NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

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Capella University

NURS-FPX4035 Enhancing Patient Safety and Quality of Care

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Date

Enhancing Quality and Safety in Emergency Department Handoffs

The handover of patients in hospital emergency departments represents a vital juncture where clinical safety and quality outcomes are most vulnerable. Patient transitions become high-risk when communication fails, resulting in treatment delays, incomplete care, and poor outcomes. Emergency departments (EDs) face added pressure due to the complex nature of patients, limited time for transitions, and frequently non-standardized handoff procedures. These factors increase the likelihood of errors, requiring attention to structured communication strategies. This paper examines common handoff errors, highlights evidence-based solutions to reduce risk, and underscores the pivotal role of nurses in enhancing coordination and safety. In addition, the involvement of key stakeholders is reviewed to demonstrate how interdisciplinary collaboration can decrease healthcare costs and improve patient outcomes.

Factors Leading to Patient Safety Risk

Multiple factors contribute to patient safety hazards in the emergency department, especially during handoffs. Among the primary challenges are poor communication and severe time constraints. The fast-paced and often chaotic nature of EDs exacerbates misinterpretation and results in incomplete transfers of crucial information. Research shows that approximately 80% of serious medical errors in patient handoffs stem from communication lapses (Kinney-Sandefur, 2024). Furthermore, professional handoff mistakes contribute to 24% of medical malpractice cases in emergency departments, highlighting the gravity of ineffective transitions.

These risks are compounded by high-pressure environments where staff must act swiftly, often without a clear protocol. Atinga et al. (2024) emphasize that communication failures in such settings account for up to 70% of poor care delivery outcomes and about half of all failed handoff events. The absence of standardized procedures leads to fragmented care and prolongs hospital stays. Patients in EDs typically present with complex, urgent needs that require seamless collaboration across healthcare professionals—something that poorly executed handoffs fail to support.

Solutions to Improve Patient Safety and Reduce Costs

To mitigate these risks, hospitals are adopting evidence-based handoff protocols such as SBAR (Situation, Background, Assessment, Recommendation). This standardized communication tool helps ensure that the critical elements of patient care are relayed accurately and consistently. SBAR has been proven to enhance the clarity of nurse-to-nurse communication, increase patient satisfaction, and improve provider adherence to structured handoffs (Ghosh et al., 2021). Moreover, SBAR enhances documentation quality, reducing billing errors and administrative costs.

Integrating electronic health records (EHRs) with handoff templates is another effective strategy. These templates provide real-time updates, minimizing reliance on memory and promoting documentation accuracy (Tataei et al., 2023). Bedside shift reports further improve communication by engaging patients and families directly in the care process, fostering better understanding and alignment. These practices collectively prevent costly errors, reduce hospital readmissions, and help avoid unnecessary medical expenses.

Table 1: Summary of Key Themes in Enhancing Quality and Safety

Nursing Coordination for Patient Safety and Reducing Costs

Nurses serve as the backbone of effective patient handoffs, ensuring continuity of care across emergency department shifts. As frontline providers, they must verify and communicate essential patient information during every transition. Their role is especially critical during interdisciplinary rounds, where nurses contribute to care planning and resolve discrepancies before patient transfers. Shirley et al. (2024) emphasize that improved communication within nursing teams can significantly reduce costly errors and improve coordination.

Closed-loop communication—where feedback confirms information receipt—is another key nursing responsibility. For instance, during the handoff of a sepsis patient, nurses must ensure the receiving team understands the urgency of antibiotic administration to avoid deterioration, extended ICU stays, and higher treatment costs. Efficient communication tools, such as electronic handoff platforms, support this role and minimize misunderstandings.

Moreover, involving families during shift reports increases transparency and promotes better outcomes. Nurses who foster these interactions can help prevent readmissions and alleviate the financial burdens associated with repeated hospital visits (Bucknall et al., 2020). Thus, the nurse’s ability to coordinate across different layers of care is indispensable in achieving safety and cost-efficiency.

