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Background: Nurses play a major role in patient safety. Poor nursing assessment and communication practices are associated with higher incidence of the adverse events of undetected deterioration, falls, and pressure injuries. Despite widespread adoption of patient safety systems, occurrence of these events continues. Aim: To implement and evaluate the feasibility and effectiveness of an organisational ward-level intervention to facilitate comprehensive systematic assessment and improved communication in clinical handover to reduce medical emergency team calls; unplanned Intensive Care Unit admissions; falls; and pressure injuries. Design: A stepped-wedge cluster randomised trial sequentially implemented over 12 months. Methods: Evidence-based implementation strategies will be employed to support implementation of an intervention focusing on comprehensive systematic patient assessment and improved nurse bedside clinical handover and multidisciplinary communication involving the patient.

Emergency teamIntensive care unitMedical emergency teamClinical handoversCommunicationEvidence based nursingImplementation scienceNursing assessmentPatient safety