Document Type

DNP Project


School of Nursing

Date of Degree

Spring 2020


Doctor of Nursing Practice (DNP)

Primary Advisor

Karen S. Kesten, DNP, APRN, CCNS, CCRN-K, CNE, FAAN; Patricia Quinlan, PhD, MPA, CPHQ


Background: In a hospital environment the care of the patient is transferred multiple times during his or her stay. Current needs assessment indicates that nurses’ perception of safety culture with handoff communication and patient safety is an area of focus for the practice site.

Objectives: This study aimed to improve the Pre-operative and Operating Room nurses’ perception of safety culture measured with four valid and reliable survey questions. The second study’s aim was to improve patient safety with the handoff process, measured by the number of adverse events reported by the practice site.

Methods: Pre-implementation data was collected. Nurses worked collaboratively to update the handoff tool which was presented at committees for review and approval. The tool was implemented and post-implementation data was collected.

Results: A total of 87 pre-intervention surveys and 76 post-intervention surveys were collected. Chi-square analysis was used and the results revealed a statistically significant improvement in the perception of safety culture for nurses. The analysis of the number of reported adverse events after implementation revealed an increase of 1, which is not a result of the new handoff communication.

Conclusions: A new handoff tool was implemented and the results of the survey revealed a statistically significant improvement in the perception of safety culture for nurses. It is important to note that 100% of respondents gave their unit a safety grade of acceptable or higher on the post-survey. Annual monitoring will include reviewing future safety culture surveys and tracking the number of adverse events quarterly.

Open Access


Included in

Nursing Commons



To view the content in your browser, please download Adobe Reader or, alternately,
you may Download the file to your hard drive.

NOTE: The latest versions of Adobe Reader do not support viewing PDF files within Firefox on Mac OS and if you are using a modern (Intel) Mac, there is no official plugin for viewing PDF files within the browser window.