31 hours ago Bedside shift report improves patient safety and nurse accountability. ... Bedside shift report improves patient safety and nurse accountability J Emerg Nurs. 2010 Jul;36(4):355-8. doi: 10.1016/j.jen.2010.03.009. Epub 2010 May 14. Author Stephanie J Baker 1 Affiliation ... >> Go To The Portal
Evidence strongly supports that bedside shift report increases nurse satisfaction. 6, 8, 9, 11 Some of the most commonly reported nurse advantages include improved report efficiency, teamwork, nursing accountability, and report accuracy; enhanced individual patient care and documentation practices; satisfaction with patients being involved; visualizing patients and the ability to prioritize care; and improved discharge or transition of care. 2, 3, 5, 7, 8, 10, 12, 13, 17, 23, 24
Full Answer
Nurses have raised some concerns when it comes to BSR, namely:
Evidence-based nursing. Evidence-based nursing ( EBN) is an approach to making quality decisions and providing nursing care based upon personal clinical expertise in combination with the most current, relevant research available on the topic. This approach is using evidence-based practice (EBP) as a foundation.
It puts patients at the center of communication and permits them to collaborate and participate in their own recovery. Bedside reporting encourages teamwork and accountability of staff and is safer for the patient because it increases the quality of hospital care.
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. Hospitals train nurses on how to conduct bedside shift report.
Most importantly, communication supports the foundation of patient care. So, hand-off reporting during shift change is a critical process that is crucial in protecting a patient's safety. Throughout the hand-off report, it is vital to provide accurate, up-to-date, and pertinent information to the oncoming nurse.
Evidence demonstrates bedside shift report is considered best practice when using standardized reporting tools/formatting. Patient safety can be improved by implementing evidence-based transfer of care at the bedside.
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.
Bedside shift reports are the essential transmission of patient information between incoming and outgoing nurses in a patient care setting. This nursing communication provides for the continuity of safe and effective medical care and prevents medical errors.
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.
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.
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 ...
In 2013, a large health system endorsed bedside shift report as a nursing practice to increase patient engagement. While numerous hospitals in the system adopted the practice of bedside shift report, the system did not see anticipated improvements in patient safety or patient satisfaction. Observations across the system revealed tremendous variation in bedside shift report practice norms. The hypothesis was that bedside shift report was either (1) too different from entrenched hand-over processes to be effectively executed, or (2) the desired state of hand-over at the bedside had not been sufficiently articulated. The health system adopted a change management approach to tackle the issue, drawing from organizational development and organizational psychology literature. The result was the creation of a bedside shift report developmental framework which broke down the practice into a series of small, specific component parts, and demonstrated that it was normal to gradually evolve to the ideal, and only after basic behaviors became hardwired. The framework was revised once before arriving at the current iteration in use today. Patient safety and patient satisfaction data will be collected throughout 2017. In the meanwhile, ongoing observations show anecdotal evidence of specific safety catches as well as appreciations from nurses, patients and family members who have greatly benefitted from bedside shift report. The framework has also significantly increased nursing adoption and expertise with bedside shift report. The practice is now in place in 98% of the health system’s hospitals (compared to 52% in 2013), with many units at mastery level.
