Date of Conferral



Doctor of Nursing Practice (DNP)




Allison Terry


The Use of a Standardized System of Communication to Change the Perception of Handoff Communication in a Psychiatric Setting


Alicia Renee' Plunkett

MSN, Walden University 2007

MSHA, University of St. Francis, 2005

BSN, University of Memphis, 1995

Project Submitted in Partial Fulfillment

of the Requirements for the Degree of

Doctor of Nursing Practice

Walden University

December 2014

The Joint Commission's review of sentinel events indicated that communication errors were the cause of over 65% of the sentinel events occurring in healthcare. The nursing profession has the responsibility of providing 24-hour care in an acute care setting and nurses are thus the primary participants in the handoff communication process. The purpose of this project was to assess the nursing staff's perception of handoff and to create a process for handoff communication. The most common framework for correcting communication errors in the literature is the Situation, Background, Assessment, and Recommendation framework, which was used as a guide for developing a process and form for handoff in this facility. The "Clinical Handover Staff Survey" developed by O'Connell, MacDonald, and Kelly (2008) was modified for use in this study. This survey was distributed to nurses and mental health technicians in 2 acute care units within a standalone acute care psychiatric hospital (n = 140). The quantitative survey identified 3 common barriers to the process in this facility that included: (a) interruptions, (b) subjective terminology used to describe patients, and (c) the lack of confidence in the information presented. After the implementation of a new process and form, the staff members were resurveyed to measure their post implementation perceptions of the handoff process. In each of the 3 areas measured, the implementation of a new process and form allowed the facility to see changes in the staffs' perceptions of the handoff process. The changes seen in this facility further indicate the need for education, standardization, and a continued focus on improving and mastering the important task of handoff communication. Improving handoff communication prevents errors in patient care from occurring, therefore decreasing mortality and morbidity rates.