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Exploring the State of the Science of the Nursing Hand-off Communication

Galatzan, Benjamin J., MSN, RN; Carrington, Jane M., PhD, RN, FAAN

CIN: Computers, Informatics, Nursing: October 2018 - Volume 36 - Issue 10 - p 484–493
doi: 10.1097/CIN.0000000000000461

Miscommunication that occurs during the exchange of information between healthcare providers accounts for approximately 80% of adverse events in the healthcare setting. Nurses devote 10% to 15% of the workday to the nurse-to-nurse hand-off communication. The hand-off itself has remained virtually unchanged for the past 20 years, although the process is prone to errors. The introduction of the electronic health record and mandates to decrease errors and improve patient outcomes has led to an influx of research on the nurse-to-nurse hand-off communication. This article provides a comprehensive synopsis of the hand-off and the state of science on nurse-to-nurse communication using hand-offs. In general, the use and implementation of standardized tools and the nurse's perception of and satisfaction with the hand-off communication have been researched extensively. A standardized hand-off tool increases nurse satisfaction with the structure and consistency of the hand-off. While electronic health record–related forms and devices are not utilized by nurses, communication patterns and communication behaviors can also influence the effectiveness of the hand-off message. The areas of memory, cognition, and content of the hand-off affect the transfer and recall of hand-off information. Continued research on hand-off communication is essential to ensure patient safety.

Author Affiliations: Helen & Arthur E. Johnson Beth El College of Nursing and Health Sciences, University of Colorado, Colorado Springs (Mr Galatzan); and University of Arizona, College of Nursing, Tucson (Mr Galatzan and Dr Carrington).

The authors have disclosed that they have no significant relationships with, or financial interest in, any commercial companies pertaining to this article.

Corresponding author: Benjamin J. Galatzan, MSN, RN, Helen & Arthur E. Johnson Beth El College of Nursing and Health Sciences, University of Colorado Colorado Springs, University Hall, 1420 Austin Bluffs Pkwy, Colorado Springs, CO 80918 (

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