18 hours ago Standardizing bedside reporting is one step toward improving communication between nurses, patients, and their families. Project: A pilot bedside shift report process was developed on a medical/surgical intermediate care unit to improve patient satisfaction scores in the area of "nurse communicated well," with the goal of reaching 90% satisfaction rates, which increased … >> Go To The Portal
Moving report to the bedside has impacted patient satisfaction and allows for free flow of accurate information centered on the patients. Additionally, bedside report cultivates an environment for mentoring relationships to develop among nursing staff and creates relationships of mutual respect.
Improving patient satisfaction with nursing communication using bedside shift report This process was instituted organization-wide. Reaching the goal of 90% satisfaction in the area of patient perceptions of nursing communication is the overall goal of this program. This process was instituted organization-wide.
The concepts that have been used in the literature for achieving acceptance and sustainability of nurse bedside shift report follow Everett Rogers' five-step approach to adoption of innovations: knowledge, persuasion, decision, implementation, and confirmation.28
Nursing leaders who want to achieve successful dissemination and sustainability of bedside shift report must have a good understanding of process management and relationship building, mentoring skills, and a well-planned and well-executed implementation process. REFERENCES 1.
Nurse satisfaction with the report process was determined using surveys adapted with permission from previously published tools ( Cairns et al. 2013; Evans et al. 2012 ). To assure question clarity and relevance of the project, surveys were completed by six members of the BSR team, three directors, and three staff.
The benefits of bedside reporting are numerous and include increased patient involvement and understanding of care, decreased patient and family anxiety, decreased feelings of “abandonment” at shift changes, increased accountability of nurses, increased teamwork and relationships among nurses, and decreased potential ...
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.
Change-of-shift report is the time when responsibility and accountability for the care of a patient is transferred from one nurse to another. The communication that ensues during this process is linked to both patient safety and continuity of care giving.
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.
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.
B) "Change-of-shift reporting ensures that oncoming staff know the most critical information about the clients they'll be caring for." Nurses often do not have time to read clients' charts prior to assuming care, which could result in errors and assumptions.
Presentation – One excellent way to give report is to present it in the form of a head-to-toe assessment. First, give a brief synopsis of the patient's medical history and day's events, including such important factors as surgery, diagnostic studies or changes from the previous shift.
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.
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 patient and family engagement? Patient and family engagement: •Creates an environment where patients, families, clinicians, and hospital staff all work together as partners
Strategy 3: Nurse Bedside Shift Report (Implementation Handbook) Guide to Patient and Family Engagement Table of Contents Introduction----- 1 Overview of the Nurse Bedside Shift Report strategy----- 1
BEDSIDE SHIFT REPORT (BSR) can save lives. 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.
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. Hospital leaders and healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse satisfaction. In the literature, changing the location of shift report from the desk or nurses’ station to the bedside has been identified as a means to increase patient safety and patient and nurse satisfaction. Shift report, when completed at the patient bedside, allows the nurse to visualize and assess the patient and the environment, as well as communicate with and involve the patient in the plan of care. 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.
Sixty-four (95%) of the nurses completed the pre- implementation survey, and fifty-seven (85%) completed the post survey. Table 2 represents the number of nurses who reported having enough time for report was significantly decreased, from 80% pre BSR to 59.6% after implementation of BSR ( p = 0.008). In the post survey, staff members were able to express concerns about BSR; 70% ( n = 45) of the nurses who responded to this question believed that BSR increased the time it took to individually give and receive report. Thirty-nine percent ( n =25) of staff reported concerns about patient confidentiality; 44% ( n =29) responded that BSR was inconvenient for nurses due to many factors (e.g., multiple nurses needing report, patient requests delayed report, and nurses preferring the status quo).
BSR is a significant change to the current shift report practice and culture of most organizations, but it is associated with both improved patient safety and patient and nurse satisfaction. A limitation of this project was that the evidence-based quality improvement design prevents generalization of findings to other settings; however, the knowledge gained may be transferred to other units or hospitals.
