evidence-based practice: bedside shift report improves patient safety and nurse accountability

Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction. 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.

Full Answer

Does bedside shift report improve 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.

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.

Who are the six authors of the bedside shift report (BSR)?

He aided the PI in preparing the findings for publication and will be listed as the six author. Jimmerson J, Wright P, Cowan PA, King‐Jones T, Beverly CJ, Curran G. Bedside shift report: Nurses opinions based on their experiences.

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.

How does bedside shift report improve patient safety?

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.

What is the purpose of 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. Hospitals train nurses on how to conduct bedside shift report.

Why is shift report important in nursing?

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.

Is bedside report evidence-based?

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.

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.

What is nurse bedside shift report?

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 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 should be included in a nursing shift 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 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 ...

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 is bedside shift report?

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.

What is bedside reporting?

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

What is NKE in nursing?

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.

What is a standardized nursing handoff form?

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.

What is bedside handover?

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.

What is clinical handover?

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.

How does miscommunication affect hospital sentinel events?

Miscommunication is a large contributing factor to hospital sentinel events. Communication with nurses is a component of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. The HCAHPS survey not only assesses patient satisfaction but also impacts how hospitals are reimbursed. A literature review reveals that nursing bedside shift positively impacts patient satisfaction and nurse communication. There is limited research on how to implement bedside report as well as what to include during report. A pilot study evaluated an educational intervention and its impact on nurses' compliance with bedside report. The study also evaluated whether bedside report compliance affected HCAHPS scores. A test of independent proportions showed that overall compliance scores increased significantly from period 1 (46%) to period 3 (81%), z = 2.23, P = -.017, one-tailed. HCAHPS scores for nursing communication went from 69.9% in quarter 1 of 2015 to 73.8% in quarter 4 of 2016, but there was no statistically significant change.

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.