Evaluation of a nursing handoff educational bundle to improve nursing student handoff communications: A pilot study

Abstract

Background: Inadequate handoff education in prelicensure nursing programs may pose a significant latent safety risk. This pilot study evaluates a Nursing Handoff Educational Bundle (NHEB) for a cohort of Accelerated Bachelor of Science (ABS) nursing students. The Evidence-Based Bundle consists of an educational workshop, a standardized handoff format, clinical faculty education, and structured, formative evaluation of student handoffs. This study was implemented during Adult Health clinical experiences conducted at four different University-affiliated  healthcare institutions in the Northeastern United States.

Methods: A pre-test, post-test design was used with a convenience sample of 28 ABS nursing students.  Fourteen students who received the NHEB were compared to a similar group (n = 14) who were not exposed.  Student handoffs were observed and rated using the Handoff Clinical Examination (CEX) tool while providing and receiving handoffs during clinical experiences. Data was obtained at the beginning and the end of a 15-week time period.

Results: The provider handoff scores in the intervention group improved significantly (M = 4.64, SD = 1.3) over the comparison group change scores (M = 1.5, SD 1.34) when measured by independent samples t-test (t = 7.33, p = .000). The handoff recipients’ scores in the intervention group also improved significantly (m = 5.5, SD = 1.01) compared to no improvement in the recipient control group (M = -0.36, SD = 1.39), (t = 12.7, p = .000).

Conclusions: Without structured handoff education, nursing students are passive recipients during handoffs and do not engage in safety communication practices. Exposure to a NHEB improves student handoff communication skills and provides an opportunity to practice evidence-based handoff skills with structured support during clinical experiences. The NHEB could be considered for incorporation into prelicensure programs. Further study using a larger sample size is recommended based on these preliminary findings. Additionally, this intervention should be evaluated in novice nurse cohorts.