"a qualitative assessment of patient and nurse outcomes of bedside nursing report implementation

What is the relevance of nursing bedside report to clinical practice?

Relevance to clinical practice: If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process.

Can We quantify quantitative outcomes of a blended form of bedside nursing?

To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. The literature identifies several benefits of bedside nursing shift report.

Do nurse bedside shift studies on patient experience with care report limitations?

The majority of the studies on nurse bedside shift report that discuss patient experience with care have limitations.

Does bedside report improve patient fall rates and nurse satisfaction?

Results demonstrated that patient fall rates decreased by 24%, and nurse satisfaction improved with four of six nurse survey questions (67%) having percentage gains in the strongly agree or agree responses following implementation of bedside report.

Does bedside report improve patient outcomes?

In Brief. Nurse-to-nurse reporting by the patient's side improves care satisfaction and increases teambuilding among staff. The benefits of bedside reporting include patients' increased knowledge of their condition and treatment, improved patient and family satisfaction, and increased teambuilding between staff.

What is bedside report nursing?

Nurse bedside shift report, or handoff, has been defined in the literature as a process of exchanging vital patient information, responsibility, and accountability between the off-going and oncoming nurses in an effort to ensure safe continuity of care and the delivery of best clinical practices.2-6 There are different ...

What is the purpose of bedside reporting?

Bedside shift reports are viewed as an opportunity to reduce errors and important to ensure communication between nurses and communication. Models of bedside report incorporating the patient into the triad have been shown to increase patient engagement and enhance caregiver support and education.

What should be on a bedside shift report?

Conduct a verbal report using the SBAR format in words the patient and family can understand. Conduct a focused assessment of the patient and a room safety assessment. Review tasks to be done. Identify patient's and family's needs and concerns.

What should be included in a nursing report?

It should include the patient's medical history, current medication, allergies, pain levels and pain management plan, and discharge instructions. Providing these sorts of details about your patient in your end of shift report decreases the risk of an oncoming nurse putting the patient in danger.

What is the bedside nurses role in communication of clinical findings?

Nursing bedside report allows both the oncoming and outgoing nurses to assess the patients, examine for any patient safety errors, and allows the patients to be a part of their plan of care.

What are the benefits of bedside handover?

A real safety benefit of bedside handover is the fact that visualising the patient may prompt nurses to recall important information that should be handed over and it may also trigger oncoming staff to ask additional questions. Further, patients have the opportunity to clarify content.

Why bedside handovers can be better for patients?

Bedside handover may improve patient participation, which may result in better experience (McMurray et al., 2011) giving the patient a feeling of accessible care and patient satisfaction (Mako et al., 2016) and patients can contribute information during the process which will improve quality of care and patient safety ...

Why should the registered nurse practicing bedside nursing be concerned about research for the delivery of quality nursing care?

Why should the registered nurse practicing nursing at the bedside be concerned about research for the delivery of quality nursing care? A. Research provides the nurse with knowledge needed to make sound clinical decisions.

What is the purpose of a shift report?

Shift reports help improve communication between coworkers or team members, and they ensure proper execution, control and oversight. Managers use shift reports to pass information about proceedings that take place during a specific shift to others.

How do I improve my bedside handover?

Yet a simple strategy to improve communication is to bring the report to the patient's bedside. This facilitates earlier connection between the oncoming nurse and the patient and presents an opportunity for the patient to ask questions and clarify information with both nurses.

What are the outcomes of a hospital's nursing report?

Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors.

How did the bedside report affect nursing?

However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented.

Is bedside nursing shift report statistically significant?

The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance.

Does bedside report increase overtime?

However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report.

What is the role of a nurse executive?

Nurse executives are tasked with helping direct-care nurses connect with patients to improve care experiences. Connecting with patients in compassionate ways to alleviate inherent patient suffering and prevent avoidable suffering is key to improving the patient experience.

What is bedside handover?

