Standardized
Tools

Armstrong, A. , Engstrand, S. , Kunz, S. , Cole, A. , Schenkel, S. , Kucharski, K. , Toole, C. & DeGrazia, M. (2022). Transferring With TACT. Advances in Neonatal Care, 22 (6), E217-E228. doi: 10.1097/ANC.0000000000001030.

Armstrong et al. (2022) describe the development and implementation of the TACT (Tools to Assist Critical Transitions) communication bundle aimed at improving the safety and effectiveness of patient handoffs during neonatal transfers. Conducted in a Level IV NICU, the initiative focused on enhancing interprofessional communication through structured tools, including checklists, standardized language, and education. The TACT bundles improved team satisfaction, clarified role delineation, and facilitated better information sharing during transfers. The study demonstrates that implementing structured, multidisciplinary communication strategies can significantly enhance the quality and safety of neonatal transitions of care.

• Nurses can utilize Armstrong et al.’s (2022) article, Transferring With TACT, to enhance the safety and effectiveness of neonatal patient transfers by applying the TACT framework—an evidence-based approach designed to improve communication and teamwork during transitions. This resource offers practical strategies for coordinating care among multidisciplinary teams, emphasizing timely, accurate, clear, and thorough communication to minimize errors and stress during transfers. It is especially suitable for use during transfers within neonatal intensive care units (NICUs) or between facilities, where vulnerable newborns require meticulous attention to detail and seamless information exchange. By employing this framework, nurses can promote patient safety, support family-centered care, and foster collaboration during critical transitions in neonatal care.

Butt, F., Varghese, N., Elhadidi, A., Abdulrahman, S., & Ben Ayad, A. (2024). Standardized Neonatal ICU Progress Note Template and Feedback System: A Clinical Documentation Improvement Initiative. Cureus, 16(12), e75309. https://doi.org/10.7759/cureus.75309

Butt et al. (2024) describe a clinical documentation improvement initiative in the NICU that involved implementing a standardized progress note template and a structured feedback system. The goal was to enhance the clarity, completeness, and consistency of daily clinical documentation by neonatal care providers. The intervention led to measurable improvements in documentation quality, including a more accurate representation of patient status and care plans. Additionally, the feedback system promoted ongoing education and accountability among clinicians. The study highlights the effectiveness of standardized templates and real-time feedback in optimizing clinical communication and supporting high-quality care in the NICU.

• Nurses can utilize Butt et al.’s (2024) article, Standardized Neonatal ICU Progress Note Template and Feedback System: A Clinical Documentation Improvement Initiative, to enhance the consistency and clarity of clinical documentation in the neonatal intensive care unit (NICU). This resource offers a standardized progress note template combined with a feedback system aimed at improving documentation accuracy, fostering better communication among healthcare providers, and ultimately enhancing patient outcomes. Nurses may find this resource particularly beneficial during daily charting and interdisciplinary rounds in the NICU, where precise and comprehensive notes are vital for addressing the complex care needs of neonates. By implementing this standardized approach, nurses can minimize documentation errors, facilitate more effective handoffs, and promote continuity of care.

Martínez-Fernández, M. C., Castiñeiras-Martín, S., Liébana-Presa, C., Fernández-Martínez, E., Gomes, L., & Marques-Sanchez, P. (2022). SBAR Method for Improving Well-Being in the Internal Medicine Unit: Quasi-Experimental Research. International journal of environmental research and public health, 19(24), 16813.

The study by Martínez-Fernández et al. (2022) examined the effects of implementing the SBAR (Situation, Background, Assessment, Recommendation) communication tool in an internal medicine unit to enhance healthcare professionals' well-being. Conducted as a quasi-experimental, longitudinal study in a Spanish hospital, the research measured job satisfaction, engagement, resilience, and job performance before and after the intervention. Results revealed a significant improvement in staff resilience and communication, although job satisfaction and engagement remained mostly unchanged or slightly declined. The findings suggest that while SBAR improves communication and supports resilience, broader organizational changes may be required to influence overall job satisfaction and engagement.