BSR was associated with decreased fall rates , and this finding is consistent with the literature ( Jeffs et al. 2013; Sand-Jecklin & Sherman, 2013 ). Since falls occur for many reasons, it is not surprising that a single environmental scan at change of shift did not eliminate all falls. However, in one instance, nurses found a patient trying to climb out of bed during BSR and timely intervention may have prevented a fall. In the staff satisfaction survey, a nurse reported discovering a patient who had experienced a change in neurological status during BSR. It would be important to note in future studies or projects that the importance of the visual assessment component of the patient and the environment in BSR should be considered as an outcome measure.
Education is the beginning of obtaining buy-in from staff. Sharing success stories, such as the “good catch” of a patient who had deteriorated on rounds or improving fall rates, helps to encourage continued participation in BSR. Some staff members may initially participate but return to the nurses’ station for report unless nursing leadership continues to monitor performance and reinforce consistent expectations. When nurses explain that BSR is “how we practice,” BSR is “anchored” on your unit.
Patient falls decreased by 24% in the four months after BSR implementation compared to pre-implementation falls. The orthopedic unit experienced the greatest reduction in the number of falls at 55.6%, followed by the neuroscience unit at 16.9%, and the general surgery unit at a 6.9% reduction. Patient falls results are presented in Figure 3.
Three units were selected for implementation of the practice change based upon the directors’ desire and willingness to participate. The populations served on the chosen nursing units were patients undergoing general surgery, and those with orthopedic and neuroscience diagnoses. Members of these units volunteered to be part of the BSR team.
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 -6There are different types of nursing reports described in the literature, but the four main types are: a written report, a tape-recorded report, a verbal face-to-face report conducted in a private setting, and face-to-face bedside handoff.3,4,7,8
Systematic literature review studies point out that implementing nurse bedside shift report can improve the patient experience with care as related to nurse communication.8,9 ,11For example, Mardis and colleagues conducted a systematic literature review of 41 articles related to the use of bedside shift report and concluded that 49% of the reviewed literature identified an increase in patient experience with care as a self-reported outcome, whereas only 2% of the reviewed studies identified patient complaints with this practice.11Sherman and associates also found patient advantages in relation to nurse bedside shift report, such as patients being more informed about and engaged in their care, improved nurse-patient relationship, and improvement in overall patient satisfaction.8
The only nursing report method that involves patients, their family members, and both the off-going and the oncoming nurses is face-to-face bedside handoff.3This type of nursing report is conducted at the patient's bedside and has different variations. In broad terms, nurse bedside shift report can be classified into two categories: “blended” and face-to-face bedside handoffs.8,10The “blended” bedside shift report can be defined as a nursing handoff composed of two parts: Half of the report is written or conducted in a face-to-face approach in a private setting and the other half of the report is conducted face-to-face at the patient's bedside. The face-to-face nurse bedside shift report is solely conducted at the patient's bedside.8
The concepts that have been used in the literature for achieving acceptance and sustainability of nurse bedside shift report follow Everett Rogers' five-step approach to adoption of innovations: knowledge, persuasion, decision, implementation, and confirmation. 28
These included difficulties understanding the report and medical jargon, tiredness as a result of information being repeated multiple times, lack of privacy, anxiety over incorrect information or too much information, and inconsistency with how the nurse bedside shift report was conducted.8,22,23
Studies also reported a number of reasons why some nurses don't prefer bedside shift report, including that they may have little awareness of and skills with engaging in a patient-centered approach to care, and that they may feel uncomfortable talking in front of patients and intimidated if patients ask questions for which they don't have answers. 7,24They may also be afraid to unintentionally disclose medical information unknown to the patient and may have concerns about violating patients' privacy.9,21But the main nursing disadvantage in relation to bedside shift report that's been reported in the literature is longer change-of-shift report time as a result of patients interrupting nurses during the process.8
The written nursing report doesn't allow the off-going and oncoming nurses to interact face-to-face, but it 's a written record of the patient's medical background, situation, treatment, and care plan that's usually conducted behind closed doors.3The tape-recorded nursing report also doesn't allow interaction between the off-going and oncoming nurses. It's considered to be a time-efficient method, but drawbacks such as a nurse's inability to clarify patient information, an unclear or low-volume audiotape recording, and outdated or misheard facts relevant to the patient's current condition are all issues that have been pointed out in the research literature.3The verbal report conducted in a private setting gives the off-going and the oncoming nurses the opportunity to interact face-to-face, but doesn't involve patients and their family members.3Furthermore, it's more time-consuming than other types of reporting.9
Additionally, bedside report cultivates an environment for mentoring relationships to develop among nursing staff and creates relationships of mutual respect. Nurses are able to visualize patients and implement safety checks at the start of their shift, reducing the length of time they spend at the nurses' station and away from the bedside. This facilitates a smoother workflow and improves the reporting process. Lastly, HCAHPS scores have shown that bedside shift report has had a positive impact on patients' perception of effective communication.
