Effective handoff communication among nurses contributes to preventing errors and improving nursing communication and teamwork. Few studies have explored strategies to improve communication among acute rehabilitation nurses. This evidence-based clinical practice study aimed to enhance a practice change by applying the TeamSTEPPS communication strategy “I PASS the BATON” into the current handoff communication during the transition of care to improve rehabilitation nurse communication and teamwork. The study applied two theoretical frameworks, which were Gibson’s theory of Affordance and Kotter’s Change Model. TeamSTEPPS proposed situational awareness and mutual support, which had the foundation on Gibson’s theory of Affordance, to improve team performance. Kotter’s Change Model stimulated nurses in changing their strategies of communication to improve teamwork.
The study was a quasi-experimental and one-group pretest-posttest design. The rehabilitation nurses (n=20) in a pediatric hospital used the handoff communication based on the mnemonic “I PASS the BATON” in eight weeks, from March 9, 2020, to May 2, 2020. The participation rate among RNs in the unit was 80 %. The participants answered a paper version of the TeamSTEPPS Teamwork Perceptions Questionnaires (T-TPQ) at week one and week eight of the project to evaluate the change of their perceptions using this handoff strategy. The nonparametric Wilcoxon Signed Rank test is used to compare the pre and post-T-TPQ mean scores. Cronbach’s alpha was calculated to test the reliability and validity of T-TPQ. The post-intervention T-TPQ mean score (4.27, SD = 0.49) was higher the pre-intervention T-TPQ mean score (3.89, SD = 0.38) with p-value = .002. The RN participants acknowledged that applying the TeamSTEPPS communication strategy, “I PASS the BATON,” improved their perceptions of team communication and teamwork. Cronbach’s alpha coefficients of the T-TPQ and its constructs vary from 0.68 to 0.97.
The findings reinforce the use of handoff “I PASS the BATON” strategy during the transition of care to improve communication and teamwork in the rehabilitation unit. The unit leaders should continue to implement the project to explore further EBP on handoff strategies that can apply in rehabilitation patients.
Learning Objectives:
- Teaching the TeamSTEPPS handoff
- PASS THE BATON to the RNs in a pediatric rehabilitation unit.
- Creating guidelines for information exchange during the transition of care.
