Performance Improvement Planning Case Study

Communication between nurses at report change is essential. The next nurse needs the most important information whether it is as Situation-Background-Assessment-Recommendation (SBAR) that the Institute for Healthcare Improvement (n.d.) outlines to use or in another form. The case of Rio Grande Regional Hospital Inc v. Villarreal discusses how one nurse breached the standard of care because the record reflects that from the time Hermes was given the double-edged razor until he died neither Nurse Bergado nor any other nurse checked to see how Hermes was doing in the bathroom” (Find Law for Legal Professionals, 2016). At Baylor Scott & White at All Saints, we have a policy that each patient is rounded on physically every hour.

The staff attending the educational session will receive the guide to take home and brochures on SBAR (Joint Commission, 2006). The author will set up the flyers to sent the information about the educational sessions, including venue, dates, class size, contact phone numbers, and program times to physician’s offices, local bulletin boards, and to all nursing departments. The advertisement will be placed in the local newspaper with the same information listing in the flyers. The SBAR educational program will develop by the author with the assistance of nursing director, and multidisciplinary team and will be presented by the multidisciplinary team appointed by the project director. Nutritious snacks, drinks, and lunch will provide by the Brampton Civic Hospital.

The shift report is an integral component of patient care due to the fact that it advances patient safety and maintains continuity of care. Shift reporting promotes best practices through communication among nursing staff, therefore, promoting professional socialization. Furthermore, shift report influences staff retention and quality of patient care by improving informational, social and organizational functions. The expertise and knowledge in shift reporting can be used to promote interdependence and teamwork. When compared to traditional reporting, bedside shift reporting has such advantages as enhancing time management, social interaction, peer support and procedural training. Shift reports taken and given at the bedside benefit patients as well. Many patients have expressed improved satisfaction and nursing accountability with bedside shift reports. For instance, an orthopedic unit manager, who dropped the traditional staffroom reporting and handover and replaced it with a patient-led system, reported increased patient satisfaction because her patients felt that they were in control.

* Plan: need to clearly identify what performance is required and how it will be measured

The emphasis on improving bedside reporting is crucial today, when it is more than ever necessary for the health care institutions to operate at higher efficiency levels. In the absence of bedside reporting, nurses are frustrated as they spend 40 minutes reviewing patient data; patients also get frustrated (Ostermeier and Clair, 2008). Bedside reporting has the ability to improve nurse and patient satisfaction and support the overall quality of the medical act.

Some advantages of the self-administered survey are: Low cost. Extensive training is not required to administer the survey. Processing and analysis are usually simpler and cheaper than for other methods. The reduction in bias error. The questionnaire reduces the bias that might result from personal characteristics of interviewers and/or their interviewing skills. Greater anonymity, absence of an interviewer provides greater anonymity for the respondent. This is especially helpful when the survey deals with sensitive issues such as questions about involvement in a gang, because respondents are more likely to respond to sensitive questions when they are not face to face with an interviewer.

Among medical surgical nursing staff does implementing bedside shift report lead to a greater satisfaction with care when compared to a traditional change of shift report at the nurses station during inpatient stays in the hospital? Bedside nursing report allows the patient to be involved in his or her care. Bedside report also allows the oncoming shift to visually assess the patient and look at any IV fluids that are currently running as well. One of the main factors that was concerning to nurses was violating HIPPA if the patient was in a semi private room with another patient. This was reviewed to leave out information that could potentially be private or sensitive information and instead share this in a quiet place where no one else can

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Bedside shift reporting, is it necessary? Baker (2010) states that is has its benefits, from patient safety, increased patient involvement and staff teamwork, ownership and accountability.” (Baker, 2010) To promote stronger engagement, Agency for Healthcare Research and Quality developed the Guide to Patient and Family Engagement in Hospital Quality and Safety for bedside reporting. (AHRQ, 2013)

Evidence also supports that bedside shift reporting is financially beneficial for staff nurses and nursing management. The average report time is significantly decreased from an average of 45 minutes to 29 minutes (Gregory, et al., 2014). This reduces overtime and saves hospitals money. Nurses’ satisfaction is improved because they get to end their shift on time. They get to proceed with shift report more quickly, with fewer distractions and in real time (when compared with writing or recording report). Increase in nursing satisfaction reduces turn over and, once again, saves hospitals money (Gregory, et al., 2014).

Recognizing that patient participation is vital to their personal medical care, healthcare organizations are conducting nursing staff shift reports at the bedside in the patient’s presence. Bedside reports aim to avoid communication failures by exchanging real-time information at shift change. Bedside reporting is a new alternative to the customary change of shift report that traditionally takes place in a unit hallway or at the nurse’s station. This provides an opportunity for questions before valuable information is lost or overlooked. In this literature review of bedside shift reporting, three studies were compared in order to show that a patient’s perspective is valued as they can see and hear from the team of professionals who are providing their care. Bedside shift report also improves the nurses’ understanding of the patient’s condition as the nurse is able to visualize the patient and share relevant information.

By focusing on overall patient care and satisfaction many areas patients are surveyed on can be improved. Once a performance standard is selected staff must develop a plan for improvement. The first step would be to research as many sources as possible to find the best evidence based practices that would work for the specific facility. This can be divided into two the two categories of direct nursing care and indirect nursing care. Direct nursing care would include implementing hourly rounding, adequate nursing staff and SBAR communication. Indirect nursing care includes availability of technology such as wireless communication, real time locating, wireless monitoring, and electronic medical records. The second step would contain education of the staff on what is to be implemented and why. The why is important for nurses to overcome any barriers that might be encountered. While nursing practice has grown based on evidence Vanhook (2009) explains the greatest barriers to evidence based practice, such as difficulty interpreting findings, limited time, and misunderstanding of research itself, and how to overcome these barriers. With phase one and two completed facilities can move forward with implementation and evaluation.

The first port of call, or initial point of contact, for performance management is usually the

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employee. This is part of day to day management and is intended to ensure that