Acute Care Setting: A Qualitative Study

The objective of this case study, qualitative research article is to examine families’ perception of bedside shift-to-shift handover. Themes that were focused on included the family interaction with staff, finding value in bedside reporting, and family understanding of the condition and treatment of the patient with regards to the information during report. The study took place in Australia with 8 family members on a rehabilitation ward. Researchers used observation, field notes and in-depth interviews to report their findings. Observations were done prior to interviews. Observations of families’ interactions occurred in the context of bedside handover. The interviews were taped and in-depth which participants were encouraged to relay

End of shift reports between nurses has been an important process in clinical nursing practice. Allowing nurses to exchange vital patient information to ensure continuity of care and patient safety. Therefore, the chance of potential communication gaps causing an error is high. According to the Joint Commission, communication is the primary cause of medical errors, with handoffs accounting for 80% of these errors [ (Zhani, 2012) ]. The most commonly practiced model of report takes place in the staff room, at the nurses’ station, or other locations away

Nursing handover is the primary method of sharing patient information between shifts and ensuring continuity of care from shift to shift. Hand over between shifts is a practice that is basic to the organization of the health works and is an essential aspect of health care delivery. Nursing handover at the bedside should be an interactive process, providing opportunities for introducing the staff to the patient as well as for obtaining the patient’s viewpoint. In particular, bedside handover ensures that patients remain at the center of their

According to the first step of Lewin’s theory Unfreeze phase is about helping nurses to recognize the need for change and encourage them to think about what the current process of end of shift reporting, what the disadvantages are, and how it can be improved. According to Sand-Jecklin and Sherman (2014), significant percentage of a nurse’s communications occurs during end of shift handoffs, and the safety of the patient can be compromised at this time. Nurses recognized that patient handoffs as a factor regarding near miss incidents. According to the Joint Commission (2011), miscommunication is one of the factors that leading to sentinel patient events, therefore, it is a requirement of Joint Commission National Patient Safety Goals. Nursing handoff report is the time, when responsibility and accountability for the care of a patient would be transferred from one nurse to another. Ineffective handovers, such as when not all required information is provided, can be risky for patients and staffs. According to Novak and Fairchild (2012), the method for delivery of shift report varies among hospitals, units, and nurses. These handoffs occur at busy times with multiple distractions and time constraints. This makes shift-to-shift report a time with high potential for the occurrence of errors related to communication. Reports done away from bedside hinder the patient’s participation in their care, which results in a decrease in patient satisfaction scores.

In the research article, The Consequences of Poor Communication During Transitions from Hospital to Skilled Nursing Facility: A Qualitative Study, skilled nursing facility (SNF) nurses are questioned about the communication used to transition patients from a hospital to a SNF. Since communication is a vital skill in the nursing field, it is crucial for nurses to understand when inadequate discharge information is being used so they may better communicate in future patient discharges. There are some unreliable sections in the research article that could be improved, but overall the article exhibits appropriate and credible information. This research critique examines the authenticity of the qualitative study and focuses on distinguishing

From the passage of the Patient Protection and Affordable Care Act in 2010 through the end of last year, merger and acquisition transactions involving acute-care hospitals increased 55% from 66 announced deals to 102 (Barlas, 2014). This movement is increasing for reasons that are evident. For providers, it is becoming a challenging environment to be a small medical practice. The system is going through a difficult switch to electronic medical records, which is expensive and requires specialized experience to avoid downsides. These challenges push physicians to pursue employment in large organizations rather than solo ownerships or partnerships in small

Nursing bedside handover is as an important part in the transferring of nursing responsibilities of clinical care for all patients from one nurse to another nurse at the end of the shift (Chin, Warren, Kornman & Cameron, 2012). Nursing handover is significant in maintaining the continuity of patient care for better health outcomes. If the information provided to another person is poorly conveyed may lead to major issues such as communication barrier, patient’s privacy, and confidentiality at the bedside (Anderson, Malone, Shanahan & Manning, 2014).

Patient satisfaction is a driving force in today’s health care system. Incorporating the patient in their care will help with the patients healing process as well as encouraging the patient to be more compliant with their prescribed care. Bedside reporting is a practice that some organizations have incorporated in their standards of care. The patients care does not stop when the nurse’s shift ends. Therefore, it is important for the patient’s information to be conveyed accurately to the oncoming nurse. Conducting shift reports at the bedside allows the oncoming nurse to both visualize and interact with the patient much sooner than if the nurse had received report in another manner. Furthermore, bedside reporting allows the patient to interact with both nurses; and allows them to see that their care is being properly managed. This type of reporting also allows the oncoming nurse to ask questions, as other methods of shift reporting limits the oncoming nurse from interacting and asking questions of the off going nurse. Patient satisfaction as well as accurate transfer of information and patient safety is a crucial part in providing quality patient care.

