You can also invite a family member or care partner to take part with you. This gives you a chance to meet the Nurse taking over your care, ask questions, and share important information with your Nurses. If you would rather not participate and you would like the Nurses do report outside your room, please notify your Nurse.
Your Nurses will talk with you about your health and the reason you are in the hospital, check the medications you are taking, discuss your goals for the shift, encourage you to ask questions and discuss your concerns. Nurse shift changes require the successful transfer of information between nurses to prevent adverse events and medical errors. Patients and families can play a role to make sure these transitions in care are safe and effective. Strategy 3: Nurse Bedside Shift Report helps ensure the safe handoff of care between nurses by involving the patient and family.
Nurse Bedside Shift Report Implementation Handbook gives an overview of and a rationale for nurse bedside shift report and provides step-by-step guidance to help hospitals put this strategy into place and address common challenges.
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Password recovery. Home Home Page Featured How reliable is your bedside shift report? How reliable is your bedside shift report? September 4, A large healthcare system shares its model for success. Takeaways: Traditional b edside shift reporting may not focus on specific patient safety prevention methods. An enhanced assessment can include targeted evidence — based actions designed to standardize patient safety into a checklist. Keeping it safe The S. Support the team. Ask questions.
They verify with an external source or ref- erence before proceeding in the face of uncertainty or when they need to escalate a concern. Focus on task. Effective communication every time.
Communicating effectively and proactively to eliminate errors in com- munication such as mistaking words or numbers that sound similar or omitting important information is the basis for this tool in the toolkit.
A team of nursing administrators, directors, staff nurses, and a patient representative was assembled to review the literature and make recommendations for practice changes.
This article begins with the background of the problem and brief literature review, and then presents the project methods, measures, and data analysis. We conclude with results and discussion of our findings and implications for nursing management. The practice of shift report at the bedside is not a new concept and is well documented in the literature.
Patient participation in the report is paramount to delivery of safe, high quality care. After the literature review, the team defined BSR as the accurate and timely communication between nurses and also between the nurses and the patient. Furthermore, through reading and discussion of the articles, the team concluded that report, when completed at the patient bedside, allows the nurse to visualize and assess patients and the environment, with better communication and patient involvement in care.
The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the current practice. Written approval to conduct the quality improvement project was obtained from the university and hospital institutional review boards IRB.
At baseline, shift report was done in a conference room, at the desk, or in the hallways. BSR was not a practice on any of the units. Report was not standardized, though all nurses had some preferred form of communication.
The populations served on the chosen nursing units were patients undergoing general surgery, and those with orthopedic and neuroscience diagnoses. Members of these units volunteered to be part of the BSR team.
Scripted Report We incorporated fictitious patient information that aligned with typical patient conditions from each area. The team developed two scripts to use for report: one for medical units and one for surgical units.
We incorporated fictitious patient information that aligned with typical patient conditions from each area. See Figure 1 for a sample of script content. Confidential aspects of report e. The clip utilized the scripts used in the training of staff. Educators helped to determine the information that should be shared confidentially via nurse-to-nurse communication and what was to be included in BSR.
The BSR began with the outgoing nurse introducing the oncoming nurse to the patient, followed by an assessment of the patient and environment.
Nurses surveyed the room for safety issues, including the bed and side-rail position and presence of clutter, and ensured that necessary items were within patient reach. One example of a linked change that occurred was script changes based upon the patient; nurse familiarity with the history; and management of patient requests for privacy. Staff members were encouraged to discuss BSR process issues with BSR team members, who made frequent rounds throughout the project.
To maintain consistency, suggested changes were discussed with BSR team members prior to implementation. Most requested changes were minor, such as asking patients how they would prefer to be addressed by staff.
Changes were passed on to other nurses during unit rounds or through directors and champions at change of shift report. Audits A BSR audit tool was implemented to assure compliance to the BSR process, including verifying that report was completed at the bedside; introducing the oncoming nurse; scripting in ISBARQ; updating the white board; and reviewing care. Shift report time audits, measured from the beginning of report until all handover communication ended, were completed pre-implementation and post-implementation.
A direct comparison of mean report times was completed on pre-implementation versus post-implementation shift times. An example of the audit report is illustrated in Figure 2. Falls The number of patient falls was obtained through the hospital incident reporting system and converted into a fall rate using the standard calculation of 1, patient days: the total number of falls divided by the number of patient days times 1, AHRQ, The number of falls in the four-month period before BSR implementation was compared to the number of falls in the four-month period following implementation of BSR.
Nurse satisfaction with the report process was determined using surveys adapted with permission from previously published tools Cairns et al. To assure question clarity and relevance of the project, surveys were completed by six members of the BSR team, three directors, and three staff.
The baseline appraisal was an anonymous, six-question survey that employed a five-item Likert scale 5-strongly agree to 1-strongly disagree.
The post-implementation survey asked the same six questions, plus an additional question about the top concern since BSR implementation. Participants were given pre-determined choices of increased time, patient confidentiality, convenience, or were permitted to write comments. Nurses providing care on the three units were invited to complete the electronic survey via email and in-person invitation. The analysis of patient satisfaction results was measured using independent samples t- test two-tailed to determine statistical significance of the data.
Nurse satisfaction survey results and shift report times utilized the Mann-Whitney Utest. Patient fall rates were analyzed using the Chi-square test. HCAHPS scores were analyzed by computing mean score totals for two specific questions related to nurse communication through comparison of the data pre and post implementation of BSR.
Performance audits of staff adherence to the tenets of the BSR process while giving report were completed on the three nursing units. Overall time of the shift report, from the time the first nurse started report until all nurses had completed report, was measured pre-implementation and post-implementation of BSR.
A total of 94 shift reports, 46 before and 48 after BSR implementation, were observed and timed.
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