Date of Award

January 2020

Document Type

Open Access Thesis

Degree Name

Doctor of Nursing Practice (DNP)


Yale University School of Nursing

First Advisor

Laura K. Andrews


Objective: To increase the rate of documentation and satisfaction by APPs using a standardized handoff tool to and from a neurology intensive care unit.

Background: A comprehensive literature review showed that there was minimal literature on handoff tools for advance practice providers (APPs), and presently at the implementation site, there was no formal handoff process for patients transferring from a neurology intensive care unit.

Methods: This project was implemented between December 1, 2019 - January 31, 2020. The first step was to have APPs complete a pre-assessment. Based on the results of the pre-assessment, an electronic handoff tool was created. APPs were educated on the use of an EPIC smartphrase to easily access the handoff tool. At the end of the implementation period, APPs were asked to complete a post-assessment to evaluate their satisfaction with the effectiveness of the electronic handoff tool.

Results: During the implementation period, there was documentation using the electronic handoff tool for 66 of the 105 neurosurgery transfers, accounting for 63% percent of patients with a completed electronic handoff. Results from the post- assessment showed that 89% felt satisfied with the handoff tool because they perceived improvements in care processes.

Conclusion: The implementation of an electronic handoff process resulted improvements in APP satisfaction (with the transfer process and in perceived improvements in patient care. This practice change has the potential to enhance communication between APP groups through standardization of processes and information


This is an Open Access Thesis.

Open Access

This Article is Open Access