Learning Objective #1: Describe how the six steps of the collaborative research utilization model were operationalized to generate a best practice protocol for nurses shift handoffs. | |||
Learning Objective #2: Describe the evaluation research design used to determine feasibility of the shift “handoff” protocol, its usefulness and effectiveness in improving nurse and patient satisfaction outcomes. |
Theoretical
Framework: Guided by theory in research
utilization as well as Roger's "adoption of innovations" literature
for the overall framework, Orlando's theory is used to provide theoretical
rational for the specific evidence-based protocol.
Methods
(Design, Sample, Setting, Measures, Analysis): A pretest, posttest-posttest evaluation research design is
being used to evaluate the protocol for feasibility (cost & timeliness), usefulness
(nurse adherence to the protocol, N=86), and effectiveness in improving patient
(N=180) and nurse satisfaction (N=86) outcomes on two medical-surgical, one
intensive care unit, and one rehabilitation unit of a 148-bed Magnet-designated
urban community hospital. A Best
Practice Audit Instrument, Nurse Satisfaction Survey (NDNQI), Press-Ganey
Survey, and Satisfaction with SBARP Survey is being used to evaluate the
outcome variables of interest along a 3-point trajectory of care. Data will be analyzed using descriptive
univariate statistics, change score transformations, and t-tests. A p<.05 level of significance is
set.
Results: The expected date of completion is March 2007.
Conclusions
and Implications:
Despite growing interest in safe practices, a lack of standardization of
nursing practice related to shift handoffs, potentially dilutes efforts to
improve patient safety. This study incorporates directions established by AHRQ,
JCAHO, and the National Quality Forum to create meaningful clinician change
that results in reducing the toll of missing or incorrect communication of
patient information, omissions of relevant care, and dissatisfaction from
patients, families, and clinicians.