Date of Doctor of Nursing Practice Project Completion

Spring 5-8-2026

Faculty Advisor

Rashmi Momin

Abstract

Purpose Implement a standardized postoperative handoff tool to improve interdisciplinary communication during transfer of placenta accreta spectrum (PAS) patients from the operating room to an obstetric intensive care unit at an academic women's hospital.

Background Placenta accreta spectrum (PAS) is a high-risk obstetric condition requiring coordinated multidisciplinary care. At the project site, operating room (OR)-to-obstetric intensive care unit (OB ICU) handoffs lacked a standardized process. This resulted in inconsistent communication and omission of critical information. Nurses reported reduced confidence. Standardized handoff tools can improve communication and promote safer transitions of care.

Methodology This 10-week quality improvement project used Plan-Do-Study-Act methodology and the Donabedian Structure-Process-Outcome framework. A paper-based handoff tool was implemented for 13 postoperative PAS patients. Three PDSA cycles improved accessibility and workflow integration. Process measures and pre/post nurse surveys were analyzed using descriptive statistics.

Results Thirteen postoperative PAS transfers occurred. Eleven handoff tools were completed (84.6%), exceeding the 70% completion goal. Positive nurse responses increased by 56.7 percentage points for overall confidence. Responses increased by 63.2 percentage points for consistency of postoperative guidance and 57.6 points for communication of postoperative expectations. Knowing who to contact with questions increased by 57.0 percentage points. Nurses reported improved access to critical information and less time searching the electronic medical record. The tool integrated smoothly into workflow.

Implications The standardized handoff tool improved interdisciplinary communication and increased nurse confidence. It supported safer postoperative transitions for PAS patients. The intervention exceeded the implementation goal and was feasible in practice. Findings support sustainability and adaptation to other high-risk obstetric populations.

Keywords

Placenta accreta spectrum; postoperative handoff; interdisciplinary communication; quality improvement; obstetric intensive care

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