, a quantitative 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.

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.

Is nurse bedside shift report implementation sustainable?

Implementingbedside shift report has been a largely discussed topic in the nursing literature. Unfortunately, sustaining this practice in real-world settings has been a challenge. This literature review considers articles on nurse bedside shift report implementation and strategies that may lead to successful practice sustainability. Methods

How did nursing perceptions of report improve?

Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, ...

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.

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.

Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project

Edward R. McAllen, Jr., DNP, MBA, BSN, BA, RN Kimberly Stephens, DNP, MSN, RN, DNP Brenda Swanson-Biearman, DNP, MPH, RN Kimberly Kerr, MSN, RN Kimberly Whiteman, DNP, MSN, RN, CCRN-K

Abstract

A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores. Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction.

Background

A team of nursing administrators, directors, staff nurses, and a patient representative was assembled to review the literature and make recommendations for practice changes. A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified that fall rates were above the national average.

Literature Review

The team completed a literature review based upon the following PICO question: Does the implementation of BSR as compared to standard shift report at the nurses’ station increase patient safety and patient and nurse satisfaction? The practice of shift report at the bedside is not a new concept and is well documented in the literature.

Methods

The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the current practice. Written approval to conduct the quality improvement project was obtained from the university and hospital institutional review boards (IRB).

Measures

Audits A BSR audit tool was implemented to assure compliance to the BSR process, including verifying that report was completed at the bedside; introducing the oncoming nurse; scripting in ISBARQ; updating the white board; and reviewing care.

Data Analysis

The software SPSS (IBM Inc., Chicago, IL, USA) version 22 was utilized to complete the data evaluation process. The analysis of patient satisfaction results was measured using independent samples t- test (two-tailed) to determine statistical significance of the data.