Nursing handoffs should involve the departing nurse informing the oncoming nurse about his or her patients. After all pertinent information has been exchanged an in-room report should be done with both nurses and the patient. This initiates a time where the incoming nurse and patient can get acquainted and any questions can be addressed.

Bedside report defined by Ferguson and Howell (2015) termed the method as transfer of vital patient information from one nurse to the next nurse during a report that allowed “an opportunity to ask questions, clarify and confirm” (p. 736). The increase communication and accountability established during report lead to effective communication and better patient outcomes. Patients feel satisfied because they are more aware of their caregiver and included in their plan of care. Visualization of the patient during shift report improves risk management, creating patient safety related to falls, medication errors, and identifying patient issues (Maxson et al., 2012, p. 144).

This ROL is based on the research that has been done on the nursing handoff in the emergency department (ED), and seeks, “ to quantify quantitative outcomes of a practice change to a blended form of bedside nursing report”(Sand-Jecklin & Sherman, 2014).  The literature highlights several advantages of nursing reporting to each other at the patient’s bedside as well as identifying that there have been sentinel events from poor handoffs, and there needs to be a systematic handoff tool developed specifically designed for ED nurses (Klim et al., 2013). However, the research that has been presented did not provide sufficient quantified results as a result of moving to bedside nursing handoff, related to several factors, including small or unreported sample sizes, or the research excluded significant statistical testing (Sand-Jecklin & Sherman,

“We will find our baseline measurement using nurse surveys, audits and observation timings. We will track what steps are covered and how long each step takes and the number of occurrences of near misses due to inefficient handoffs relating to patient safety. We will also measure our patient baseline data from current patient satisfaction surveys” N. Guyse (personal communication, February 22, 2014). Currently we are inefficient and unsafe with handoff practices due to missing or incomplete information, multiple processes used between the nursing staff, and multiple report out processes being practiced on the floor. Multiple processes are causing confusion and incidental overtime. With multiple processes, information is being missed between nursing staff, which is a safety concern due to the increased errors. Our organization is working on the creation of one standardized process used between all employees to ensure that all handoffs are efficient and safe. “We have implemented a group report out for nursing staff in conjunction with the beside report outs” N. Guyse (personal communication, February 22, 2014).

Bedside shift reports or as some call them patient handoffs, Nursing hand offs or Report are now common among hospital and nursing talking about patient between shift change (Ofori-Atta, J. 2015). This type of report was not always done at the bedside because of fears that patients were thought to have about medical care. According to Ofori-Atta, J. (2015), preventive medicine and autonomy have been encouraged over the past several years which leads us to allowing the patient to be involved in care and bedside shift reports. It is also helps nursing to identify safety issues when changing shifts.

“A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation” is a quasi-experimental study by Kari San-Jecklin and Jay Sherman. The purpose of this study was to use pre and post implementation of surveys to monitor not only patient’s viewpoint of bedside reporting correlated to care received, but nurses opinions as well (2854). Strengths of this article includes the surveys taken. The patients’ surveys had 17 questions pertaining to nurses’ actions, education, respectfulness, and communication. Similar to the patients’ surveys, there were seventeen items on the nursing survey. Although, the nursing survey included questions regarding bedside reporting. Questions were used to establish the advantages and

Shift report has been recognized as a period when chances for futile communication contribute to jeopardizing patient safety (Boshart, Knowlton, & Whichello, 2016). Performing patient shift report near the bedside fosters effective communication between healthcare providers and patients through a transparent and open conversation. Research shows that bedside report allows nurses’ to effectively take accountability for patient safety as it allows them to directly visualize the patients and family in order to discuss information and plan for their care (Baker, 2010). Bedside handoff gives patients the opportunity to become actively involved in the process of developing a successful care plan. Patients are provided with the chance to hear and see the group of healthcare professionals who are involved in their plan of care. Encouraging patient involvement within the plan of care allows for a decrease in ineffective communication as it allows for better compliance to treatment (Taylor & Julia,