Publication Date
4-28-2026
Degree Awarded Date
December 18, 2026
DOI
https://doi.org/10.48765/05q8-ap92
Abstract
Background and Significance: Inconsistent ICU to OR handoff practices create conditions for information loss, threatening patient safety and continuity of care. Communication errors contribute to an estimated 250,000 fatalities and $20 billion in annual U.S. healthcare costs.
Review of Literature Findings: A thorough literature review revealed that standardized handoff procedures are shown to improve communication and team dynamics.
Methods: This quality improvement (QI) project implemented a standardized handoff process using the Handoff Reference Tool when transferring patients from the Intensive Care Unit (ICU) to the Operating Room (OR) in a large academic medical center. Pre- and post-implementation observations evaluated handoff completeness, accuracy, participation, and efficiency among ICU nurses and providers, anesthesia personnel, and surgical representatives.
Results/Discussion of Findings: Using the Handoff Reference Tool, post-implementation data showed increased handoff completeness, participation, and efficiency, with a statistically significant improvement in nurse completeness (p < .001). Mean handoff duration decreased from 9.1 minutes to 6.3 minutes. Pre-and post-implementation accuracy maintained 100%.
Implications: Implementation of a structured handoff tool improved communication, standardization, and collaboration across disciplines, enhancing the quality and safety of perioperative transitions. The findings support systemwide policy adoption and leadership engagement to sustain standardized handoff practices.
Summary: The implementation of this handoff tool established a dependable procedure to ensure the reliable transfer of information during ICU to OR handoff.
Language
English (en)
Document Type
Other
Advisor
Spencer, Julie DNP, RN, CDCES (Chair) Barnes Jewish College, Goldfarb School of Nursing
Associated Committee
Torres, Brian DNP, CRNA (Committee Member) Barnes Jewish College, Goldfarb School of Nursing
Recommended Citation
Alfeldt, Jenna; Hoffer, Kristen; Miles, Ashley; and Schwarztrauber, Amanda, "Preventing Information Loss During ICU to OR Handoff" (2026). Doctor of Nursing Practice (DNP) Student Projects. Paper 25.
https://doi.org/https://doi.org/10.48765/05q8-ap92
