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Research investigating patient handoff processes has inundated the safety literature, but not in nephrology nurse practice settings. Effective patient handoffs are essential for maintaining patient safety by avoiding errors related to poor information exchange. This mixed methods research study investigated the process of patient handoff across nephrology practice settings and the implications for patient safety and nursing practice. Findings indicate there are too frequently issues with handoffs of patients with chronic kidney disease who must move between many different healthcare providers and healthcare settings. Nephrology nurses reported thar the use of multiple methods for handoff communications and practice sites having differing hours of operation present challenges to practitioners, which result in information too often "falling through the cracks."
Key Words: Nephrology nursing, patient handoff, transitions in care, patient safety.
Research investigating patient handoff processes has inundated the safety literature, but not in the specialty of nephrology nursing. Effective patient handoffs are essential for maintaining patient safety to avoid errors related to poor information exchange. Eighty percent of serious medical errors involve miscommunication during the handoff between healthcare providers (Huang et al., 2010).
A successful handoff is defined by the Joint Commission Center for Transforming Healthcare (2014) as "a transfer and acceptance of responsibility for patient care achieved through effective communication. It is a real-time process of passing relevant patient information from one caregiver or team to another to ensure continuity and safe patient care" (p. 2). Nurses in all practice settings play an essential role in safe and effective handoff and transitions in care.
Significance
In 2014, Ulrich and Kear conducted the first national study to assess the safety culture in nephrology nurse practice settings. Eight of the 76 questions of their survey focused on patient handoffs. Two open-ended questions asked nurses to share narratives related to safety. Findings from this study revealed that patient handoff was a critical issue that required further investigation with a more robust tool due to risks associated with poor communication of patient information (Kear & Ulrich, 2015; Ulrich & Kear, 2014). Forty-nine percent of the 979 respondents agreed or strongly agreed that important information "falls through the cracks" when patients with kidney disease are admitted to the hospital; 61% agreed or strongly agreed that this also occurs when...