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Article Analysiso16 sources• 3 Outdated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
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
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Qualitative Studyo2 Sourceso Reference Range Outdated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
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
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