bailey , cheryl k., cheryl n.,...
TRANSCRIPT
Bailey , Cheryl K., Cheryl N., Kristine
To determine if there is enough research to
support that bedside reports produce:
Improved Patient Outcomes
Increased Patient Satisfaction
Smoother Transition at Shift Change
Job Satisfaction Correlation
Database o CINAHL
o PubMed
Keywords o Bedside Handover
o Change of Shift
o Patient Satisfaction
Publications o 150 Scholarly Publications
• Past 5 Years
• Nurse Author 50 Articles
Critically Appraised o 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
Descriptive Summary
Purpose of Change
Common Practice
Process Change
Bedside Reporting
oNational Patient Safety Goal
oTransfer Accountability
oIncreased Communication
Article Analysis
o16 sources
• 3 Outdated
oJoint Commission
National Patient Safety Goals
oInstitute for Patient and Family
Centered Care
Respect and Dignity
oHonor Family Wishes
Information Sharing
oComplete and Unbiased Information
Participation
oFamily and Patient
Collaboration
oPolicy and Program Development
Challenges oResistance to Change oConfidentiality oTime Management
Benefits oPatients Seen Sooner oStaff Accountability
Implementation oCommunication oEvaluation
Increased Patient Participation
Increased Safety
Increased Satisfaction
Descriptive Summary
Report Standardization o Promote Efficiency o Promote Quality
Hospital o Magnet Hospital
• 34 Beds
• 55 Employees
Authors o 3 Nurses
• 1 Doctoral Degree
• 1 Masters Degree
• 1 Bachelors Degree
Limited Data Available
Nursing Staff and
Physician Dissatisfaction
Quality Information Exchange
3 Sources
oGeneralized Statements
oLack Description and Appraisal
New Report Method
oLiterature
oNursing Suggestions
Standardized Reports
Report Time Decreased
Overtime Reduction
Improved Safety
Descriptive Summary Authors o 2 Nurses
• 1 Masters Degree
• 1 Bachelors Degree
Bedside Reporting Benefits ◦ Safety ◦ Teamwork ◦ Accountability ◦ Patient Participation
Barriers ◦ Confidentiality ◦ Report Time
Communication Failures
Irrelevant Information
Patient Involvement
Qualitative Study
o2 Sources
o Reference Range Outdated
Limited Sample Size
oWeak Study
• Percentages Only, No Numbers
Pre-Implementation
oResistant to Change
oStaff Concerns
Implementation
◦ Education
◦ Survey
◦ Patient Involvement
Post Implementation
◦ Survey
◦ Concerns
Potential Bias
Statistics
Teamwork
Patient Participation
Descriptive Summary
Study
o 74 Full Time Nursing Staff
o 2 Medical and 1 Rehabilitation Unit Affected
Focus
o Why the Specific Change was Targeted
o Provide the Framework for Change
Hospital
o Queensland, Australia
• 330 Beds
• 454 Full Time Nursing Staff
Authors
o 5/6 Registered Nurses
• 3 Post Doctoral Degrees
2 Masters
Lack of Implementation Guidelines and
research for bedside Reports
Improve Patient Centered Care
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
Unfreezing
◦ Recognition Necessity of Change
Moving
◦ Written Guidelines
◦ Communication
◦ Education
Refreezing
◦ New Policy
Interviews with Patients,
Nurses and Multidisciplinary Teams
Prior and Post Changes
Benefits
oSupport
oImproved Safety
oImproved Outcomes
Changes Since Study
Benefits
◦ Increased Patient Safety
◦ Identify Missing Information
◦ Improved Teamwork
Barriers
◦ Medical Jargon
◦ Focus of Report
Limitations
◦ One Hospital
◦ Informal Evaluation Process
◦ Variables
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 4
o Verbal Report
Bedside Report
◦ Increases effective communication
◦ Increases Nurse & Patient Satisfaction
◦ Produces Better Patient Outcomes
Based on Unit Uniqueness
◦ Not appropriate for all Acute Care Settings
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