Bedside reporting also allowed for increased mentoring opportunities between nursing staff. By visualizing the patient and equipment during the report time, nurses were prompted to ask questions based on the current patient situation. Patients were encouraged to participate in the report process, thereby gaining a better understanding of the plan of care and verifying information. This patient-centered and transparent approach helped foster an environment of trust, mutual respect, and understanding.
Communication between caregivers is an important aspect of patient care. Consistent and accurate exchange of patient information is imperative to maintain patient focus and promote a culture of safety and trust. The American Nurses Association estimates that 80% of serious medical errors involve miscommunication between caregivers ...
Bedside Shift Report: A Way to Improve Patient and Family Satisfaction with Nursing Care
to collect data to understand patient satisfaction with nursing care and communication. The
Poor communication during the handoff process contributes to approximately 30% of
satisfaction within the organization. The HCAPS survey fails to recognize unit specific patient
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. Hospital leaders and healthcare organizations are making concentrated efforts to change their environments to assure patient safety and patient and nurse satisfaction. In the literature, changing the location of shift report from the desk or nurses’ station to the bedside has been identified as a means to increase patient safety and patient and nurse satisfaction. Shift report, when completed at the patient bedside, allows the nurse to visualize and assess the patient and the environment, as well as communicate with and involve the patient in the plan of care. 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.
Sixty-four (95%) of the nurses completed the pre- implementation survey, and fifty-seven (85%) completed the post survey. Table 2 represents the number of nurses who reported having enough time for report was significantly decreased, from 80% pre BSR to 59.6% after implementation of BSR ( p = 0.008). In the post survey, staff members were able to express concerns about BSR; 70% ( n = 45) of the nurses who responded to this question believed that BSR increased the time it took to individually give and receive report. Thirty-nine percent ( n =25) of staff reported concerns about patient confidentiality; 44% ( n =29) responded that BSR was inconvenient for nurses due to many factors (e.g., multiple nurses needing report, patient requests delayed report, and nurses preferring the status quo).
BSR is a significant change to the current shift report practice and culture of most organizations, but it is associated with both improved patient safety and patient and nurse satisfaction. A limitation of this project was that the evidence-based quality improvement design prevents generalization of findings to other settings; however, the knowledge gained may be transferred to other units or hospitals.
BSR was associated with decreased fall rates , and this finding is consistent with the literature ( Jeffs et al. 2013; Sand-Jecklin & Sherman, 2013 ). Since falls occur for many reasons, it is not surprising that a single environmental scan at change of shift did not eliminate all falls. However, in one instance, nurses found a patient trying to climb out of bed during BSR and timely intervention may have prevented a fall. In the staff satisfaction survey, a nurse reported discovering a patient who had experienced a change in neurological status during BSR. It would be important to note in future studies or projects that the importance of the visual assessment component of the patient and the environment in BSR should be considered as an outcome measure.
Education is the beginning of obtaining buy-in from staff. Sharing success stories, such as the “good catch” of a patient who had deteriorated on rounds or improving fall rates, helps to encourage continued participation in BSR. Some staff members may initially participate but return to the nurses’ station for report unless nursing leadership continues to monitor performance and reinforce consistent expectations. When nurses explain that BSR is “how we practice,” BSR is “anchored” on your unit.
Patient falls decreased by 24% in the four months after BSR implementation compared to pre-implementation falls. The orthopedic unit experienced the greatest reduction in the number of falls at 55.6%, followed by the neuroscience unit at 16.9%, and the general surgery unit at a 6.9% reduction. Patient falls results are presented in Figure 3.
Three units were selected for implementation of the practice change based upon the directors’ desire and willingness to participate. The populations served on the chosen nursing units were patients undergoing general surgery, and those with orthopedic and neuroscience diagnoses. Members of these units volunteered to be part of the BSR team.