Planned Change : Reintroducing The Bedside Report

Our last study is by Olson-sitki, Weitzel, and Glisson (2013), that performs a case study that discusses the transitions and outcomes from recorded reporting to bedside reporting using a defined process. A strength of this study is that it is a case study. This means that they performed the study themselves and are not relying on information obtained from other studies they did not conduct themselves (Olson-Sitki, Weitzel, & Glisson, 2013, p.25). Another strength of this article was that there was a video designed to demonstrate how bedside report should be performed, written guidelines given to nurses, and a to-do list informing nurses on what needs to be included

In every profession there are changes that propel how tasks are done; nursing is no stranger to this. One of the biggest changes that have come into nursing’s daily events is how report hand-offs are being done. Gone are the days of taped report that each off going nurse must tape about each patient and the oncoming nurse must listen to. Nurses are now being encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very important to know how this can affect the patient and even the nurse’s schedule. With every change, there are positives and negatives that can finalize the decision to keep or forego

The hand over process of communication between nurses to nurses is done with the intention of transferring essential information for safe, and patient centered care. Traditionally, this shift report has been done away from the patient’s bedside, at the nurse’s station, or other place like staff’s room. In addition, the shift report used to be delivered through audio recording of the patient’s information. These reporting mechanisms did not include face-to-face reporting of the patient information, nor involvement of patient. Therefore, information regarding the patient’s care was not shared with the patient, leaving them out of his/her own care plan. Recent studies and development of Patient Centered Care Philosophy have challenged this belief of giving a report away from the patient. Tan (2015) said, “Shift report must not only be restricted in nurse to nurse communication, but it must involve patients as the recipients of care” (p. 1). Incorporating the patient into the end of shift report is essential for providing patient centered care and patient satisfaction. Nurses at the St Jude Medical center in the acute in-patient rehabilitation unit are not exceptional. Most of the end of the shift report between nurses are still done away from the patient. Aim of this paper is to make a change in the work place, which is the process of giving end of shift report at the bedside incorporating patient and families in the acute in-patient rehabilitation unit at St Jude Medical

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.

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

Two types of data were collected through surveys, both before and after implementation of the combined approach (Sand-Jecklin and Sherman,2014). The first data was on nurses’ point of view with regards reporting process, and the second on patients view regrading nursing care. The baseline survey included 233 patients and 148 nurses, while the survey three months into the implementation period included 157 patients and 98 nurses. The final survey, 13 months into the impanation, was completed by 154 patients and 54 nurses. The patient survey also included responses from patient families. These were 70, 72, and 53 responses for baseline survey, three-month postimplementation surveys, and 13-month postimplementation surveys.

For this study the authors instituted a change to bedside handover on a surgical unit. Staff members were invited to participate in pre and post implementation and as well as 60 patients (30 pre and 30 post implementation). Survey questions for the nursing staff measure perceptions of changes in accountability, quality of communication, medication reconciliation, workload prioritization and ability to communicate with other members of the healthcare team after receiving handoff. Patients were surveyed on their perceptions of input into the plan of care, understanding of plan of care, professionalism of staff during handoff, confidentiality during handoff and open communication between health team members.

Scottsdale Healthcare is an organization of magnet status and is continuously striving to find ways in which to improve patient satisfaction and quality of care. As of October 2011, Scottsdale Healthcare implemented bedside report in order increase patient satisfaction providing the patient and family knowledge in regards to their condition and plan of care in order to set goals for the patients recovery and gives them the ability to ask questions. Prior to bedside report taking effect, management gathered all employees from the unit going over what is to be expected and how bedside report was not only taking effect on our unit alone, but hospital wide. Nursing leaders knew that they had a situation at hand due to the fact that nursing staff was so comfortable in giving report at the nurses station and did not want to wake the patient or deal with a family member, but they remained positive and encouraged staff that this would dramatically change our satisfaction scores. In maintaining patient satisfaction scores, the hospital would qualify for reimbursement from Medicare. The nurse

The purpose of this initiative is to increase patient satisfaction, improve patient safety and strengthen team work by improving the process of communication during shift change. The bedside shift report became a mandatory process by the nursing management of St Francis medical center in June 2016 for all the nurses. The goal of this change project is to increase the nurse’s compliance with bedside shift reporting on the unit 100% within next four months. The three stages of Lewin’s Change Theory will be utilized to create a change of bedside shift report. All changes, whether positive or negative are scary and generate fear.

Surveys show that for 10 days during the month of June, 116 out of 205 patients surveyed (56.5%) of patients answered no to at least one of the following questions: “Does your nurse answer all questions to your understanding?” “Do you feel that your physician adequately reviewed your disease process with you?” “Do you understand your current medical plan of care?” “Does your nurse explain your treatment plan with you?” and the average rating of the stay of the unit at 6/10. These findings support the change initiative

The authors of this article Lucas et al., 2014, helped to determine the types of bedside shift reports (called handovers) that help improve patient outcomes. The article also explains why nurses do bedside shift report. The supporting articles further explain reducing patient errors and finding them at the bedside is just as effective in good patient outcomes.

Palumbo (2013) states that one of the biggest assumption of such a project is that the nursing staff are motivated to increase patient satisfaction scores through the implementation of bedside shift reporting. Maxson, et al. (2012) research to determine whether bedside reporting increased accountability, teamwork and prioritization among nurse’s survey that included 15 nurse’s results showed that nurses strongly agreed that bedside

“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

Among staff nurses on the medical-surgical unit, does implementing bedside shift-to-shift report, compared to traditional shift report at the nursing station, improve patients’ satisfaction?

As with any time change occurs in a large organization, resistance from staff will more than likely occur. Therefore, having plenty of training for staff, supportive management presence during shift change on the units, and making changes based on staff feedback to have report more effective will be critical for staff to embrace this new way of reporting. Potential limitations could include a small sample size if patients decline to participate. This would make it challenging to generalize the findings to other hospitals if the sample size is too small. Future recommendations would be to develop a training program where staff would feel comfortable with this new method of reporting within a three month period of time. This will allow more patients to receive high quality care across the nation in a quicker amount of time. Based on the findings of this study, bedside reporting ought to become the national standard at all