Abstract

Background Handoffs between medical providers serve a crucial patient safety function. While most published literature on the topic studies the handover process amongphysicians, robust literature is available on interdisciplinary medical communication. Little is known about the downstream effects of effective physician handover on subsequent physicianand nursing interactions. Objective Our objective was to implement a handoff curriculum, SAFETIPS (Statistics, Assessment, Focused plan, pertinent Exam findings, To dos, If/thens, Pointers/pitfalls, and Severity of illness), for pediatric residentsand to investigate its impact on nurses' perceptions of resident preparedness, efficiency, and competency. Methods Nurses were asked to score residents in five domains and describe the frequency of nurse-to-resident and resident-to-nurse interruptions. The survey was distributed before and after the SAFETIPS introduction. Results Statistical analysis revealed significant post-intervention mean score increases of one full point in four categories, namely organization and efficiency, communication, content, and clinical judgment. The percentage of nurses using the term "reasonable/relevant" to describe interactions with residents significantly increased from 45% to 76% (p = 0.004). The percentage of nurses reporting that residents gave "unsure response[s]," made decisions that differed from nurses' decisions, and made decisions without family/parental interests significantly decreased by 31 (p = 0.004), 22 (p = 0.034), and 30(p = 0.002) percentage points, respectively. Conclusion The introduction of a structured handoff curriculum significantly improves communication among residents.This is then associated with improved interactions between residents and nurses.

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