improved patient care safety in postpartum in relation to nurse to nurse report to bedside

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

Why is it important to provide nursing care to a postpartum?

It is also essential to make sure that the woman is in a stable condition because the immediate postpartum is a critical stage for both the woman and her baby. Providing nursing care to a postpartum woman during the first 24 hours entails the following:

How to prevent postpartum complications and defects?

Examine both the mother and the newborn physically to note any signs of postpartum complications or defects. Remind the mother about the health maintenance visit of the newborn once she reaches 2 to 4 weeks old, and her return checkup 4 to 6 weeks after birth.

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.

How to take care of the postpartal woman?

The care of the postpartal woman should always be integrated into the discharge planning. It is important to make sure that the woman is well taken cared of, for she would also be responsible for the welfare of her newborn.

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 should be on a bedside shift report?

According to AHRQ, the critical elements of a BSR are: Introduce the nursing staff, patient, and family to each another. Invite the patient and (with the patient's permission) family to participate. The patient determines who is family and who can participate in the BSR.

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 ...

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 should nurses do bedside 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.

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 included in a nursing report?

What to cover in your nurse-to-nurse handoff reportThe patient's name and age.The patient's code status.Any isolation precautions.The patient's admitting diagnosis, including the most relevant parts of their history and other diagnoses.Important or abnormal findings for all body systems:More items...•

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.

How do you write a nursing handover report?

What goes in to a handover?Past: historical info. The patient's diagnosis, anything the team needs to know about them and their treatment plan. ... Present: current presentation. How the patient has been this shift and any changes to their treatment plan. ... Future: what is still to be done.

What key actions should happen in the bedside handover?

There are four aspects to the preparation for bedside handover: 1) Staff and patient allocation; 2) Updating the handover sheet; 3) Informing patients; and 4) Family and Other Visitors. Bedside handover has been used successfully where team nursing is practised.

What is bedside handover in nursing?

Bedside handover: direct patient handover that occurs at the patient's bedside and includes patients and parents/ carers. EMR Review: process of working through the EMR activities to collect pertinent patient details.

What is the purpose of individual instruction after postpartum?

Individual instruction is also sought after postpartum, as the family will need to know how to care for the woman and the newborn after discharge. Teaching should not always be formal; it may come in the form of comments during classes or procedures.

Why is it important to make sure that the woman is in a stable condition after giving birth?

It is also essential to make sure that the woman is in a stable condition because the immediate postpartum is a critical stage for both the woman and her baby.

What is home visit after discharge?

A home visit after the discharge is usually recommended to check on how the family is doing now that they have a newborn in the house. High-risk newborns, newborns born to adolescent mothers, and newborns with mothers who have abused drugs during pregnancy need to have a specially planned discharge and home visit.

When to assess pregnancy history?

Pregnancy history is assessed during the postpartum visit and if there are any difficulty with the bonding between the mother and the baby, and allow the woman to relate her labor and birth experiences. Assess the newborn history and if there are any concerns about the newborn that the woman has noticed.

Why is it important for a woman to rest at home?

The woman can rest better at home and may eat better if she has cultural preferences regarding food. The newborn can also be exposed earlier to the routines of the family, and make it easier for her to adjust to extrauterine environment.

When do newborns have to have health maintenance?

The newborn must have her health maintenance when she turns 2 to 4 weeks old. The care of the postpartal woman should always be integrated into the discharge planning. It is important to make sure that the woman is well taken cared of, for she would also be responsible for the welfare of her newborn.

How long after birth should you check on a newborn?

Remind the mother about the health maintenance visit of the newborn once she reaches 2 to 4 weeks old, and her return checkup 4 to 6 weeks after birth.

What is CNE in nursing?

This continuing nursing educational (CNE) activity is designed fornurses and other health care professionals who care for and educat-ed patients and their families regarding bedside nurse-to-nursehandoff and patient safety. For those wishing to obtain CNE credit, anevaluation follows. After studying the information presented in thisarticle, the nurse will be able to:

Why is bedside handoff important?

It also allows the oncom-ing nurse an opportunity to visualize the patient and ask questions. This is criticalin meeting the Joint Commission’s 2009 National Patient Safety Goals. It encour-ages patients to be involved actively in their care and it implements standardizedhandoff communication between nursing shifts. Bedside handoff promotespatient safety and allows an opportunity for patients to correct misconceptions.

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.

Why is it important to hand over nursing?

According to [6], the importance of the nurse handover in the process of caring for patients has motivated the development of protocols to standardize the process in different health institutions, even though the literature shows that the results obtained are not satisfactory. In the majority of health institutions, there are protocols and guides for the shift change, which are defined as activities that guarantee the patient's continuity of care by nursing personnel and attendance to elements necessary for patient care, such as a service inventory or a report of any change that has occurred [6]. ...

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 transition of care?

Transitions of care (ToCs), also referred to as handoffs or sign-outs, occur when the responsibility for a patient's care transfers from 1 health care provider to another . Transitions are common in the acute care setting and have been noted to be vulnerable events with opportunities for error. Health care is taking ideas from other high-risk industries, such as aerospace and nuclear power, to create models of structured transition processes. Although little literature currently exists to establish 1 model as superior, multiorganizational consensus groups agree that standardization is warranted and that additional work is needed to establish characteristics of ToCs that are associated with clinical or practice outcomes. The rationale for structuring ToCs, specifi cally those related to the care of children in the emergency setting, and a description of identifi ed strategies are presented, along with resources for educating health care providers on ToCs. Recommendations for development, education, and implementation of transition models are included.

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 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

Background

See more on psnet.ahrq.gov

Nurses' Working Conditions and Patient Safety

"Missed" Nursing Care

Safety and Quality Rating Systems

References