bedside report + patient falls

by Prof. Skye Crist MD 8 min read

Exploring Practices of Bedside Shift Report and Hourly

2 hours ago Objective: To describe the relationship of inpatient falls to bedside shift report (BSR) and hourly rounding (HR). Background: Falls are a major healthcare concern. Although measures such as BSR and HR are reported to reduce falls, studies are often based on self-reported data related to nurse compliance with protocols for HR and bedside report. >> Go To The Portal


An evaluation of evidence-based literature reveals that the practice of bedside shift report (BSR) leads to a reduction in both patient falls and medication administration errors. Indeed, BSR is evidence-based practice (EBP) that promotes an overall environment of safety, quality care, and improved communication between nurses and patients.

Full Answer

Does the bedside shift report influence patient falls?

Increased nurse frequency with patient may signal increased fall risks. Bedside shift report and HR may require robust and sustained interventions to provide lasting effects. Exploring Practices of Bedside Shift Report and Hourly Rounding. Is There an Impact on Patient Falls?

How do you write a bedside report on a patient?

It should start outside of the patient's room covering the general information history what's occurred, then kind of go through a head‐to‐toe assessment of what's going on. Then you go into the room and you can finish the bedside report at the bed, looking at all of the things that you might have noted.

Is nurse frequency associated with fall risk in bedside nurses?

Increased nurse frequency with patient may signal increased fall risks. Bedside shift report and HR may require robust and sustained interventions to provide lasting effects. Increased nurse frequency with patient may signal increased fall risks. Bedside shift report and HR may require robust and sustained interventions to provide lasting effects.

Is bedside report evidence-based practice?

An evidence-based practice change incorporating bedside report into standard nursing care was implemented and evaluated over a four-month time period on three nursing units. Fall rates, HCAHPS and Press Ganey® scores, and nurses’ response to a satisfaction survey were measured before and after the project implementation.

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Does bedside shift report reduce falls?

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.

What is included in a bedside report?

Bedside benefits Shift change was included in The Joint Commission's 2009 National Patient Safety Goals, which requires that shift hand-offs must include up-to-date information about the care, treatment, current condition, and recent or anticipated changes in the patient.

What is bedside handoff 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.2-6 There are different ...

Does bedside reporting increased patient safety?

The evidence based research reviewed unanimously concludes that conducting bedside reporting leads to increased patient safety, patient satisfaction, and nurse satisfaction. Nurses communicate with patients, patient families, healthcare providers, and other axillary departments constantly during a shift.

How do I write a good bedside report?

5 Best Practices For an Effective Bedside Shift ReportShift Reports Should be Done at the Bedside. ... A Great Bedside Report Sets the Tone for the Shift. ... Be Mindful of Patient Privacy. ... Benefits of a Great Shift Report. ... Ask The Oncoming Nurse “What Other Information Can I Provide For You?

Do patients like bedside report?

The evidence based research reviewed unanimously concludes that conducting bedside reporting leads to increased patient safety, patient satisfaction, and nurse satisfaction.

What is the benefit of completing a bedside report during hand off?

What is the benefit of completing a bedside report during hand-off? The patient and family can participate. When preparing a nursing report, which of the following steps should the reporting nurse take? Prioritize information on the basis of the patient's needs and problems.

How do you write a nursing shift report?

The following are ways you can create more thorough and adequate end-of-shift reports for your relieving nurses.Use Concise and Specific Language. ... Record Everything. ... Conduct Bedside Reporting as Often as Possible. ... Reserve Time to Answer Questions. ... Review Orders. ... Prioritize Organization. ... The PACE Format. ... Head to Toe.

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.

Why is bedside report so important?

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.

Why should nurses do bedside report?

The BSR process acknowledges the patient as a partner and reassures the patient that the nurses work as a team. Knowing that nursing staff is getting the information needed to facilitate care decreases patient and family anxiety and improves patient satisfaction.

Why is bedside rounding important?

Interprofessional rounding that occurs at the bedside can impact the sense of teamwork and value according to Gausvik et al (7). A total of 62 staff including nurses, therapists, patient care assistants, and social workers were surveyed regarding their perceptions on the impact of IR.

Why are nurses always on the same page during the report?

Nurses are always on the same page during the report because they're both looking at the same information at the same time. 12. The patient benefits from BSR too.

How many people died from BSR in 2010?

According to the Inspector General Office, Health and Human Services Department, less-than-competent hospital care contributed to the deaths of 180,000 Medicare patients in 2010. However, the real number may be higher: According to one estimate, between 210,000 and 440,000 patients who go to ...

How does BSR help nurses?

The advantages for the nurse begin with the efficiency of report, which streamlines all pertinent information and saves nursing time. BSR improves staff's teamwork by giving nurses the opportunity to work together at the bedside, ensuring accountability. Using a standardized format reduces the risk of miscommunication because it overcomes different communication styles. Better communication also helps the oncoming nurse prioritize assignments according to need. The nurse is informed about the patient earlier in the shift because report time is shortened. Nurses are always on the same page during the report because they're both looking at the same information at the same time. 12

Why is BSR important in nursing?

Because nurses are the first line of defense when it comes to patient safety, BSR is an integral part of the care plan. The nurse is accountable for the communication that occurs during the change-of-shift report.

How many breaths per minute did the nurse take in 1920?

When two nurses entered her room at 1920 for the BSR, her respiratory rate had dropped to 6 breaths/minute. One nurse stayed in the room while the other obtained and administered naloxone as per protocol. The patient quickly recovered without complications.

Why is standardized format important for nurses?

Using a standardized format reduces the risk of miscommunication because it overcomes different communication styles. Better communication also helps the oncoming nurse prioritize assignments according to need. The nurse is informed about the patient earlier in the shift because report time is shortened.

What is the role of a nurse in a change of shift?

The nurse is accountable for the communication that occurs during the change-of-shift report. This is the time that the nurse can verify the patient's health history, physical assessment findings, and plan of care, including prescribed medications.

What are the barriers to bedside reporting?

One barrier associated with bedside report may be related to patient privacy concerns. However, bedside report is already included in the Health Insurance Portability and Accountability Act (HIPAA) [4]. Another barrier may be the length of time associated with bedside report, but the majority of the literature found that report at the bedside took less time [2]. Other barriers of bedside report include fear of waking up patients, that medical jargon may confuse patients or increase anxiety, or that the patient or family may monopolize the conversation during report [6].

What is a nurse leader?

Nurse leaders are responsible for ensuring the success of their team through effective communication, meting quality measures, and improving patient satisfaction. Our organization used innovative ways to increase participation of bedside report. The process that has been described concerning implementing bedside report may give other institutions an example on how bedside report can be implemented. Innovative leaders should encourage and monitor this handoff process to maintain the practice of bedside report hospital wide.

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.

What is the goal of a bedside shift report?

The goal of the Nurse Bedside Shift Report strategy is to help ensure the safe handoff of care between nurses by involving the patient and family. The patient defines who their family is and who can take part in bedside shift report.

What is the guide to patient and family engagement in hospital quality and safety?

The Guide to Patient and Family Engagement in Hospital Quality and Safety is a resource to help hospitals develop effective partnerships with patients and family members with the ultimate goal of improving multiple aspects of hospital quality and safety.*

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