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Title Handoff standardization in the neonatal intensive care unit with an EMR-based handoff tool.
Author(s) Nickel N, Amin D, Shakeel F, Germain A, Machry J.
Source J Perinatol, Vol. 41, No. 3, Pages 634-640
ePub Epub 2020 Jul 20.
DOI doi: 10.1038/s41372-020-0740-z.
Publication Date 3/1/2021
Abstract Objective: This quality improvement project aimed to improve the accuracy and efficiency of handoff communication among NICU medical providers with an Electronic Medical Record (EMR)-based handoff tool (HT). Study design: Three Plan-Do-Study-Act (PDSA) cycles were utilized following the implementation of a NICU-specific EMR-based HT and a standardized handoff process. Primary measures included accuracy of demographic components: patient name, bed, age, gestational age, postmenstrual age; and medical components: active diagnoses, weight, vascular access, respiratory support, diet, total fluid goal, medications. Secondary measures included environmental components (start time, duration, location, and distractions) as indicators of efficiency. Results: Accuracy of handoff components improved from 68% to 99% (p < 0.001). Efficiency of the handoff improved with time needed to complete patient handoff decreasing from 78 to 47 s per patient (p < 0.001). Conclusions: Standardizing the NICU handoff process using an EMR-based HT allowed for increased accuracy of handoff components and improved efficiency, which may promote enhanced patient safety.


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