Date of Graduation

Spring 5-11-2024

Document Type


Degree Name

Doctor of Nursing Practice (DNP)


School of Nursing and Health Professions




DNP Completion

First Advisor

Dr. Rhea Ferry

Second Advisor

Dr. Christopher Kemnitz

Third Advisor

Dr. Lisa Starr


Nature and Scope of the Project: Rural, volunteer emergency medical services (EMS) face unique challenges related to financial viability, resource management, and quality improvement (QI). In order to provide high quality patient care, EMS must improve interprofessional communication and coordination of care. EMS must focus QI effort on handoffs to Emergency Department (ED) staff because effective handoffs are crucial points in the transition of patient care. This project aimed to improve interprofessional communication and increase volunteer EMS comfortability with EMS-to-ED handoff.

Synthesis and Analysis of Supporting Literature: Projects focusing on handoffs, transitions, and communication need to be conducted. The evidence overwhelmingly argued for standardized EMS-to-ED handoff, but it could not narrow recommendations to any one method or tool. The Iowa Model and Lewin’s Change Theory served as guiding frameworks for this project.

Project Implementation: Demographic and pre-implementation surveys were administered at a regularly scheduled, monthly ambulance meeting. A short educational session was conducted reviewing the IMIST-AMBO handoff tool. The tool was used for ten weeks within the ambulance service, followed by a post-implementation survey.

Evaluation Criteria: Descriptive statistics were conducted with information collected from the demographic survey. The pre-implementation and post-implementation surveys were analyzed using Mann Whitney U tests. In order to accept or reject the hypothesis that implementing the IMIST-AMBO handoff tool would increase EMS comfortability, a confidence interval of 95% was used.

Outcomes: Outcome, process, and balancing measures were developed and examined for this project. Main outcome measures revolved around EMS comfortability during handoff and EMS perception of handoff pre- and post-implementation. Results were not statistically significant.

Recommendations: Additional projects must be contributed to EMS literature; especially for rural, volunteer ambulance services.

Included in

Nursing Commons