30-Second Head-to-Toe Tool in Pediatric Nursing

Cultivating Safety in Handoff Communication

Debbie Popovich, MSN, CPNP


Pediatr Nurs. 2011;37(2):55-60. 

In This Article

Benefits of using the HTT

Educational benefits were demonstrated as the faculty member and students reviewed the HTT in pediatric clinical orientation. The rationale for each item was identified and discussed. To assess relevance and outcomes of the checklist process, each student performed the HTT immediately after receiving change of shift report. For four consecutive semesters, at least two times per week, each student submitted at least one HTT form on which appropriate items at the time of transfer were checked off and discrepancies from report noted. Safety benefits for patients were demonstrated as these discrepancies were illuminated for both students and nurses. A discrepancy is defined as a lack or contradiction regarding what was verbalized at report or was on orders/chart related to labels, settings, reminders, or calculations, and what the student observed firsthand at the bedside. Frequencies of discrepancies for each item were calculated, and descriptive data were collated.

The HTT checklist is easy to use, efficient, and confined to one page. Students are made aware that initially completing the checklist will require approximately 5 to 10 minutes due to their novice status as health care providers and depending on the complexity of the clinical situation. They receive patient assignments the day prior to clinical and are encouraged to review the checklist that night. Once complete, they must submit it to the instructor by 8:00 a.m., usually 30 minutes after they receive report. At that time, the student and faculty member review the HTT together, and corrections are made as necessary.


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