Degree Name
Nursing Practice, DNP
Publication Date
6-24-2026
First Advisor
Lisa Drake
Second Advisor
Leigh Swartzendruber
Abstract
Effective nurse-to-nurse handoff communication is essential in hospital-at-home telehealth care, where remote nurses depend on accurate electronic health record documentation and structured shift-to-shift communication. This quality improvement project evaluated whether education and implementation of a standardized Situation, Background, Assessment, Recommendation (SBAR) workflow improved staff-reported handoff quality and reduced communication-related near-miss events over 8 weeks. Lewin's Change Theory, Rogers's Diffusion of Innovations, and the Plan-Do-Study-Act framework guided implementation and sustainability. A quantitative, quasi-experimental one-group pretest-posttest design was used. The intervention included SBAR education, a workflow checklist, and a handoff template. Outcomes were selected Handover Evaluation Scale (HES) responses and aggregate near-miss counts. Twenty nurses completed each survey phase. Wilcoxon signed-rank tests showed statistically significant improvement across selected reverse-scored HES items; pre-intervention means of 1.55–2.45 increased to post-intervention means of 5.60–6.45 (p < .001). Communication-related near-miss events decreased from 13 to 2, an 84.6% reduction. Limitations included a single site, small sample, short timeframe, item-level analysis, and possible underreporting. Findings indicated that SBAR was a feasible workflow change that improved handoff perceptions and supported safer home-acute care transitions.
Rights Management
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License
Recommended Citation
Speed, Antonius Devon, "Quality Improvement Project: The Impact of Standardized Handoff Communication in a Home Acute Care Setting" (2026). Doctor of Nursing Practice Projects. 363.
https://arch.astate.edu/dnp-projects/363
