Patient handoff

Question 1

ISBAR

Answer 1

Identification
Situation
Background
Assessment
Recommendation

Question 2

leading root cause of sentinel events reported by the joint commission

Answer 2

breakdown in communication

Question 3

australia how much issues were due to miscommunication compared to 6% in inadequate training?

Answer 3

11%

Question 4

hand over problem are rooted in

Answer 4

health care provider education and lack there of

lack of role models

health care system that promotes/rewards autonomy and individual performance

Question 5

IPASS

Answer 5

Illness severity
Patient Summary
Action List
Situational Awareness/Contingency
Synthesis by receiver

Question 6

PSYCH mneumonic

Answer 6

for Psych patients

patient information
your assessment
clinical information
hindurance to discharge

Question 7

I PUT PATIENTS FIRST

Answer 7

Identify yourself and role and obtain nurse’s name

Patient’s past medical history (medical, surgical, social)

Underlying diagnosis and procedure

Technique (general anesthesia, neuraxial, regional)

Peripheral IVs, arterial lines, central lines, drains
Allergies

Therapeutic interventions (pain medications, antibiotics)

Intubation (very difficult, moderately difficult, easy)

Extubation likelihood (already extubated, very likely,
unlikely, definitely no extubation planned)

Need for drips (epinephrine, vasopressin, norepinephrine,
insulin, propofol, etc.)

Treatment plan for postoperative care (blood pressure
goals, ventilator settings)

Signs (vital signs during case and most recent)

Fluids (in’s and out’s, blood product(s), administered)

Intraoperative events (if any)

Recent labs (hemoglobin, glucose, etc.)

Suggestions for immediate postop care (ex: special
positioning, pain control, need for pumps, etc.)

Timing/expected time of arrival to ICU

Question 8

Actions recommended by the joint commission

Answer 8

Demonstrate leadsership commitment to successful hand-offs

Standardize critical content to be communicated by the sender during a hand off. Both verbal and in writing.

conduct face-to-face hand off communication and sign outs between senders and receivers in locations free from interruption

Standardize training on how to conduct a successful hand off from both sender and receiver

EHR to enhance hand offs

Monitor the success of interventions to improve hand off communication and use lessons to drive improvement

Sustain and spread best practices in hand offs and make high quality hand off culture a priority

Question 9

what percent of malpractice claims are directly related to hand offs

Answer 9

30%

Question 10

as a receiver what is an effective way to improve hand offs

Answer 10

read back

Question 11

teach back

Answer 11

during discharge the care giver has the patient teach expectations back to them

Question 12

what is one good patient safety strategy?

Answer 12

to let the patient read their own medical records

Question 13

What are some examples ofcritical contentthat should be included in a hand-off?

Answer 13

• Sender contact info
• Illness assessment
• Patient summary
• To-do action list
• Contngency plans
• Allergy list
• Code status
• Medication list
• Dated laboratory tests
• Dated vital signs

Question 14

what percent of clinical learning environments do not have a standardized hand off process

Answer 14

69%

Question 15

how many clinical education sites DO have a standardized hand off process?

Answer 15

20%

Question 16

TST reduced ineffective hand offs by how much in alaska

Answer 16

58.2%

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