Bedside handover is one of nursing care activities which involve patient during nurse-patient interaction a side of patient’s bed between change shift. Patient may inquire all they want to know about their health condition, complaining and request for nursing care. However, the bedside handover often ineffectively run when a group of nurse hand in the nursing care plan for the following nurses shift. This study aimed to describe bedside handover activities based on patient’s perspective in inpatient ward at one military hospital at Jember. This research used a quantitative approach with a descriptive survey design. There were 100 respondents recruited in this study using purposive sampling technique with criteria the patients had received nursing care at least two days in the inpatient ward. Data were collected using bedside report item survey questionnaire to measure bedside handover based on patient perception. The results showed the median of bedside handover was 33 (min-max = 10-40), indicated that the bedside handover from patient’s point of view was in good category. Basically, the nurses have implemented the bedside handover, however there are problems occurred during its’ implementation such as, high burden of nurse’s work, limited time, lack of understanding and awareness regarding bedside handover. Patients have right to receive holistic nursing care, and it is the responsibility of nurses to provide excellent service including the action of bedside handover. Nursing manager should evaluate and supervise the bedside handover for all nurses routinely.

What is the purpose of a systematic review?

Purpose: The purpose of this systematic review was to determine the impact of person-centered interventions on patient outcomes in an acute care setting. Methods: The review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Eligible interventions included person-centered interventions that address at least one of these outcomes: pressure ulcer, accidental falls, medication errors, and/or cross infection. Results: The review showed that there is a paucity of evidence supporting the use of person-centered interventions in reducing patient falls. For the other outcomes, existing research provides an insufficient evidence base on which to draw conclusions. Conclusions: Theory of person-centeredness is still in its ascendency. Poor evidence may also be the result of quantitative research designs that are insufficient in studying the impact of a person-centered approach. We postulate that use of mixed-methods designs is beneficial and would give a clearer picture of the impact of person-centered interventions.

What is the role of consumers in handover?

The involvement of consumers in handover with nurses has been identified as reducing miscommunication between transitions in care and associated with reduction in adverse events in generalist nursing settings. The notion of having consumers present in nursing handover on acute mental health inpatient unit remains a relatively new concept. Central to recovery-focused mental health care is the consumer's active participation in the delivery of their care. The aim of this study was to explore the views of consumers with a mental illness about their experiences of being involved in nursing handover on acute mental health inpatient unit post-implementation of a new nursing handover involving consumers. Using an exploratory descriptive qualitative design, participants (N = 10) were recruited using purposive convenience sampling. Semi-structured interviews were undertaken, and the data were thematically analysed. Participants' principal diagnoses were schizophrenia (n = 2), schizoaffective disorder (n = 3), bipolar affective disorder (n = 2), borderline personality disorder (n = 1), and depression (n = 2). Three themes were generated from the interviews: (i) Knowing who, (ii) Shared decision-making, with subthemes: my voice was heard and not just a meet and greet, and (iii) Having time and space. The delivery of mental health care needs to put the consumer at the centre of such care regardless of the setting. In line with recovery-focused principles, the consumer's active involvement in the crucial activity of nursing handover on acute mental health inpatient unit is very important. The study has implications for ensuring consumer voices are heard in all aspects of their care delivery.

What is NHEB in nursing?

This pilot study evaluates a Nursing Handoff Educational Bundle (NHEB) for a cohort of Accelerated Bachelor of Science (ABS) nursing students. The Evidence-Based Bundle consists of an educational workshop, a standardized handoff format, clinical faculty education, and structured, formative evaluation of student handoffs. This study was implemented during Adult Health clinical experiences conducted at four different University-affiliated healthcare institutions in the Northeastern United States. Methods: A pre-test, post-test design was used with a convenience sample of 28 ABS nursing students. Fourteen students who received the NHEB were compared to a similar group (n = 14) who were not exposed. Student handoffs were observed and rated using the Handoff Clinical Examination (CEX) tool while providing and receiving handoffs during clinical experiences. Data was obtained at the beginning and the end of a 15-week time period. Results: The provider handoff scores in the intervention group improved significantly (M = 4.64, SD = 1.3) over the comparison group change scores (M = 1.5, SD 1.34) when measured by independent samples t-test (t = 7.33, p = .000). The handoff recipients’ scores in the intervention group also improved significantly (m = 5.5, SD = 1.01) compared to no improvement in the recipient control group (M = -0.36, SD = 1.39), (t = 12.7, p = .000). Conclusions: Without structured handoff education, nursing students are passive recipients during handoffs and do not engage in safety communication practices. Exposure to a NHEB improves student handoff communication skills and provides an opportunity to practice evidence-based handoff skills with structured support during clinical experiences. The NHEB could be considered for incorporation into prelicensure programs. Further study using a larger sample size is recommended based on these preliminary findings. Additionally, this intervention should be evaluated in novice nurse cohorts.

