Date of Award

Fall 12-2016

Degree Type

Doctoral Nursing Capstone Project

Degree Name

Doctor of Nursing Practice (DNP)

Committee Chair

Dr. Katherine Nugent

Committee Chair Department


Committee Member 2

Dr. Lachel Story

Committee Member 2 Department


Committee Member 3

Dr. Patsy Anderson

Committee Member 3 Department



Ineffective communication in the post-anesthesia care unit (PACU) is considered to have incidences of increased error, mortality, morbidity, which leads to decrease patient outcomes and quality of care. Therefore, the purpose of this study was to introduce a structured, standardized, and consistent handoff tool to Certified Registered Nurse Anesthetists (CRNA), Anesthesiologists, and Post Anesthesia Care Unit Nurses (PACU) that may result in favorable perception of usage. Without a structured handoff tool, the organization risks the occurrence of increasing errors when the message is not transmitted effectively and efficiently every time. Distractions leave the handoff susceptible to a breakdown during the patient transfer process. Using a structured handoff tool as the centerpiece for communication will require the development of routine actions by the anesthesia providers and the PACU nurse, which will introduce consistency in communication. An organized handoff process should be adopted as standard operating procedure as it will lessen much of the weak links in patient handoffs, which currently pose increased risks to morbidity, mortality, and generally undesirable outcomes to the patient care (Hudson, McDonald, Hudson, Tran & Boodhwani, 2015; Nagpal et al., 2010a).

This doctoral project assessed whether the introduction of a structured, standardized, and consistent communication handoff tool would result in favorable perception of usage. Evidenced-based studies were reviewed and supported the need to institute an effective handoff communication tool in the clinical setting. A well-known mnemonic communication tool “I PUT PATIENTS FIRST” designed by Dr. Moon was introduced to the CRNAs, Anesthesiologists, and PACU RNs. The sample (N=28) consisted of CRNAs (n=14), Anesthesiologists (n=5), and PACU RNs (n=9) that used the tool for 2 weeks. To measure favorable perception of usage, this project included a post handoff survey that revealed favorable perception of usage that the communication tool as a means that could increase patient safety, decrease errors, and improve verbal communication, efficiency, and quality of care.