Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C


Sarah Jackson, DNP, APRN, FNP-C


Amy Terbrock, MSN, PCCN, SCRN, RN


Implementing a Standardized Nursing Communication Tool to Improve Inpatient Nursing Communication

Ashley D. Nator

B.S. Nursing, University of Missouri-St. Louis, 2018

A Dissertation Submitted to The Graduate School at the University of Missouri-St. Louis in partial fulfillment of the requirements for the degree

Doctor of Nursing Practice with an emphasis in Family Nurse Practitioner

August 2022

Advisory Committee

Cathy Koetting, PhD, DNP, APRN, CPNP, PMHS, FNP-C


Sarah Jackson, DNP, APRN, FNP-C

Amy Terbrock, MSN, PCCN, SCRN, RN

Copyright, Ashley D. Nator, 2021

Original: 08/2021 Revised: 09/2021, 10/2021, 04/2022


Problem: Patient handovers occur among nurses more than 4,000 times in a day at a typical teaching hospital. While common, failed patient handovers result due to the lack of standardization in nurse-to-nurse communication while handing over patient responsibility in the inpatient setting. The result of this is inadequate communication among nursing that has the potential to lead to adverse patient events.

Methods: This quality improvement (QI) project utilized a prospective, descriptive design with a post-intervention survey. A unit specific Situation, Background, Assessment, and Recommendation (SBAR) patient handover tool was created and implemented as the standardized method among a convenience sample of nurses following SBAR education. Quantitative data was collected via review of the number of SBAR patient handover tools used, total number of handovers completed, and post-intervention survey responses.

Results: Following the implementation of this QI project, a total of 141 tools were utilized out of 1,480 total patient handovers done resulting in a 10% compliance rate. The average demographic of nurses employed on this unit was females aged from 20 to 30 with less than two years of nursing experience.

Implications for Practice: Overall, the results of this QI project suggested positive results towards improving inpatient nursing communication and patient handover quality. Challenges to implementing a tool of this type include consistent encouragement and leadership presence to maintain better adherence to its use.

Additional Files

Nator, Ashley Final Poster.pptx (2117 kB)