Handoff Tool Promotes Nurse-to-Nurse Communication to Avoid Patient Adverse Events

May 05, 2017

Treatment with checkpoint inhibitors can lead to immune-related adverse events (AEs), such as hepatitis, enterocolitis, thyroiditis, pneumonitis, and dermatitis, which require prompt identification and surveillance to avoid treatment discontinuation and fatal outcomes. Nurse-to-nurse handoff communication is a crucial step in preventing these AEs, but limited research on this topic exists.

An interprofessional team that included RNs, nurse practitioners, and physicians working with patients receiving immunotherapy identified the need for a handoff tool to enhance effective communication and maintain continuity of care.

RuthAnn Gordon, MSN, FNP-BC, OCN®, from Memorial Sloan-Kettering Cancer Center in New York, and coauthors presented the findings during a poster session at the ONS 42nd Annual Congress in Denver, (http://congress.ons.org) CO. The poster was titled “Utilizing Nurse to Nurse Handoff Communication to Manage Immune Related Adverse Events in an Outpatient Immunotherapy Clinic.”

An email tool was established based on immunotherapy algorithms, and follow-up intervals and instructions were plotted on a grid. Each day, an RN was assigned a list of patients and follow-up per monitoring instructions. At the end of a shift, the list was sent to the entire team with updates and recommendations for further follow-up for assigned daily coverage.

The researchers found that 100% of staff reported engagement with the tool. Anecdotal feedback indicated patient satisfaction as an added bonus of using the tool. In addition, the nursing team reported increased team efficiency and accountability.

“This tool can be easily replicated for any practice setting without substantial financial resources,” the researchers concluded.

Copyright © 2017 by the Oncology Nursing Society. User has permission to print one copy for personal or unit-based educational use. Contact pubpermissions@ons.org for quantity reprints.