfaction survey and project leader observations of perioperative handoff. A paired t-test was used to determine statistical significance of the practice change. A review of pre- and post-implementation data revealed project outcome attainment that was statistically significant. Evidence-based perioperative handoff communication promotes expedited patient evaluation, compliance with regulatory standards, safer perioperative environment, and improved nurse satisfaction.

  2. Kathleen says:

    Nancy,

    Nursing communication process is key to patient safety and positive outcomes. Your focus and project identified an area that could potentially have dangerous outcomes for the patient. It is easy to become distracted off task in nursing especially as we are asked to do more and more. Thank you for your work in this area. As someone who had surgery a year ago, I was very pleased to have the nursing staff mark my leg with a purple marker, to the time to explain about a nerve block, and reassure me through my pre and post-operative experience. It takes a team of nursing staff to create positive outcomes!

    Kathleen

    • Nancy Leighton Robinson says:

      Kathleen,
      This project actually resulted from an adverse event that occurred during my role as a risk manager. As nurses, we need to learn from errors or unfortunate outcomes and turn them into “never” events. I hope Perioperative PEARLS can begin to accomplish that.
      Nancy

  3. Julie Slade says:

    Nancy,

    This is a great poster on an important topic. I’ve never worked in a PACU but I was in an ICU for many years and I know how distracting it can be to try to admit a patient, provide care, and obtain report all at the same time. I’m glad to read that you had positive results in your project. I wonder how accepting some of the teammates were, though, to have to worry about another piece of documentation? If it means patient safety I hope you didn’t have too much push-back.

    • Nancy Leighton Robinson says:

      Julie,
      Thank you for your feedback. Because of the perioperative team involvement in this project and the methodical delivery of the practice change, the additional paper did not seem to be a major issue. some hospitals thar I’ve presented this to, have expressed an interest in using an online version of Perioperative PEARLS. The form was built with the expectation that it could be easily integrated into the EMR. Perioperative PEARLS was designed as a worksheet and is not a permanent part of the medical record.
      Nancy

  4. Cindy says:

    Nancy, As I am a staff CRNA and a professor in a nurse anesthesia program, I know these issues very well. I appreciate the work you did on this presentation. I especially like the detail you included for the PEARLS implementation. Prior to being in anesthesia, I spent 25 years working in the PACU and often felt reports were inadequate. The OR RN never accompanied the patient to the PACU at my facility so the anesthesia person provided the only report (anesthesiologist vs CRNA)thus there was no consistency. Hierarchy in communication also contributed to concerns.
    I direct the simulation activities at my anesthesia program and utilize standardized patients for the students to practice assessment and hand-off communication skills. I also am a speaker for PACU seminars and have led discussions on hand-off communication using some of the other methods like ISBAR and TeamSTEPPS. I like your version as it fits the procedural patient best.

    • Nancy Leighton Robinson says:

      Cindy,
      Thank you for your feedback. I have presented this project in a poster format at the national ASPAN conference where it was very well received by the participants. While SBAR is the most popular acronym for handoff, it is essential to make any tool/acronym work for the specific clinical setting. I am off to the national ANA conference in Atlanta next week to present this poster. I am excited to be able to share and disseminate my work in hopes that it will continue to improve patient outcomes and perioperative nurse satisfaction.
      Nancy

  5. Michelle Doas says:

    Hi Nancy,
    Excellent work! I observe communication/hand off errors nearly every time I work as a staff nurse. Variables often include “rushing” to complete the shift and clock out. Your work reminds me of the importance of taking the time to focus (and realize the value) of accurate/objective nurse hand off in any setting. Thank you.

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