Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow

Starmer, Amy J.; Schnock, Kumiko O.; Lyons, Aimee; Hehn, Rebecca; Keohane, Carol A.; Landrigan, Christopher P.

doi:10.1136/bmjqs-2016-006224

Cited by 48 publications

(43 citation statements)

References 38 publications

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“…Implementation of the same protocol with nurses resulted in a significant increase in the number of nursing handoffs containing acuity assessments; however, no data concerning anticipatory guidance were reported (Starmer et al, 2017). While the effects of such practices on nurses' judgments still remain to be clarified, it is plausible that they could result in greater agreement between nurses.…”

Section: Discussionmentioning

confidence: 99%

Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed‐methods study

Lavoie

Clarke

Clausen

et al. 2020

Journal of Clinical Nursing

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Aims and objectives To explore how change‐of‐shift handoffs relate to nurses' clinical judgments regarding patient risk of deterioration. Background The transfer of responsibility for patients' care comes with an exchange of information about their condition during change‐of‐shift handoff. However, it is unclear how this exchange affects nurses' clinical judgments regarding patient risk of deterioration. Design A sequential explanatory mixed‐methods study reported according to the STROBE and COREQ guidelines. Methods Over four months, 62 nurses from one surgical and two medical units at a single Canadian hospital recorded their handoffs at change of shift. After each handoff, the two nurses involved each rated the patient's risk of experiencing cardiac arrest or being transferred to an intensive care unit in the next 24 hr separately. The information shared in handoffs was subjected to content analysis; code frequencies were contrasted per nurses' ratings of patient risk to identify characteristics of information that facilitated or hindered nurses' agreement. Results Out of 444 recorded handoffs, there were 125 in which at least one nurse judged that a patient was at risk of deterioration; nurses agreed in 32 cases (25.6%) and disagreed in 93 (74.4%). These handoffs generally included information on abnormal vital signs, breathing problems, chest pain, alteration of mental status or neurological symptoms. However, the quantity and seriousness of clinical cues, recent transfers from intensive care units, pain without a clear cause, signs of delirium and nurses' knowledge of patient were found to affect nurses' agreement. Conclusions Nurses exchanged more information regarding known indicators of deterioration in handoffs when they judged that patients were at risk. Disagreements most often involved incoming nurses rating patient risk as higher. Relevance to clinical practice This study suggests a need to sensitise nurses to the impact of certain cues at report on their colleagues' subsequent clinical judgments. Low levels of agreement between nurses underscore the importance of exchanging impressions regarding the likely evolution of a patient's situation to promote continuity of care.

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Section: Discussionmentioning

confidence: 99%

Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed‐methods study

Lavoie

Clarke

Clausen

et al. 2020

Journal of Clinical Nursing

View full text Add to dashboard Cite

show abstract

“…This work joins a growing literature that demonstrates the positive effects gained from standardising communication content and delivery methods 3. The IPASS bundle was initially studied in paediatric residents across the USA4 and was adapted by Starmer et al 2 for use by nurses in a paediatric intensive care unit. These researchers found that implementation of this bundle increased the frequency, quality and efficiency of key handoff elements, including fewer interruptions during nursing shift change 2.…”

mentioning

confidence: 86%

“…In this issue of BMJ Quality and Safety , Starmer and colleagues2 describe a framework, IPASS, to bridge this gap. IPASS stands for I llness severity; P atient summary, A ction list; S ituation awareness and contingency planning; and S ynthesis by receiver.…”

mentioning

confidence: 99%

“…The IPASS bundle was initially studied in paediatric residents across the USA4 and was adapted by Starmer et al 2 for use by nurses in a paediatric intensive care unit. These researchers found that implementation of this bundle increased the frequency, quality and efficiency of key handoff elements, including fewer interruptions during nursing shift change 2. Collectively, these findings suggest that the benefits of communicating patient information in a structured manner apply similarly to residents, nurses and (potentially) other health professionals.…”

mentioning

confidence: 99%

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Handoffs: what’s good for residents is good for nurses…so what’s next?

2017

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“…The effectiveness of communication tools has been demonstrated for episodic communication, such as handoffs and time-outs, but not for day-today communication. [33][34][35] Because of the need for effective communication, the use of communication tools is an essential part of the evolving model of pediatric critical care delivery. 1 Two studies found that improving the quality of communication may have the biggest impact on quality care ratings.…”

Section: Communication Toolsmentioning

confidence: 99%

Communication in Pediatric Critical Care Units: A Review of the Literature

Hallman

Bellury

2020

Critical Care Nurse

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Topic Current communication styles in pediatric critical care units do not often consider the needs of providers, patients, or family members. Clinical Relevance The Child Hospital Consumer Assessment of Healthcare Providers and Systems score has begun real-world testing and soon will be mandatory and tied to reimbursement. Poor communication in pediatric critical care units can lead to reduced continuity of care, escalated or unnecessary care, and poor outcomes for patients and hospitals. Improving communication in pediatric critical care units is imperative. Purpose of Paper Extant literature was reviewed to assess communication in pediatric critical care from the provider, parent, and patient perspectives. Communication tools were also reviewed. Content Covered Twenty-eight articles met inclusion criteria and were analyzed according to study focus (provider, parent/caregiver, patient, or tool). This review links communication to outcomes related to providers, parents, and patients. Current tools are reviewed to evaluate their effectiveness in addressing communication barriers and to guide future research in communication. Findings indicate that effective communication is challenging in intensive care units despite robust evidence that effective communication improves patient outcomes and quality metrics. Repeated and varied forms of communication, especially written reinforced with verbal communication, seem to have the strongest effect and show promising results. Common barriers nurses face on their units are identified, and solutions are suggested. This review adds to current knowledge by linking communication to measurable outcomes and examining communication barriers and needs specific to pediatric critical care populations from the provider, parent, and patient perspectives.

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Effects of the I-PASS Nursing Handoff Bundle on communication quality and workflow

Cited by 48 publications

References 38 publications

Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed‐methods study

Nursing handoffs and clinical judgments regarding patient risk of deterioration: A mixed‐methods study

Handoffs: what’s good for residents is good for nurses…so what’s next?

Communication in Pediatric Critical Care Units: A Review of the Literature

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