What is shift to shift handover?

Effective nurse shift-to-shift handover is a prerequisite for high-quality inpatient care. Combining person-centeredness with the need for improved handover rituals, we introduced and evaluated person-centered handover (PCH) in an oncological inpatient setting. PCH is the shift-to-shift nursing report performed together with the patient according to a set structure focused on patient participation, relevant clinical information, and patient safety. Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction. A cross-sectional design featuring two points of measurement at one intervention ward and two control wards was applied. The EORTC IN-PATSAT32 questionnaire was used for measuring patient satisfaction. Baseline measurements were taken during the spring of 2014, when all three wards used a non-verbal handover model, and included responses from 116 patients. Follow-up measurements (comparing PCH and non-verbal handover) involved 209 patients and were on-going from September 2014 to May 2015. After the introduction of PCH, one change in patient satisfaction was detected regarding the subscale measuring exchange of information between caregivers. Patients from the intervention ward scored statistically higher after the implementation of PCH when compared to the control wards (p = .0058). The difference remained after a multivariate regression analysis controlling for clinical variables. In conclusion, PCH is feasible in oncological inpatient care but does not seem to affect patient satisfaction.

What is non verbal handover?

Non-verbal handover, standard at the department, is conducted via the electronic health record, in absence of the patient, and without a set structure. The aim of the study was to compare person-centered handover with non-verbal handover in an oncological inpatient setting with regard to patient satisfaction.

What is the knowledge phase in nursing?

The knowledge phase is defined as the time when bedside handoff is introduced to the nursing unit(s) and organization, and the following interventions take place: leadership support and commitment, relationship building, staff meetings, and nursing education.4,15,17,18-20,27Providing education can take the form of a journal club, formal training in bedside shift report practice through written and video materials, educational sessions that offer case scenarios based on nursing feedback, staff communication skill development training, and mandatory continuing education and annual performance competencies.2,9,11,16-18,20,27

What is a nurse bedside handoff?

The only nursing report method that involves patients, their family members, and both the off-going and the oncoming nurses is face-to-face bedside handoff.3This type of nursing report is conducted at the patient's bedside and has different variations. In broad terms, nurse bedside shift report can be classified into two categories: “blended” and face-to-face bedside handoffs.8,10The “blended” bedside shift report can be defined as a nursing handoff composed of two parts: Half of the report is written or conducted in a face-to-face approach in a private setting and the other half of the report is conducted face-to-face at the patient's bedside. The face-to-face nurse bedside shift report is solely conducted at the patient's bedside.8

How does a bedside shift report help?

Systematic literature review studies point out that implementing nurse bedside shift report can improve the patient experience with care as related to nurse communication.8,9 ,11For example, Mardis and colleagues conducted a systematic literature review of 41 articles related to the use of bedside shift report and concluded that 49% of the reviewed literature identified an increase in patient experience with care as a self-reported outcome, whereas only 2% of the reviewed studies identified patient complaints with this practice.11Sherman and associates also found patient advantages in relation to nurse bedside shift report, such as patients being more informed about and engaged in their care, improved nurse-patient relationship, and improvement in overall patient satisfaction.8

What are the five steps of Everett Rogers' bedside shift report?

The concepts that have been used in the literature for achieving acceptance and sustainability of nurse bedside shift report follow Everett Rogers' five-step approach to adoption of innovations: knowledge, persuasion, decision, implementation, and confirmation. 28

What are the disadvantages of bedside shift?

These included difficulties understanding the report and medical jargon, tiredness as a result of information being repeated multiple times, lack of privacy, anxiety over incorrect information or too much information, and inconsistency with how the nurse bedside shift report was conducted.8,22,23

What is a nurse bedside shift report?

