Bedside Reporting

Bailey , Cheryl K., Cheryl N., Kristine

To determine if there is enough research to support that bedside reports produce:

Improved Patient OutcomesIncreased Patient SatisfactionSmoother Transition at Shift ChangeJob Satisfaction Correlation

Problem Statement

Research Databaseo CINAHLo PubMed

Keywordso Bedside Handovero Change of Shifto Patient Satisfaction

Publicationso 150 Scholarly Publications• Past 5 Years• Nurse Author

50 Articles

Critically Appraisedo 4 Articles• Enough Evidence to

Support Change• Increased Outcomes• Increased Safety• Increased Satisfaction

Miscommunication During Shift Report can Cause Vital Information to be Lost

o 70% of all Sentinel Events JACHO 2003

Current Methods of Report vary from Hospital to Hospital and

from Unit to Unit

Introduction

Descriptive Summary

Purpose of Change

Common Practice

Process Change

Bringing Change-of- Shift Report to the Bedside: A Patient-and-family Centered Approach

T. Griffin

Bedside Reporting

oNational Patient Safety Goal

oTransfer Accountability

oIncreased Communication

Critical AppraisalProblem and Purpose Statement

Article Analysiso16 sources• 3 Outdated

oJoint Commission National Patient Safety Goals

oInstitute for Patient and Family Centered Care

Review of Literature

Respect and DignityoHonor Family Wishes

Information SharingoComplete and Unbiased Information

ParticipationoFamily and Patient

CollaborationoPolicy and Program Development

Framework4 Core Concepts

ChallengesoResistance to ChangeoConfidentialityoTime Management

BenefitsoPatients Seen SooneroStaff Accountability

ImplementationoCommunicationoEvaluation

Results

Increased Patient Participation

Increased Safety

Increased Satisfaction

Conclusion

Descriptive Summary

Report Standardizationo Promote Efficiencyo Promote Quality

Hospitalo Magnet Hospital• 34 Beds• 55 Employees

Authorso 3 Nurses• 1 Doctoral Degree• 1 Masters Degree• 1 Bachelors Degree

Standardization of Change-of-Shift Report

Athwel, Fields, Wagnell

Limited Data Available

Nursing Staff and Physician Dissatisfaction

Quality Information Exchange

Critical AppraisalProblem and Purpose Statement

3 Sources

oGeneralized StatementsoLack Description and Appraisal

Review of Literature

New Report Method

oLiteratureoNursing Suggestions

Standardized Reports

Framework

Report Time Decreased

Overtime Reduction

Improved Safety

Results

Descriptive Summary Authors

o 2 Nurses• 1 Masters Degree• 1 Bachelors Degree

Bedside Reporting Benefits◦ Safety◦ Teamwork◦ Accountability◦ Patient Participation

Barriers◦ Confidentiality◦ Report Time

Incorporating Bedside Reporting into Change-of-Shift Report

D. Laws, S. Amato

Critical AppraisalProblem and Purpose Statement

Communication Failures

Irrelevant Information

Patient Involvement

Qualitative Studyo2 Sourceso Reference Range Outdated

Limited Sample SizeoWeak Study• Percentages Only, No Numbers

Review of Literature

Pre-ImplementationoResistant to ChangeoStaff Concerns

Implementation◦Education◦Survey◦Patient Involvement

Post Implementation◦Survey◦Concerns

Framework

Potential Bias

Statistics

Teamwork

Patient Participation

Summary

Descriptive Summary Studyo 74 Full Time Nursing Staffo 2 Medical and 1 Rehabilitation Unit Affected

Focuso Why the Specific Change was Targetedo Provide the Framework for Change

Hospitalo Queensland, Australia• 330 Beds• 454 Full Time Nursing Staff

Authorso 5/6 Registered Nurses• 3 Post Doctoral Degrees 2 Masters

Bedside Handover: Quality Improvement Strategy to “Transform Care at the Bedside”

W. Chaboyer, A. McMurray, J. Johnson, L. Hardy, Wallis, Ying

Lack of Implementation Guidelines and research for bedside Reports

Improve Patient Centered Care

Critical AppraisalProblem and Purpose Statement

2 Recent Studies

Primary Sources

o Not Critically Appraised

• Possible Conclusion:

Lack of Significant Research and Studies Weak Studies Lack of Thorough Review by Authors

Review of Literature

Unfreezing◦Recognition Necessity of Change

Moving◦Written Guidelines◦Communication◦Education

Refreezing◦New Policy

FrameworkLewin’s 3-Step Model for Change

Interviews with Patients, Nurses and Multidisciplinary Teams Prior and Post Changes BenefitsoSupport oImproved SafetyoImproved Outcomes

Changes Since Study

Results

Benefits◦Increased Patient Safety◦Identify Missing Information◦Improved Teamwork

Barriers◦Medical Jargon◦Focus of Report

Limitations◦One Hospital◦Informal Evaluation Process◦Variables

Discussion

Author 1◦ SBAR ◦ Clinical Bedside Reporting Experience

Author 2◦ Bedside Introduction◦ Privacy Issues with ER Bedside Reporting

Author 3◦ Kardex◦ Verbal Report at Nurse’s Station

Author 4o Verbal Report

Group Members Influential Experiences

Bedside Report◦Increases effective communication◦Increases Nurse & Patient Satisfaction◦Produces Better Patient Outcomes

Based on Unit Uniqueness◦Not appropriate for all Acute Care Settings

RecommendationsTo Utilize or Not to Utilize

Alvarado, K., et al., (2006). Transfer of Accountability: Transforming Shift Handover to Enhance Patient Safety. Healthcare Quarterly, 9(75-79). Retrieved from http://www.longwoods.com/content/18464

Athwal, P., Fields, W., & Wagnell, E. (2009). Standardization of Change-of-Shift Report. Journal of Nursing Care Quality, 24(2), 143-147. DOI: 10.1097/01.NCQ.0000347451.28794.38

Burns, N.& Grove, S., (2011). Understanding nursing research: Building an evidenced-based practice. Maryland Heights, MO: Saunders Elsevier Inc.

Chaboyer, W., McMurray, A., Johnson, J., Hardy, L., et. al. (2009). Bedside handover: Quality improvement strategy to “transform care at the bedside”. Journal of Nursing Care and Quality 24(2): pp. 136-142. Wolters Kluwer Health: Lippincott Williams & Wilkins.

Friesen, M.A., White, S.V., Byers, J.F. (2008). Patient safety and quality: an evidence based handbook for nurses. Agency for Healthcare Research and Quality. Chapter 34. Handoffs: Implications for Nurses. Retrieved from http://www.ahrq.gov/qual/nurseshdbk/docs/FriesenM_HOIN.pdf

Griffin, T. (2010, October/December). Bringing Change-of-Shift Report to the Bedside: A Patient-and Family-Centered Approach. Journal of Perinatal and Neonatal Nursing, 24(4), 348-353. Retrieved from http://www.longwoods.com/content/18464

Laws, D., Amato, S., (2010). Incorporating Bedside Reporting into Change-of-Shift Report, Rehabilitation Nursing 35(2), p.70-74.

Revere, A., & Eldridge, N. (2008, Jan/Feb). Joint Commission National Patient Safety Goals for 2008. Topics in Patient Safety, 12(1),

1-4. http://www.patientsafety.gov/TIPS/Docs/TIPS_JanFeb08.pdf

References