• Nurses can utilize Martínez-Fernández et al.’s (2022) study on the SBAR method to improve communication and well-being within internal medicine units by implementing this structured communication tool—Situation, Background, Assessment, Recommendation—during patient handoffs and interdisciplinary interactions. This resource demonstrates how SBAR enhances clarity, reduces misunderstandings, and facilitates a more organized exchange of information, which can positively affect staff satisfaction and patient safety. Nurses may find it particularly suitable to employ the SBAR method during shift changes, critical conversations, and care transitions where accurate communication is vital. Adopting this method can cultivate teamwork, alleviate stress, and encourage a safer, more supportive clinical environment.

Noura, N., Dipti, A., Fauzia, S., Germain, A., & Joana, M. (2021). Handoff standardization
in the neonatal intensive care unit with an EMR-based handoff tool. Journal of Perinatology, 41(3), 634-640. https://doi.org/10.1038/s41372-020-0740-z

Nickel et al. (2021) conducted a quality improvement project in a neonatal intensive care unit (NICU) to enhance handoff communication among medical providers through an Electronic Medical Record (EMR)-based handoff tool (HT). Over three Plan-Do-Study-Act (PDSA) cycles, they implemented a NICU-specific EMR-based HT and standardized handoff processes. The primary measures included the accuracy of demographic components (e.g., patient name, bed, age) and medical components (e.g., active diagnoses, weight, vascular access), while secondary measures assessed environmental components (e.g., start time, duration, location, and distractions) as indicators of efficiency. Results demonstrated a significant improvement in accuracy, rising from 68% to 99% (p < 0.001), and efficiency, with the time needed to complete patient handoff decreasing from 78 to 47 seconds per patient (p < 0.001). The study concluded that standardizing the NICU handoff process using an EMR-based HT led to improved accuracy and efficiency, which could enhance patient safety.

• Nurses can use Noura et al.’s (2021) article, "Handoff Standardization in the Neonatal Intensive Care Unit with an EMR-Based Handoff Tool," to enhance the consistency and accuracy of patient handoffs by incorporating a standardized electronic medical record (EMR)–based handoff tool into their workflow. This resource emphasizes how utilizing an EMR-based tool streamlines communication, reduces information loss, and improves continuity of care in the high-acuity NICU environment. Nurses may find this resource particularly useful during shift changes and patient transfers within the NICU, where precise and timely information exchange is crucial. By adopting such a tool, nurses can facilitate safer transitions, minimize errors, and promote efficient collaboration among care teams.

Soares, D. R. A., Rodrigues, D., & Carmona, F. (2023). Implementation of a standardized handoff system (I-PASS) in a tertiary care pediatric hospital. Revista paulista de pediatria : orgao oficial da Sociedade de Pediatria de Sao Paulo, 41, e2022123. https://doi.org/10.1590/1984-0462/2023/41/2022123

Soares, Rodrigues, and Carmona (2023) conducted a prospective intervention study to evaluate the implementation of the I-PASS standardized handoff system in a pediatric ward at a tertiary care hospital in Brazil. The study involved training physicians (staff and residents) through online sessions that included lectures and simulations. Medical handoffs were recorded before and after the intervention to assess changes in the amount and quality of information transmitted. Results indicated a significant increase in the delivery of relevant information for 12 out of 16 assessed items, without a corresponding increase in handoff duration (45.9 vs. 48.0 seconds; p=0.349). Additionally, there was a notable reduction in time spent on interruptions and unrelated communication (18% vs. 2.7%). The implementation of I-PASS led to higher reporting of action lists and contingency plans, with increases from 31% to 81% and 16% to 73%, respectively (p<0.001 for both). The study concluded that standardizing handoffs using I-PASS improved the efficiency, objectivity, and quality of information transfer, thereby enhancing patient safety and communication among healthcare providers.

• Nurses can utilize Soares, Rodrigues, and Carmona’s (2023) article on implementing the standardized handoff system I-PASS to enhance the quality and safety of patient transitions in pediatric care. This resource outlines how adopting the I-PASS framework, which includes components such as Illness severity, Patient summary, Action list, Situation awareness, and Synthesis by the receiver, can improve communication accuracy, decrease errors, and foster teamwork during handoffs. Nurses may find this resource especially relevant during shift changes, patient transfers, and interdisciplinary rounds in tertiary pediatric settings, where complex cases necessitate clear and structured information exchange. By incorporating I-PASS into their practice, nurses can facilitate safer care transitions and promote better clinical outcomes for pediatric patients.