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Improving OR-to-CSICU Communication: Implementing a Standardized Handoff Tool
Dissertation

Improving OR-to-CSICU Communication: Implementing a Standardized Handoff Tool

Natalie Stockman
University of Iowa
Doctor of Nursing Practice (DNP), University of Iowa
Spring 2026
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Abstract

Background: Communication failures during patient handoffs are a leading cause of sentinel events, with more than two thirds attributed to communication breakdowns and over half occurring during handoff reports. The OR-to-ICU transition is especially vulnerable in cardiac surgery due to high patient acuity and a fast-paced environment, often resulting in inconsistent reporting and omission of critical information. In the Cardiac Surgical ICU (CSICU) at Midwestern Medical Center, the lack of standardized handoff practices for open heart surgical patients contributed to variable report quality, lower nurse satisfaction, and decreased confidence in postoperative care. Purpose: The purpose of this evidence-based practice project is to improve the overall effectiveness of communications during bedside report between the OR and the CSICU, specifically for patients undergoing open-heart surgery by implementing a standardized handoff tool. Methods: A standardized OR to CSICU handoff tool, adapted from Lupei et al. (2021), was implemented over a three-month period. Baseline and post implementation data were collected using a modified Perioperative Handoff Survey to measure nurse satisfaction and a modified PROMIS General Self Efficacy Survey to measure nurse confidence. Bedside report efficiency was measured through manual chart review of anesthesia documentation. Findings: Nurse satisfaction improved significantly from an average score of 8.13 to 11.13 (p = 0.006), indicating enhanced perceptions of communication quality. Nurse self-efficacy showed a modest, nonsignificant increase from 15.27 to 16.40 (p = 0.289). Report efficiency improved by 12.3%, reducing average report time from 14.15 to 12.41 minutes (p= 0.510). Discussion: Implementation of a standardized handoff tool improved communication satisfaction and efficiency in the OR to CSICU transition of care for open heart surgical patients. While nurse confidence showed only slight improvement, findings aligned with the existing literature demonstrating that standardized tools enhance clarity, organization, and perceived communication quality.
 Communication Handoff Standardized tool Satisfaction Cardiac Surgery Intensive Care Unit

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