I-PASS Nursing Reports: Overview and FAQ
Patient handoff is a critical moment in each nurse’s shift. It’s important to mention all relevant data at this critical juncture to avoid care delay and patient harm. Facilities can incorporate the I-PASS nursing handover tool into bedside reports to prevent communication errors and improve health outcomes.
What is the I-PASS report tool, and how can it be used to streamline patient care? Below, we provide an overview of the I-PASS mnemonic, explain how nurses can use it to give quick and accurate handover reports, and review an example I-PASS report template to help ensure patients receive the high-quality care they deserve.
What Is the I-PASS Mnemonic?
During transitions in care, offgoing healthcare staff are required to brief oncoming team members on updates, plans, and concerns for each patient. This is a challenging period for many staff members, as noises, distractions, and emergencies can hinder efficient communication.
Standardizing the structure and language of handover reports reduces healthcare errors and decreases patient length of stay. The I-PASS nursing handover tool is one style of patient reporting that can promote safety and efficiency during shift changes.
The term “I-PASS” is an acronym that represents the following five components of safe nursing handoff and what they cover.
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|
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|---|---|
| I: Illness severity | Categorization of the patient as stable, “watcher” (borderline), or unstable |
| P: Patient summary | Summary statement that includes events leading up to admission or care transition, hospital course or treatment plan, ongoing assessment, and contingency plans |
| A: Action list | To-do list covering timelines and ownership of tasks |
| S: Situation awareness | Description of what’s going on and plans for what might happen |
| S: Synthesis by receiver | Statement by the receiver covering what was heard, any questions, and a restatement of key actions and to-do items |
During each nurse handoff, team members review the patient’s current clinical status in the order of “I-PASS,” meaning medical updates, treatment plans, and to-do lists are reviewed and summarized prior to the completion of the transition in care.
The simple, five-letter mnemonic helps healthcare staff remember the correct order of items to be discussed and standardizes nursing reports across units and facilities. Streamlining the process for delivering and receiving patient information makes it easier for nurses to organize and relay sensitive information in a timely manner.
How Can the I-PASS Nursing Report Improve Patient Safety?
Up to 70% of healthcare sentinel events occur due to ineffective communication, leading to increased healthcare costs, longer patient stays, and intensified caregiver dissatisfaction and turnover.
Implementing a standardized communication tool like the I-PASS medical report can help healthcare staff relay important patient data in an organized and concise way. Studies show that facilities can significantly reduce healthcare errors and “near misses” by utilizing a communication tool like I-PASS.
Epic, Cerner, and other electronic health record platforms have integrated this tool into patient charts for easy reference during nurse handoff. Visualizing the I-PASS communication tool beside patient lab values, radiology images, and surgical reports helps nurses better comprehend the patient’s overall plan of care.
How Does the I-PASS Report Tool Compare to Other Healthcare Communication Tools?
Many healthcare facilities use the SBAR (situation, background, assessment, recommendation) tool to communicate critical information during handover or emergency situations. You might be wondering, “Why would I want to use the I-PASS nursing tool instead of SBAR?”
While the SBAR tool is similar to I-PASS, it lacks one important component: synthesized review. Closed-loop communication helps teams ensure proper understanding of an intended message.
Another handover tool, SHARQ (situation, history, assessment, recommendations, questions), allows an opportunity for questions, but doesn’t encourage active listening or verbal acknowledgement of key information. Many staff may be in a rush near the end of the report, and will skip over the “questions” section in an attempt to jump straight into patient care.
I-PASS is the most comprehensive and systematic healthcare communication tool available, and should be used by staff to prevent miscommunications and misunderstandings.
Example I-PASS Template
The following I-PASS nursing example report sample illustrates how the tool can be used to relay pertinent information. In this example template, we’ll refer to the patient as Mr. Cruz.
Offgoing Nurse
I: Illness Severity
“This is Mr. Cruz. He is one of the sickest patients in the unit. He had a cardiac arrest yesterday afternoon, and has been stabilized on vasoactive IV medications.”
P: Patient Summary
“Mr. Cruz has a history of cardiomyopathy, hypertension, and diabetes. He received a heart transplant three days ago and was doing well until yesterday afternoon. He showed signs of altered mental status, and his blood pressure dropped to 80/40.
After five minutes, he went into cardiac arrest and required 3 defibrillator shocks to restabilize normal sinus rhythm. He is now intubated on the ventilator and requires epinephrine and vasopressin drips to keep his blood pressure within normal limits.
We have notified Mr. Cruz’s family of his change in condition, and they are on their way to the hospital.”
A: Action List
“His next vital signs are due to be documented at midnight; the respiratory therapist will come to do an endotracheal tube assessment then as well. There was supposed to be an x-ray taken half an hour ago, but the technician is running late. He should be here within the hour.”
S: Situation Awareness
“Dr. Miller would like to be paged with any signs of increased temperature, as he is concerned about sepsis. If Mr. Cruz does spike a temperature, Dr. Miller will likely order blood cultures and a bolus of lactated ringers solution.”
Oncoming Nurse
S: Synthesis by Receiver
“Ok, I think I understand. Mr. Cruz was admitted three days ago after his heart transplant, but has suffered complications while in our unit. He had a cardiac arrest yesterday, and is now on epinephrine and vasopressin to keep his vitals stable.
An x-ray is pending, and if the technician isn’t here within the hour I’ll be sure to give them a call for a status update. I’ll watch for an increased temperature, and will notify Dr. Miller immediately to prepare for septic workup if I see anything concerning.”
Learn More Ways to Reduce Healthcare Errors at Your Facility
Mistakes in healthcare can be catastrophic. Using the I-PASS nursing handover tool can help streamline communication and keep patients safe. Don’t miss out on more potentially lifesaving insights. Follow along in IntelyCare’s free newsletter for more tips on improving healthcare quality at your facility.