THE EFFECT OF THE IPASS METHOD ON NURSES’ SELF-EFFICACY IN HANDOVER IMPLEMENTATION IN THE INTENSIVE CARE UNIT: A QUASI-EXPERIMENTAL STUDY
DOI:
https://doi.org/10.70332/jkp.v4i1.66Keywords:
clinical communication; patient safety; quasi-experimental study; role-play training; structured communicationAbstract
Background: Patient handover in the intensive care unit requires concise, accurate, and risk-focused communication because incomplete information transfer may compromise continuity of care and patient safety. This study aimed to determine the effect of the I-PASS method, consisting of Illness severity, Patient summary, Action list, Situation awareness and contingency planning, and Synthesis by receiver, on nurses’ self-efficacy in performing handovers in the intensive care unit. Methodes: A quasi-experimental one-group pretest-posttest design was conducted among 31 intensive care unit nurses selected through purposive sampling in a general hospital in Bandung, Indonesia. Participants received structured I-PASS training followed by supervised role-play using intensive care case scenarios. Self-efficacy was measured before and immediately after the intervention using the General Self-Efficacy Scale. Result: Data were analyzed using descriptive statistics and the Wilcoxon signed-rank test. The proportion of nurses with high self-efficacy increased from 61.29% before the intervention to 87.10% after the intervention. Mean self-efficacy scores also increased from 29.35 (SD = 3.42) to 34.26 (SD = 3.87), and the difference was statistically significant (z = -3.41, p = 0.001). Conclussion: The findings indicate that I-PASS-based role-play training can improve nurses’ confidence in organizing, prioritizing, and communicating critical information during intensive care handover. Integration of structured handover training into continuing nursing education is recommended to strengthen communication competence and patient safety culture
References
Abou Hashish, E. A., Asiri, A. A., & Alnajjar, Y. K. (2023). Shift handover quality in Saudi critical care units: Determinants from nurses’ perspectives. BMC Nursing, 22, Article 186. https://doi.org/10.1186/s12912-023-01348-z
Ahn, J. W., Jang, H. Y., & Son, Y. J. (2021). Critical care nurses’ communication challenges during handovers: A systematic review and qualitative meta-synthesis. Journal of Nursing Management, 29(4), 623-634. https://doi.org/10.1111/jonm.13207
Anshasi, H., & Almayasi, Z. A. (2024). Perceptions of patients and nurses about bedside handover: Qualitative synthesis. Nursing Research and Practice, 2024, Article 3208747. https://doi.org/10.1155/2024/3208747
Bandura, A. (1977). Self-efficacy: Toward a unifying theory of behavioral change. Psychological Review, 84(2), 191-215. https://doi.org/10.1037/0033-295X.84.2.191
Blazin, L. J., Sitthi-Amorn, J., & Hoffman, J. M. (2020). Improving patient handoffs and transitions through adaptation and implementation of I-PASS across multiple handoff settings. Pediatric Quality & Safety, 5(4), Article e323. https://doi.org/10.1097/PQ9.0000000000000323
Bressan, V., Mio, M., & Palese, A. (2020). Nursing handovers and patient safety: Findings from an umbrella review. Journal of Advanced Nursing, 76(4), 927-938. https://doi.org/10.1111/jan.14288
Bukoh, M. X., & Siah, C. J. R. (2020). A systematic review on the structured handover interventions between nurses in improving patient safety outcomes. Journal of Nursing Management, 28(3), 744-755. https://doi.org/10.1111/jonm.12936
Chien, L. J., Slade, D., Dahm, M. R., Brady, B., Roberts, E., Goncharov, L., Taylor, J., Eggins, S., & Thornton, A. (2022). Improving patient-centred care through a tailored intervention addressing nursing clinical handover communication in its organizational and cultural context. Journal of Advanced Nursing, 78(5), 1413-1430. https://doi.org/10.1111/jan.15110
Chung, J. Y. S., Li, W. H. C., Cheung, A. T., Ho, L. L. K., & Chung, J. O. K. (2022). Efficacy of a blended learning programme in enhancing the communication skill competence and self-efficacy of nursing students in conducting clinical handovers: A randomised controlled trial. BMC Medical Education, 22, Article 275. https://doi.org/10.1186/s12909-022-03361-3
Clari, M., Conti, A., Chiarini, D., Martin, B., Dimonte, V., & Campagna, S. (2021). Barriers to and facilitators of bedside nursing handover: A systematic review and meta-synthesis. Journal of Nursing Care Quality, 36(4), E51-E58. https://doi.org/10.1097/NCQ.0000000000000564
Forde, M. F., Coffey, A., & Hegarty, J. (2020). Bedside handover at the change of nursing shift: A mixed-methods study. Journal of Clinical Nursing, 29(19-20), 3731-3742. https://doi.org/10.1111/jocn.15403
Ghosh, S., Ramamoorthy, L., & Pottakat, B. (2021). Impact of structured clinical handover protocol on communication and patient satisfaction. Journal of Patient Experience, 8, 1-7. https://doi.org/10.1177/2374373521997733
Hada, A., & Coyer, F. (2021). Shift-to-shift nursing handover interventions associated with improved inpatient outcomes: Falls, pressure injuries and medication administration errors. Nursing & Health Sciences, 23(2), 337-351. https://doi.org/10.1111/nhs.12825
