STANDARDIZATION OF ONCOLOGY NURSING SHIFT HANDOFF UTILIZING A CLOUD-BASED APPLICATION.

Staffing changes within this Comprehensive Cancer Center during the pandemic clarified the need for standardized change of shift nursing handoff processes. Five inpatient units had different processes for shift handoff. Current literature indicates that standardization of handoff can positively affect nurse satisfaction and decrease adverse patient events. Improving communication through optimal handoff is a Joint Commission national patient safety goal, with safety experts recommending evidence-based criteria for handoff communications. This quality improvement project aimed to implement a web or mobile accessible technology to ensure social distancing and standardization of shift handoff among all inpatient units. A mobile application was implemented, allowing easy shift handoff according to a structured templates via verbal recordings or web-accessed written summaries. Staff who participated downloaded the HIPAA-approved application to their personal phone or logged into a secure network computer. Report accuracy was measured by audits comparing reports against Joint Commission recommended criteria for four weeks after the process change. Staff satisfaction with the new process was measured through a survey two months after implementation. Audit data showed the most prevalent criteria included in the handoff report included illness assessment, patient summary, action items and contingency plans. Over 46% of users found the web-based application "extremely easy", with 26% finding it at least "somewhat easy". Both handoff methods demonstrated errors in timing of chemotherapy or lab tests. The new mobile verbal report was preferred by 62% of users, citing that written report encourages frequent copying and pasting which can lead to error. Users who preferred a typed report noted it was easy to print and write on during the shift. Some staff declined to download the application on their personal phone due to privacy concerns or unwillingness to use their own data for work needs, giving them only the typed option. The use of hospital approved phones to access this application would eliminate this concern, but is not a current option. Standardizing handoff report across all inpatient oncology units to web-based and mobile applications was successful, aligned with Joint Commission criteria, and received positively by staff nurses. More work is needed to enhance adherence to best practices, but the standardized approach provides an objective method to identify and address inconsistencies in practice. [ABSTRACT FROM AUTHOR]