With the changing healthcare climate, healthcare organizations are increasing their focus on delivering high-quality care and improving patient safety.1 One nursing practice that is getting heightened attention is the practice of bedside reporting (BSR) as the preferred means of end-of-shift handoff communication. Extensive literature supports the practice of bedside reporting as a means of improving quality care, patient satisfaction, and patient–family participation in the plan of care.2 and 3 Additionally, BSR can increase communication and accountability between nurses, improve communication between the nurse and patient, improve coordination of patient care, and increase patient–family adherence with the plan of care.4
Kaiser Permanente implemented a new model of nursing communication at shift change-in the bedside nursing report known as the Nurse Knowledge Exchange (NKE) in 2004-but noted variations in its spread and sustainability across medical centers five years later. The six core elements of NKEplus were as follows: team rounding in the last hour before shift changes, pre-shift patient assignments that limit the number of departing nurses at shift change, unit support for uninterrupted bedside reporting, standardization for report and safety check formats, and collaboration with patients to update in-room care boards. In January 2011 Kaiser Permanente Southern California (KPSC; Pasadena) began implementing NKEplus in 125 nursing units across 14 hospitals, with the use of human-centered design principles: creating shared understanding of the need for change, minimum specifications, and customization by frontline staff. Champion teams on each nursing unit designed and pilot tested unit-specific versions of NKEplus for four to eight weeks. Implementation occurred in waves and proceeded from medical/surgical units to specialty units. Traditional performance improvement strategies of accountability, measurement, and management were also applied. By the end of 2012, 100% of the 64 medical/surgical units and 47 (77.0%) of the 61 specialty units in KPSC medical centers implemented NKEplus-as had all but 1 of the specialty units by May 2013. The mean KPSC score on the NKEplus nursing behavior bundle improved from 65.9% in 2010 to 71.3% in the first quarter of 2014. The mean KPSC Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) score for nurse communication improved from 73.1% in 2010 to 76.4% in the first quarter of 2014 (p < . 001). Human-centered implementation appeared to help spread a new model of nursing handoffs and change the culture of professional nursing practice related to shift change.
A standardized nursing handoff form was designed and implemented to improve handoff process, and rates of nursing errors were measured to determine the effectiveness of the intervention. This study was a prospective intervention study, using 1-group pretest-posttest quasi-experimental design, conducted on an inpatient medical unit. The rates of nursing errors decreased from 9.2 (95% confidence interval, 8.0-10.3) to 5.7 (95% confidence interval, 5.1-6.9) per 100 admissions (P < .001), comparing the pre- and postintervention periods.
Bedside handover has been proposed as a patient-focused nursing practice model with the potential to reduce adverse events and improve standards of care. This pre-/postintervention study examined changes in completion of nursing care tasks and documentation after the implementation of bedside handover. Analysis of 754 cases revealed significant improvements in several nursing care tasks and documentation, whereas there was no variation in handover duration. Implementing bedside handover may enhance nursing care for hospitalized patients.
Background: Clinical handover involves the transfer of accountability and responsibility of clinical information from one health professional to another. The main role of clinical handover is to transmit accurate, relevant and current details about the patients' care, treatment, health service needs, clinical assessment monitoring and evaluation, and goal planning. [4] Objective: To assess nurses awareness about clinical handover among critical care nurses. Methods: this was descriptive across-sectional study, conducted in Elmek Nimer hospital among nurses work in intensive care unit. The data was collected by close ended questionnaire which composed (18question) and it is analysis by SPSS vision (20). Result and conclusion: Result conducted that all most (90%) of study group had good knowledge about elements of handover also majority (76.7% ) of them had fair knowledge about barriers to effective communication and majority (83.3%) of them had good knowledge about Transfer of patient, patient satisfaction during change of duty and (73.3%) had fair knowledge about type of teaching points. KEY WARDS: clinical – handover – critical – nurse – knowledge.
The most frequent cause of sentinel events is poor communication during the nurse-to-nurse handoff process. Standardized methods of handoff do not fit in every patient care setting. The aims of this quality improvement project were to successfully implement a modified bedside handoff model, with some report outside and some inside the patient's room, in a postpartum unit. A structured educational module and champion nurses were used. The new model was evaluated based on the change in compliance, patient satisfaction, and nursing satisfaction. Two months after implementation, there was an increase in nursing compliance in completing all aspects of the model as well as an increase in both patient and staff satisfactions of the process. Replicating this project may help other specialty units adhere to safety recommendations for handoff report.
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
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.
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.
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.
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).
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.
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.
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.
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.
How (and why) BSR works. By definition, BSR is the change-of-shift report between the offgoing nurse and the oncoming nurse that takes place at the bedside. This makes patients a part of the process in the delivery of their care.
The SBAR communication tool can be adapted for BSR as follows. A dry erase board placed in the patient's line of vision can be used to convey information such as the names of nurses and healthcare providers and to highlight the patient's goal for the day.
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
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.
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 ...