Kapuria, M., Hanna, J., Hall, M. A. K., Afriyie, S., Wondmeneh, S., Obisesan, A., Hemrajani, R., & Miller, A. (2025). I-PASS-based handoff pilot in a high-volume urban hospital: Benefits and barriers for hospitalists. Cureus, 17(3), Article e80040. https://doi.org/10.7759/cureus.80040
Khalaf, Z. (2023). Improving patient handover: A narrative review. African Journal of Paediatric Surgery, 20(3), 166-170. https://doi.org/10.4103/ajps.ajps_82_22
Kim, J. H., Lee, J. L., & Kim, E. M. (2021). Patient safety culture and handoff evaluation of nurses in small and medium-sized hospitals. International Journal of Nursing Sciences, 8(1), 58-64. https://doi.org/10.1016/j.ijnss.2020.12.007
Kim, J. H., Lim, J. M., & Kim, E. M. (2022). Patient handover education programme based on situated learning theory for nursing students in clinical practice. International Journal of Nursing Practice, 28, Article e13005. https://doi.org/10.1111/ijn.13005
Lee, D. H., & Lim, E. J. (2021). Effect of a simulation-based handover education program for nursing students: A quasi-experimental design. International Journal of Environmental Research and Public Health, 18(11), Article 5821. https://doi.org/10.3390/ijerph18115821
McCarthy, S., Motala, A., Lawson, E., & Shekelle, P. G. (2025). Use of structured handoff protocols for within-hospital unit transitions: A systematic review from Making Healthcare Safer IV. BMJ Quality & Safety, 34(10), 680-690. https://doi.org/10.1136/bmjqs-2024-018385
Noh, Y. G., & Lee, I. (2020). Effects of a stepwise handovers ISBARQ programme among nursing college students. Nursing Open, 7(5), 1551-1559. https://doi.org/10.1002/nop2.537
Oxelmark, L., Whitty, J. A., Ulin, K., Chaboyer, W., Oliveira Goncalves, A. S., & Ringdal, M. (2020). Patients prefer clinical handover at the bedside; nurses do not: A discrete choice experiment. International Journal of Nursing Studies, 105, Article 103444. https://doi.org/10.1016/j.ijnurstu.2019.103444
Pazar, B., Kavakli, O., Ak, E. N., & Erten, E. E. (2024). Implementation and evaluation of the SBAR communication model in nursing handover by pediatric surgery nurses. Journal of PeriAnesthesia Nursing, 39(5), 847-852. https://doi.org/10.1016/j.jopan.2023.12.021
Pun, J. (2021). Factors associated with nurses’ perceptions, their communication skills and the quality of clinical handover in the Hong Kong context. BMC Nursing, 20, Article 95. https://doi.org/10.1186/s12912-021-00624-0
Pun, J. (2023). Using a simulation-based approach to promote structured and interactive nursing clinical handover: A pre- and post-evaluation pilot study in bilingual Hong Kong. BMC Nursing, 22, Article 38. https://doi.org/10.1186/s12912-023-01189-w
Starmer, A. J., Spector, N. D., Srivastava, R., West, D. C., Rosenbluth, G., Allen, A. D., Noble, E. L., Tse, L. L., Dalal, A. K., Keohane, C. A., Lipsitz, S. R., Rothschild, J. M., Wien, M. F., Yoon, C. S., Zigmont, K. R., Wilson, K. M., O’Toole, J. K., Solan, L. G., Aylor, M., ... Sectish, T. C. (2014). Changes in medical errors after implementation of a handoff program. New England Journal of Medicine, 371(19), 1803-1812. https://doi.org/10.1056/NEJMsa1405556
Starmer, A. J., Spector, N. D., O’Toole, J. K., Bismilla, Z., Calaman, S., Campos, M. L., Coffey, M., Destino, L. A., Everhart, J. L., Goldstein, J., & the I-PASS SHM Mentored Implementation Study Group. (2023). Implementation of the I-PASS handoff program in diverse clinical environments: A multicenter prospective effectiveness implementation study. Journal of Hospital Medicine, 18(1), 5-14. https://doi.org/10.1002/jhm.12979
Tataei, A., Rahimi, B., Afshar, H. L., Alinejad, V., Jafarizadeh, H., & Parizad, N. (2023). The effects of electronic nursing handover on patient safety in the general (non-COVID-19) and COVID-19 intensive care units: A quasi-experimental study. BMC Health Services Research, 23, Article 527. https://doi.org/10.1186/s12913-023-09502-8
Toren, O., Lipschuetz, M., Lehmann, A., Regev, G., & Arad, D. (2022). Improving patient safety in general hospitals using structured handoffs: Outcomes from a national project. Frontiers in Public Health, 10, Article 777678. https://doi.org/10.3389/fpubh.2022.777678
Vanderzwan, K. J., Kilroy, S., Daniels, A., & O’Rourke, J. (2023). Nurse-to-nurse handoff with distractors and interruptions: An integrative review. Nurse Education in Practice, 67, Article 103550. https://doi.org/10.1016/j.nepr.2023.103550
Franco Vega, M. C., Ait Aiss, M., George, M., Day, L., Mbadugha, A., Owens, K., Sweeney, C., Chau, S., Escalante, C., & Bodurka, D. C. (2024). Enhancing implementation of the I-PASS handoff tool using a provider handoff task force at a Comprehensive Cancer Center. The Joint Commission Journal on Quality and Patient Safety, 50(8), 560-568. https://doi.org/10.1016/j.jcjq.2024.03.004
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Jurnal Keperawatan PPNI Jawa Barat
This work is licensed under a Creative Commons Attribution 4.0 International License.
