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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Enhancing Quality and Safety

The patient handover process in hospital emergency departments is a critical component of healthcare delivery that significantly impacts safety and outcomes. When transitions between providers are not effectively managed, the result can be communication errors, delayed care, and compromised patient health. Emergency departments (EDs), characterized by their fast-paced and high-stakes environments, face unique challenges in standardizing handoff procedures. The urgency and complexity inherent to emergency care amplify the consequences of miscommunication. Therefore, implementing structured communication strategies becomes vital. This section examines the causes and risks associated with poor handoff practices in emergency settings, and it highlights the necessity for evidence-based methods that promote quality, safety, and coordinated nursing care. Additionally, this analysis identifies the key stakeholders whose involvement can significantly enhance outcomes and reduce hospital expenses.

Communication breakdowns during ED handoffs are a leading contributor to preventable medical errors. Limited time, patient complexity, and the absence of standardized communication protocols create vulnerabilities in the handover process. Literature suggests that nearly 80% of severe medical errors during handoffs are tied to miscommunication and noncompliance with existing protocols (Kinney-Sandefur, 2024). In such environments, rushed interactions can lead to missing or inaccurate information transfer. Moreover, up to 70% of healthcare outcomes and 50% of handover events are directly impacted by poor communication practices in emergency departments (Atinga et al., 2024). These risks are exacerbated when patient care is fragmented due to unclear responsibilities and inconsistent documentation.

To counter these risks, hospitals are adopting evidence-based strategies such as the SBAR (Situation, Background, Assessment, Recommendation) framework. SBAR promotes clear and consistent communication, improving patient satisfaction, staff collaboration, and documentation accuracy. Research supports that SBAR leads to fewer errors, better billing, and cost savings (Ghosh et al., 2021). Technology also plays a critical role—electronic health records (EHRs) with built-in handoff tools allow real-time updates and reduce reliance on memory-based reporting (Tataei et al., 2023). Conducting shift reports at the patient’s bedside encourages family participation, enhances understanding, and reduces confusion. Collectively, these practices mitigate adverse events, minimize waste from preventable complications, and ensure safer transitions within the ED.

Nursing Coordination for Quality Improvement

Nurses are central to ensuring effective handoffs and minimizing patient risk. As frontline care providers, they are responsible for verifying patient data during every phase of a transition. By actively engaging in multidisciplinary rounds, nurses collaborate with physicians and specialists to develop coherent care plans. This reduces communication errors, fosters timely interventions, and proactively prevents adverse events (Shirley et al., 2024). The integration of closed-loop communication, where nurses confirm the message is received and understood, further reduces missteps such as delayed lab tests or incorrect medication administration.

In complex cases like sepsis, timely communication from nurses to incoming teams can determine patient outcomes and reduce costs. Ensuring that the urgency of treatment is conveyed, especially in critical situations, helps avoid deterioration and the need for intensive interventions like ICU admission. Furthermore, nurses’ use of electronic handoff tools and family-inclusive discussions improves communication transparency and aligns care priorities. According to Bucknall et al. (2020), these initiatives not only reduce hospital readmissions but also enhance the efficiency and effectiveness of hospital operations.

Nurses also serve as liaisons between various stakeholders, helping to align goals and maintain continuity of care. Through structured handoffs and well-documented communication, they contribute to the reduction of hospital errors and ensure that transitions do not result in information loss. By facilitating patient and family engagement, nurses strengthen the support system necessary for recovery, while also improving care coordination and cost efficiency.

Stakeholder Involvement in Patient Safety

Improving the quality of patient handoffs requires collaboration from multiple stakeholders within the healthcare system. Physicians rely on accurate and timely information from nurses to make critical treatment decisions. Any delay or miscommunication in this exchange can lead to negative outcomes and higher treatment costs (Jemal et al., 2021). Pharmacists are essential in verifying medication orders and preventing errors that could otherwise stem from incomplete handoff information. Considering the financial burden that medication errors place on the healthcare system, pharmacist involvement is crucial in mitigating risks.

Hospital administrators also play a pivotal role by supporting the implementation of standardized handoff procedures and providing the necessary infrastructure. Their investments in technology, training, and policy enforcement enable clinical staff to perform more accurate and safer handoffs. Quality improvement teams and patient safety officers monitor errors and guide corrective actions, ensuring alignment with best practices. Additionally, involving patients and their families during bedside handoffs strengthens continuity of care and improves outcomes. According to Bucknall et al. (2020), this inclusive approach reduces preventable readmissions and encourages more meaningful patient engagement.

Ultimately, collaboration among stakeholders—from clinical staff to administrators and patients—creates a resilient system that prioritizes safety and efficiency. Nurses are well-positioned to coordinate this collaboration, acting as the linchpin that ensures communication flows effectively across all levels of care. These joint efforts not only enhance patient outcomes but also lead to sustainable cost reductions across healthcare settings.

Summary Table

Enhancing Quality and Safety	Nursing Coordination for Quality Improvement	Stakeholder Involvement in Patient Safety
ED handoffs are high-risk for communication failure.	Nurses verify critical info before, during, after handoff.	Physicians rely on accurate handoffs for treatment.
Up to 80% of serious errors come from poor handoff.	Nurses participate in multidisciplinary rounds.	Pharmacists help prevent medication errors.
SBAR and EHRs improve communication and reduce costs.	Closed-loop communication ensures message delivery.	Admins support standard tools and training.
Time constraints increase the risk of miscommunication.	Nurses use EHR tools and bedside reports for clarity.	Patient-family involvement leads to better outcomes.
Structured handoffs reduce delays and adverse events.	Nurses prevent errors like missed meds or tests.	Collaboration ensures safety and cost-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

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

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

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

NURS FPX 4035 Assessment 1 Enhancing Quality and Safety

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