Nurse practitioner-based sign-out system to facilitate patient communication on a neurosurgical service: a pilot study with recommendations

• Published in: The Journal of neuroscience nursing Vol. 41; no. 6; pp. 329 - 335
• Main Authors: Rabinovitch, Deborah L, Hamill, Melinda, Zanchetta, Clauda, Bernstein, Mark
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, WK Health 01.12.2009; American Association of Neurosurgical Nurses
• Subjects: Analysis; Attitude of Health Personnel; Communication; Complications and side effects; Computer Security; Continuity of Patient Care - organization & administration; Humans; Internet - organization & administration; Medical errors; Medical Errors - nursing; Medical Errors - prevention & control; Medical Errors - psychology; Medical Records Systems, Computerized - organization & administration; Medical Staff, Hospital - organization & administration; Medical Staff, Hospital - psychology; Neurosurgery - nursing; Neurosurgery - organization & administration; Night Care - organization & administration; Nurse practitioners; Nurse Practitioners - organization & administration; Nurse Practitioners - psychology; Nursing; Nursing Evaluation Research; Ontario; Physician and patient; Physician-Nurse Relations; Pilot Projects; Practice; Prevention; Program Evaluation; Surveys and Questionnaires; Teaching Rounds - organization & administration; Total Quality Management - organization & administration; Ontario; Canada
• ISSN: 0888-0395; 1945-2810
• DOI: 10.1097/JNN.0b013e3181b6beae

Failure to communicate important patient information between physicians causes medical errors and adverse patient events. On-call neurosurgery physicians at the Toronto Western Hospital do not know the medical details of all the patients that they are covering at night because they do not care for the entire service of patients during the day. Because there is no formal handover system to transfer patient information to the on-call physician, a nurse practitioner-based sign-out system was recently introduced. Its effectiveness for communication was evaluated with preintervention-postintervention questionnaires and by recording daily logins. There was a statistically significant decrease in number of logins after 8 weeks of use (p = .05, Fisher's exact test), and the tool was abandoned after 16 weeks. Modifications identified to improve the system include the ability to sort by attending physician and to automatically populate the list with new patients. Effective communication is important for reducing medical errors, and perhaps these modifications will facilitate this important endeavor.