Friday, July 13, 2007
This presentation is part of : EBN Innovations
Using a Collaborative Research Utilization Model to Translate Best Practices in Nursing Shift Handoffs
Marlene A. Dufault, PhD, RN1, Cathy Duquette, PhD, RN, CNAA, BC2, and Shirley Sargent, MS, RN1. (1) College of Nursing, University of Rhode Island, Kingston, RI, USA, (2) Nursing Department, Newport Hospital, Newport, RI, USA
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.

Purpose: Ineffective communication is the most frequently reported cause of sentinel events in hospitals. This study's purpose is to use a six-step "translating-research-into-practice" model (Collaborative Research Utilization Model) to generate and pilot-test an evidence-based best practice protocol for nurses' shift handoffs.

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.