Enhancing Transfer of Accountability in Burn Intensive Care Unit Nursing: A Quality Improvement Initiative.
In the burn intensive care unit (ICU), effective nurse handovers are critical to patient safety. Communication gaps during the transfer of accountability (TOA) contribute to preventable safety incidents. We designed a quality improvement (QI) initiative to standardize TOA and improve safety culture....
| Publicado en: | Journal of Burn Care & Research Vol. 46; no. 6; pp. 1444 - 1452 |
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| Autores principales: | , , , |
| Formato: | Journal Article |
| Publicado: |
Oxford University Press / USA
Nov/Dec2025
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=190699957&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 190699957 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 1559047X 1W56 jtl: Journal of Burn Care & Research issn: 1559047X maglogo: N pubinfo: dt: Nov/Dec2025 vid: 46 iid: 6 pid: 622 pub: Oxford University Press / USA artinfo: ui: 190699957 10.1093/jbcr/iraf169 190699957 ppf: 1444 ppct: 8 formats: tig: atl: Enhancing Transfer of Accountability in Burn Intensive Care Unit Nursing: A Quality Improvement Initiative. aug: au: Shantz, Gavin Au, Anita Callahan, Ashley Rogers, Alan David affil: Ross Tilley Burn Centre, Sunnybrook Health Sciences Centre, Toronto, ON M4N 3M5, Canada sug: ab: In the burn intensive care unit (ICU), effective nurse handovers are critical to patient safety. Communication gaps during the transfer of accountability (TOA) contribute to preventable safety incidents. We designed a quality improvement (QI) initiative to standardize TOA and improve safety culture. A baseline safety culture survey of 31 burn ICU nurses and a 3-month review of incident reports (mean: 18/month) identified handover-related communication failures, including omitted treatments, delayed wound care, and missed monitoring responsibilities. We co-developed a structured, burn-specific TOA tool with frontline nurses and introduced it through targeted education. The intervention was implemented over eight weekly Plan-Do-Study-Act (PDSA) cycles. Outcomes included incident rates, nurse-reported safety culture, and process adherence. Postintervention, safety incidents decreased by 50% (from 18 to 9/month), and TOA-related safety culture scores improved by 20%, achieving both SMART objectives. Tool adherence exceeded 90% by the final cycle. Nurses reported improved clarity, reduced cognitive load, and enhanced interprofessional communication. No adverse workflow impacts were observed. A co-designed TOA tool, integrated with education and iterative PDSA refinement, significantly improved handover safety and reduced incidents in the burn ICU. This initiative provides a practical, scalable model for enhancing communication and safety culture in high-risk clinical settings. pubtype: Academic Journal doctype: Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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