Stakeholders’ Involvement in Nursing Coordination

Successful patient handoffs in the ED depend on collaboration among several stakeholders. Physicians rely on accurate handoff information to make prompt clinical decisions, making nurse-physician communication a critical partnership. Misalignment between these professionals may cause care delays and increase patient risks (Jemal et al., 2021). Pharmacists also play a pivotal role, as they review medication orders and flag inconsistencies. Their collaboration can prevent adverse drug events, a leading cause of preventable healthcare expenses.

Hospital administrators influence handoff effectiveness by investing in staff training and technology infrastructure. Their decisions to adopt standardized protocols empower clinical staff to implement safer practices. Safety officers and quality improvement teams review handoff-related incidents to develop corrective policies that reduce communication breakdowns. Lastly, patients and their families provide valuable input during bedside handoffs. Their involvement has been shown to improve care continuity and decrease readmissions (Bucknall et al., 2020). Nurses serve as a connecting link among all these stakeholders, ensuring coordinated efforts toward patient-centered and cost-effective care.

Conclusion

Effective handoffs in emergency departments significantly influence patient safety and healthcare costs. Poorly communicated transitions result in errors, increased hospital stays, and additional financial strain. However, these issues can be mitigated through the implementation of structured communication tools like SBAR, the use of EHR-integrated handoff templates, and family-inclusive practices. Nurses play a pivotal role in coordinating these processes and ensuring accurate communication. Support from stakeholders—including physicians, pharmacists, administrators, and patients—amplifies the positive outcomes of safe handoff practices. Hospitals that prioritize standardized, collaborative handoffs not only reduce errors but also elevate the quality of care and operational efficiency.

References

Atinga, R. A., Gmaligan, M. N., Ayawine, A., & Yambah, J. K. (2024). “It’s the patient that suffers from poor communication”: Analysing communication gaps and associated consequences in handover events from nurses’ experiences. SSM – Qualitative Research in Health, 6, 100482–100482. https://doi.org/10.1016/j.ssmqr.2024.100482

Bucknall, T. K., Hutchinson, A. M., Botti, M., McTier, L., Rawson, H., Hitch, D., Hewitt, N., Digby, R., Fossum, M., McMurray, A., Marshall, A. P., Gillespie, B. M., & Chaboyer, W. (2020). Engaging patients and families in communication across transitions of care: An integrative review. Patient Education and Counseling, 103(6), 1104–1117. https://doi.org/10.1016/j.pec.2020.01.017

Ghosh, S., Ramamoorthy, L., & Pottakat, B. (2021). Impact of structured clinical handover protocol on communication and patient satisfaction. Journal of Patient Experience, 8(1), 1–6. https://doi.org/10.1177/2374373521997733

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

Jemal, M., Kure, M. A., Gobena, T., & Geda, B. (2021). Nurse–physician communication in patient care and associated factors in public hospitals of Harari regional state and Dire-Dawa city administration, Eastern Ethiopia: A multicenter-mixed methods study. Journal of Multidisciplinary Healthcare, 14(1), 2315–2331. https://doi.org/10.2147/jmdh.s320721

Kinney-Sandefur, A. V. (2024). Improving patient handoff in the emergency department microsystem. University of New Hampshire Scholars’ Repository. https://scholars.unh.edu/thesis/1799

Shirley, S. G. A., Abdullah, B. F., & Dioso, R. I. (2024). Enhancing teamwork through effective handover practices among nurses in elder care setting. The Malaysian Journal of Nursing, 15(04), 100–108. https://doi.org/10.31674/mjn.2024.v15i04.0012

Tataei, A., Rahimi, B., Afshar, H. L., Alinejad, V., Jafarizadeh, H., & Parizad, N. (2023). The effects of electronic nursing handover on patient safety in general (non-covid-19) and COVID-19 intensive care units: A quasi-experimental study. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-09502-8