Amy HoFollow

Date of Graduation

Winter 12-14-2018

Document Access

Project/Capstone - Global access

Degree Name

Master of Science in Nursing (MSN)


School of Nursing and Health Professions

First Advisor

Mary Seed


Emergency room (ER) to Intensive care unit (ICU) handoff reports are often ineffective because the lack of an standardized guideline. The aim of the Clinical Nurse Leader (CNL) improvement project was to improve the nurse satisfaction survey scores in the ER and ICU microsystems within a mid-sized community hospital in northern California. Participates included registered nurses, and ER and ICU managers. The failure mode and effect analysis (FMEA), Strength, weaknesses, opportunities, and threats (SWOT) analysis, and the Plan-Do-Study-Act (PDSA) cycle were used for this project. Literature reviews were conducted to identify effective theories, patterns, and tools for handoff reports. Nurse surveys were conducted to evaluate their satisfaction with handoff reports before and after the quality improvement project. A handoff guide was developed that was influenced by nursing feedback for implementation. Although the goal of improving survey results by 30% following two weeks of project implementation was not achieved, nurse satisfaction still greatly improvedby 23% from 54% to 77%. Identification and implementation of a standardized handoff report guide improved nurse satisfaction within the microsystems of ER and ICU. Additional work is needed to ensure 100% compliance and reassessment after long term usage.