The Nurse 's Performance During Their Handoff Report Essay

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

I have decided to reflect upon the first time I did a nursing handover. In accordance with the Nursing and Midwifery Council (2004) Code of professional conduct, confidentiality shall be maintained and the patient’s name is changed to protect indentity.

I have scheduled an interview and time to observe a nurse leader with the Director of Nursing (DON) for the Virginian Nursing and Rehab facility in Fairfax, Virginia for Thursday October 2, 2014 at 7:30am. I plan on spending a full eight-hour shift with the nurse leader observing the following three leadership activities: 1) Observing her making rounds on the units 2) Observing and or participating in a nursing leadership meeting and 3) Observing the facility’s interdisciplinary team meeting.

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 basic reason for this study is to identify ways to improve the quality of healthcare among patients through bedside reporting method.This will better satisfaction and services delivered at the hospitals. The ever increasing specialization to improve patient outcomes and better health care delivery can contribute to the serious riskof fragmentation of care and problems with handoffs. These are some of the issues associated with emergency room reporting method (Radtke, 2013). There is need to evaluate the handoff method used in hospitals and understand which is the best way to use that increases patient satisfaction. Bedside handoff gives the patient an opportunity to contribute to his or her plan of care. It allows the nurse to visualize the client and as necessary questions regarding their health status. This is the reason there is a need to conduct research on bedside reporting.

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into

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.

During many years the role of school nurse was traditionally viewed as one where the nurse cared for students that were injured, applied bandages and gave out ice bags. Throughout the years the role of the school nurse has evolved into one of leadership and management along with many other duties including traditional roles as mentioned above. The services provided by a school nurse range from assessment and screening to coordinating care for regular students as well as students with special needs. School nursing requires experience and knowledge in school, public, community and emergency health to meet the many needs of school aged children and youth. The school nurse provides many services but the basic services provided include

Lily was a 65 year old lady with stage 5 CKD, she had recently begun hemodialysis treatment three times a week as an inpatient and had been responding well to treatment. During dialysis treatment on the morning of the first day, Lily’s observations showed that she was: tachycardic, hypotensive, tachypnoeaic, had an oxygen saturation level of 88% and was becoming confused and drowsy. It became apparent that Lily had become hypovolaemic. The hypovolaemic shock seen in this patient was of a particular critical nature due to the fact that her dialysis treatment had moved her rapidly through the first two stages of shock with her compensatory mechanisms failing very quickly (Tait, 2012). It was also much harder to identify the early signs of

Nursing-sensitive indicators can be an important tool in identifying patient care issues that could potentially arise during a hospital stay. By analyzing the data on specific nursing-sensitive indicators, the quality of patient care can be optimized and patient satisfaction can be improved. The American Nurses Association (ANA) and the National Database of Nursing Quality Indicators (NDNQI) are two sources of information and guidelines for nurses and nurse managers to use in planning patient care and workloads for each nursing unit. The use of available resources, staffing by acuity and patient needs, appropriate referral indicators, and cooperation

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

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.

As a competent registered nurse, my career goal is to become a healthcare quality improvement leader, a position that would enhance my commitment in promoting patient safety. I not only believe in enhancing the capacity of other care providers, but also in improving the quality of the healing environment for the benefit of both patients and their care providers. This means not only promoting collaboration with the multidisciplinary teams, but also building the necessary healing partnerships with our patients. To enhance the quality of the healing environment, I aspire to continue analyzing researches for evidence based practices and advocating for their actualization. I will continue focusing my time and energy in encouraging other nurses to improve their skills through formal education, so they can empower themselves as advocates of quality improvement for the benefit of their patients and coworkers.

The first quantitative study analyzed was conducted by Dabney and Kalisch in 2015 and surveyed 729 patients. The purpose of the study was to continue researching for any correlation between patient outcomes and nurse staffing. They analyzed patient reports of missed nursing care and determined if there was a relationship between patient reports and the nurse staffing levels. The design and sample include data that was obtained in the study of patient reports of missed nursing care and compared it to the level of nurse staffing. The sample was made up of 729 patients on 20 units in 2 hospitals. The 20 units consisted of 12 medical units with 420 participants, 6 surgical units with 255 participants, and 2 rehabilitation