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Materials and Methods: A QI team introduced the “I-PASS handover bundle” into a 42-bed tertiary NICU. Completed orders for 40 patient handovers were compared between the preintervention phase and each of three Plan-Do-Study-Act cycles using the Mann–Whitney test. Results: Completed orders improved across PDSA cycles and prescription inaccuracies fell from 80% to 17.5%.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":11,"@type":70,"position":76},"https://docshare.wps.com/template/presentations/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/implementation-of-a-structured-handover-in-the-nicu-quality-improvement-study/244081/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/implementation-of-a-structured-handover-in-the-nicu-quality-improvement-study/244081.png","ImageObject",442,249,{"name":88,"@type":89},"Bill Black","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-19","2026-09-12",true,{"@type":98,"interactionType":99,"userInteractionCount":25},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What was the main aim of the quality-improvement initiative in the NICU?","Question",{"text":108,"@type":109},"To implement a structured handover in the NICU and assess its impact on the efficiency of executing medical orders and the rate of medication errors for neonates on respiratory support.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What intervention was introduced as part of the structured handover?",{"text":113,"@type":109},"The QI team introduced the “Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-Outs Study (I-PASS) handover bundle” as part of the structured handover.",{"name":115,"@type":106,"acceptedAnswer":116},"How did the results change across the Plan-Do-Study-Act cycles?",{"text":117,"@type":109},"The number of completed orders improved gradually each cycle, and a significant comparison was found between the preintervention phase and the third PDSA cycle. Prescription inaccuracies in daily order sheets decreased from 80% to 17.5%.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},244081,1791531924,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":8,"category_name":11,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":25,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":135,"language":136,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":137,"faqs":138,"seo_title":139,"seo_description":61,"update_tm":140,"read_time":76},24189269381491,"https://ap-avatar.wpscdn.com/avatar/160000cf11732dd8392?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788146458752108895","QualityImprovement Study  \n PERINATOLOGY • Vol 22 • No. 2 • Jul–Sep 2021  \nImplementation of a Structured Handover in the NICU  \nAshwini Khedkar*, Saumil Desai, Ruchi Nanavati  \n*Correspondence  \nDr Ashwini Khedkar  \nPost Diploma DNB Resident Department of Pediatrics Rangadore Memorial Hospital 1st Cross Road, Shankarapuram Basavanagudi  \nBengaluru 560004, Karnataka India  \nE-mail: [khedkarashwini@hotmail.com](khedkarashwini@hotmail.com)  \nAbstract  \nAim: This quality-improvement (QI) initiative aimed at implementing a structured handover in the NICU to determine its effect on the efficiency in executing medical orders and rate of medication errors in neonates on respiratory support.  \nMaterials and Methods: A QI team (comprising 2 senior faculty members and 1 neonatology registrar) introduced the use of “Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-Outs Study (I-PASS) handover bundle” as part of the structured handover in a 42-bed tertiary care NICU. The completed orders of 40 patient handovers in the preintervention phase was compared with the completed orders after each of the 3 Plan-Do-Study-Act (PDSA) cycles using the Mann–Whitney test.  \nResults: A gradual improvement was noted in the number of completed orders in each PDSA cycle. A P value of .0008 (significant) was obtained upon comparison of the completed medical orders between the preintervention phase and the third PDSA cycle. The percentage of inaccurately written prescriptions in daily order sheets reduced from 80% to 17. 50% .  \nConclusion: The implementation of a structured handover process led to increased efficiency in executing medical orders, and a significant reduction in the rate of medication errors was achieved. This indicates that this QI initiative has the potential to bring about a positive effect on patient safety.  \n114  \nQuality-Improvement Study  \n Khedkar A, et al. Structured Handover in the NICU  \nKey Words: Quality improvement, medical order, medication error, patient safety, I-PASS handover bundle, Plan-Do-StudyAct cycle  \nIntroduction  \nThe WHO launched the program World Alliance for Patient Safety a few years ago. One of the key action areas emphasized in this program was the development of patient safety solutions. The term “patient safety solutions” is defined as “any intervention that demonstrates the ability to prevent or mitigate patient harm stemming from the processes of health care.”1 The following 2 components are part of the WHO’s Patient Safety Solutions Preamble – May 20071:  \n1. Communication during patient handovers  \n2. Ensuring medication accuracy at transitions in care  \nClinical handover is the transfer of professional responsibility and accountability for some or all aspects of care for a patient or a group of patients to another person ora professional group on a temporary or permanent basis. Improper handovers can result in delays in management, resource wastage, medication errors, miscommunication of test results, and repetition of tests.2 Recent evidence has identified a gap in the practice of handover and called for interventions to standardize it.3  \nAs the second priority, the WHO’s Patient Safety Solutions Preamble emphasizes on ensuring medication accuracy to reduce “medication errors” in clinical settings. The National Coordinating Council for Medication Error Reporting and Prevention defines medication errors as “any preventable event that may lead to inappropriate medication use or patient harm while the medication is in the control of the health care professional, patient, or consumer”.4 The report To Err Is Human: Building a Safer Health System released by the Institute of Medicine (IOM) states that “the majority of medical errors result from faulty systems and processes”. A study that assessed 289,411 medication orders in a tertiary care, teaching hospital reports an overall  \nerror rate of 3.13 errors per 1000 orders, with the rate of significant errors b","cbCaiqxUksCkSGTP","https://ap.wps.com/l/cbCaiqxUksCkSGTP","pdf",314442,9,"English","# Abstract\n## Aim\n## Materials and Methods\n## Results\n## Conclusion\n# Introduction\n## Patient safety solutions and handovers\n## Medication accuracy and error prevention\n## Rationale for the NICU intervention","[{\"question\":\"What was the main aim of the quality-improvement initiative in the NICU?\",\"answer\":\"To implement a structured handover in the NICU and assess its impact on the efficiency of executing medical orders and the rate of medication errors for neonates on respiratory support.\"},{\"question\":\"What intervention was introduced as part of the structured handover?\",\"answer\":\"The QI team introduced the “Innovation in Pediatric Education-Pediatric Research in Inpatient Settings Accelerating Safe Sign-Outs Study (I-PASS) handover bundle” as part of the structured handover.\"},{\"question\":\"How did the results change across the Plan-Do-Study-Act cycles?\",\"answer\":\"The number of completed orders improved gradually each cycle, and a significant comparison was found between the preintervention phase and the third PDSA cycle. Prescription inaccuracies in daily order sheets decreased from 80% to 17.5%.\"}]","Implementation of a Structured Handover in the NICU - Quality-Improvement Study | PDF",1789211914]