New Hand Off Policy Ensures Communication, Patient Safety
OR nurse Rosemarie Passamonte, RN, (at left) hands off a patient to Kristin Styer, RN, BSN, of the PACU.
BWH has been working since August to implement a standardized approach to hand off communications among care providers when a patient is transferred from one setting to another. The hospital is standardizing hand offs to ensure the best and safest care for all patients and to remain compliant with JCAHO’s second National Patient Safety Goal.
The first phase of the project addressed OR-to-PACU hand offs; nurse-to-nurse hand offs; and resident and physician assistant hand offs. One team determined that the OR to PACU process needed minor updates, and distributed the updated policy to staff.
Nancy Hickey, RN, director of Emergency and Medical Nursing and interim director of Cardiovascular Nursing, and Melissa Joseph, RN, assistant nurse manager of Diversity, led a team to develop the nurse-to-nurse hand off policy. The policy is to be followed for all hand offs between nurses, including during patient shift report and break coverage in various clinical and procedural settings.
The Hand Off Communication Policy includes:
The next phase of the project addresses hand offs between attending physicians and hand offs in procedural and ambulatory areas.
- • Hand offs must be interactive so the nurse receiving the patient has an opportunity to have questions answered by the nurse who previously cared for the patient. The hand off information may be communicated face-to-face, taped or via phone as long as interaction is possible. In situations where a patient is transferred to a procedural or diagnostic area, the patient communication sheet will be used to provide information during the hand off.
- • Minimize interruptions. The content of the report should be objective, concise and related to the patient’s plan of care. Nurses shall be sensitive to a patient’s right to privacy and confidentiality (HIPAA) when participating in hand off communications.
- • Nurses are responsible for ensuring that all hand off communications contain the following baseline information: name; age; gender; chief complaint; allergies; safety issues; precautions if applicable; and code status if applicable, in addition to information related to the patient’s individual plan of care.
- • Each clinical area is developing standardized report content guidelines to determine what information is pertinent to the care and management of patients in that particular setting. The nursing flow sheet specific to the particular clinical area may be used to provide relevant information during the hand off.