Document Type



Doctor of Nursing Practice



Date of Defense


Graduate Advisor

Vanessa Loyd, DNP, PhD


Nancy Magnuson, DSN, APRN, PCNS, FNP-BC


Daniel Ferguson, MSN, FNP-C


­­Background: Effective communication should include the use of a standardized handoff reporting tool. Without the use of a standardized reporting tool in the hospice setting, there is the risk for a lack of communication between team members, which can lead to increased symptoms at end of life and less-than-optimal quality care.

Purpose: The purpose of this project is to implement a standardized handoff reporting tool, known as HAND-IT, to be used with hospice admissions. The primary outcome measure is to record the percentage use of the HAND-IT tool with admissions.

Methods: A quality improvement prospective design was used for this project. A convenience sample of newly admitted hospice patients between the ages of 18 to 102 years old was used, and retrospective descriptive statistical data was collected over a 12-week period. The evidence-based framework which guided this project was the Institute for Healthcare Improvements (IHI) Model for Change using the Plan Do Study Act (PDSA) cycle.

Results: Improved communication between hospice team members when the HAND-IT tool was used. During the implementation period (N=107) hospice patients were admitted that met inclusion criteria. There were (n=95), 88.7%, admissions where the HAND-IT tool was used and (n=12), 11.3% admissions where it was not.

Implication for practice: The HAND-IT template was designed for hospice admissions, and is tranferable, cost-free, and user-friendly. The HAND-IT tool is also applicable to be used in palliative care services when converting a patient from palliative to hospice.