Standardizing the Content of Nursing Shift-To-Shift Report to Improve the Quality of Communication Among Healthcare Providers on an Inpatient Psychiatric Unit

Introduction: Nurse-to-nurse shift handoffs are highly vulnerable to communication failures that can threaten patient safety and continuity of care. Nurses working in various settings recognize this gap and report low satisfaction with shift handoff communication, but evidence to guide quality improvement initiatives for nursing handoffs is limited. Standardization of the content included in nursing shift handoff is an evidence-based strategy to improve nurses' satisfaction with the quality of handoff communication in general medical settings, but this has not been studied extensively within inpatient psychiatric settings. This study aimed to improve nurses' satisfaction with shift handoff communication on an inpatient psychiatric unit by piloting an electronic shift handoff tool which standardized a minimum set of content to include for each patient during nursing shift handoff. Method: Development of the standardized electronic shift handoff tool was informed by content experts, the best available evidence, and nursing staff working on the unit designated as the site for this study. The shift handoff tool was incorporated into the electronic health record of each patient for a 3-week pilot-testing period. A survey was administered to nursing staff working on the designated unit (N=17) before and after the pilot-testing period. The survey was comprised of 12 questions that measured nurses' satisfaction with 12 elements of shift handoff communication. The questions used a 5-point Likert-scale (1= strongly agree, 2= agree, 3= neutral, 4= disagree, 5= strongly disagree) to measure nurses' satisfaction. Lower scores reflected higher levels of satisfaction. A Wilcoxon Signed Rank Test was conducted to compare pre-& post-intervention survey data for each of the 12 questions. Results: Statistical analysis revealed significantly lower scores for 5 of the 12 elements of shift handoff communication following the pilot-testing period for the standardized electronic shift handoff tool, indicating an increase in nurse satisfaction in these 5 areas (p