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

Errors Identified

Over four semesters, students cared for 352 children and completed an HTT on each child. Findings confirmed the importance of focusing attention on safety of the child and environment during shift change with a standardized checklist and instilling this routine in students' clinical experience. Results included:

  • Errors in 30% of the HTT were identified (n = 106).

  • Of the HTT forms with errors, 29% were related to inline 0.22 micron filters required by hospital policy to be used with all children under 2 years of age or with a cardiovascular diagnosis.

  • Of the HTT forms with errors, 36% were related to children without an identification band on the body.

  • Of the HTT forms with errors, 14% did not have an Emergency Drug Reference with Current and Accurate Weight posted at the child's bedside, as required by hospital policy for all children under 50 kg.

  • Other errors included intravenous fluids or tubing not labeled with expiration date and time, infusion pumps with incorrect settings, apnea/bradycardia and oxygen saturation monitor parameters set incorrectly and/or not age-appropriate, and physician-ordered interventions not at the bedside (for example, incentive spirometers and sequential compression devices).

All errors were corrected by students within the first 30 minutes of care.


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