Nurse bedside shift report, or handoff, has been defined in the literature as a process of exchanging vital patient information, responsibility, and accountability between the off-going and oncoming nurses in an effort to ensure safe continuity of care and the delivery of best clinical practices.2 -6There are different types of nursing reports described in the literature, but the four main types are: a written report, a tape-recorded report, a verbal face-to-face report conducted in a private setting, and face-to-face bedside handoff.3,4,7,8

Why don't nurses do bedside shifts?

Studies also reported a number of reasons why some nurses don't prefer bedside shift report, including that they may have little awareness of and skills with engaging in a patient-centered approach to care, and that they may feel uncomfortable talking in front of patients and intimidated if patients ask questions for which they don't have answers. 7,24They may also be afraid to unintentionally disclose medical information unknown to the patient and may have concerns about violating patients' privacy.9,21But the main nursing disadvantage in relation to bedside shift report that's been reported in the literature is longer change-of-shift report time as a result of patients interrupting nurses during the process.8

What is the significance of Figure 4?

Figure 4 represents all three units’ scores, demonstrating improvement in patient satisfaction as measured by Press Ganey scores. Only the general surgery unit had statistically significant ( p = 0.03) improvement in patient satisfaction after implementation of BSR with the average Press Ganey® score for the eight questions producing a result that increased from average score 87.7% to 91.6%. HCAHPS showed improvement, but the changes were not statistically significant.

What is BSR in nursing?

BSR is a significant change to the current shift report practice and culture of most organizations, but it is associated with both improved patient safety and patient and nurse satisfaction. A limitation of this project was that the evidence-based quality improvement design prevents generalization of findings to other settings; however, the knowledge gained may be transferred to other units or hospitals.

How many nurses completed the BSR survey?

Sixty-four (95%) of the nurses completed the pre- implementation survey, and fifty-seven (85%) completed the post survey. Table 2 represents the number of nurses who reported having enough time for report was significantly decreased, from 80% pre BSR to 59.6% after implementation of BSR ( p = 0.008). In the post survey, staff members were able to express concerns about BSR; 70% ( n = 45) of the nurses who responded to this question believed that BSR increased the time it took to individually give and receive report. Thirty-nine percent ( n =25) of staff reported concerns about patient confidentiality; 44% ( n =29) responded that BSR was inconvenient for nurses due to many factors (e.g., multiple nurses needing report, patient requests delayed report, and nurses preferring the status quo).

Why is BSR important for nurses?

BSR was associated with decreased fall rates , and this finding is consistent with the literature ( Jeffs et al. 2013; Sand-Jecklin & Sherman, 2013 ). Since falls occur for many reasons, it is not surprising that a single environmental scan at change of shift did not eliminate all falls. However, in one instance, nurses found a patient trying to climb out of bed during BSR and timely intervention may have prevented a fall. In the staff satisfaction survey, a nurse reported discovering a patient who had experienced a change in neurological status during BSR. It would be important to note in future studies or projects that the importance of the visual assessment component of the patient and the environment in BSR should be considered as an outcome measure.

What is a bedside shift report?

Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care. Hospital leaders and healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse satisfaction. In the literature, changing the location of shift report from the desk or nurses’ station to the bedside has been identified as a means to increase patient safety and patient and nurse satisfaction. Shift report, when completed at the patient bedside, allows the nurse to visualize and assess the patient and the environment, as well as communicate with and involve the patient in the plan of care. Bedside shift report (BSR) enables accurate and timely communication between nurses, includes the patient in care, and is paramount to the delivery of safe, high quality care.

Why is sharing success stories important?

Education is the beginning of obtaining buy-in from staff. Sharing success stories, such as the “good catch” of a patient who had deteriorated on rounds or improving fall rates, helps to encourage continued participation in BSR. Some staff members may initially participate but return to the nurses’ station for report unless nursing leadership continues to monitor performance and reinforce consistent expectations. When nurses explain that BSR is “how we practice,” BSR is “anchored” on your unit.

How much did falls decrease after BSR?

Patient falls decreased by 24% in the four months after BSR implementation compared to pre-implementation falls. The orthopedic unit experienced the greatest reduction in the number of falls at 55.6%, followed by the neuroscience unit at 16.9%, and the general surgery unit at a 6.9% reduction. Patient falls results are presented in Figure 3.