Answer

Clinical Guidelines and Implementation Plan on Bedside Change of Shift Report

Statement Problem

By definition, bedside shift report (BSR) is a change of shift report between the off going nurses and the oncoming nurses which takes place at the bedside during hospitalization. During shifting process, the plan of care and critical information about the patient must be properly communicated to avoid omission and human error which are common during this period. Notably, having the shift-to-shift report in the hospital enables families and patient to be part of care during treatment. In addition, it allows them to participate in sharing information, which ensures that the patient and family’s goals are identified and reached. It also increases the satisfaction of the patient, improves nurse -to-nurse relationship, lessens cases of patient falls, decreases time of discharge, fortifies teamwork, and leads to better nurse prioritization and accountability at the beginning of every shift (Cairns et al., 2013). Therefore, BSR is a quality improvement activity which fulfils The Joint Commission (TJC) (2007) necessities for improving the manner in which nurses communicate with families and patients and consequently improving the delivery of high-quality patient-centered healthcare.

Evidenced-Based Question

For hospitalized patients, does proper bedside shift report result in a greater patient experience and satisfaction?

Literature Review

According to the study conducted by Gregory et al. (2014), one of the most important part of BSR is communication. The communication is between nurse to nurse, nurse to patient, and nurse to family members. Although the three categories of communication are important, nurse to nurse communication on client information is more critical. Radtke (2013) adds that communication is necessary for high quality and safe patient-centered care. Adequate communication not only signifies a safety aspect within the hospitals, but also important from the financial view point. A review of literature conducted by Pub Med which used search terms such as “bedside shift report”, “bedside handover”, “end of shift report”, and “nursing report” revealed certain important and critical information about BSR. The search was limited to articles published between 2010 and 2015. The articles looked at bedside reporting issues such as barriers, effectiveness, useful tools, nurses and patient perspective. The studies showed that patients who are involved in their own care recover quickly and are likely to follow to prescribe drugs. They are very satisfied with care given to them since thy are part of that care and their opinions are considered during treatment period. Radtke (2013) also provided longitudinal result on bed shift reports. He revealed that six months after the implementation of bed shift report, 85% patient responded that bedside shift reports improved patient safety as well as patient outcome.

Research Synthesis

Research has demonstrated that BSR improves communication and safety among nurses and patients. Studies have also demonstrated that BSR has a positive impact on how patients and families recognize quality health care services. According to the results, increased nurse-patient communication, and nurse-family communication, and satisfaction of the patient is demonstrated when BSR is instigated on medical acute hospitals, especially in surgical units. In summary researchers have showed that BSR strengthens patient satisfaction; endorses nurse accountability, reduces communication faults; and institutes the trust of the patient between the patient-family and health care provider.

Clinical Protocol

The key members of BSR implementation team are administrative champions, clinical leaderships, patient experience champions, nurses, and family and patient advisors. The team unites the data and findings from research conducted and continue with implementation.

Specific and Realistic Patient Outcome

Several realistic and specific outcomes have been realized when bedside shift reports are implemented. One of the outcome is patient and family satisfaction. This has been proved by several studies. For example, Ford, Heyman, and Chapman (2014) conducted a systematic literature review of 41 articles which are related to bedside shift report. The results concluded that concluded that 50% of the literature recognized an upsurge in patient and family experience with care. However, only 2% of the studies acknowledged patient grievances with the practice. Implementation of the BSR also improves accountability and accuracy. A study conducted by Radtke (2013) revealed that human errors and omission are reduced to about 50% when the report is implemented.

Timeline with Criteria for Evaluating the Outcome

The recommended timeline for evaluating the outcome which include patient satisfaction, accountability, and good relation between nurses as well as patients takes approximately six months. Patient satisfaction tally is of the uppermost interest since this is the chief reason for initiating the project.

Barriers or Obstacles during Implementation

Implementation of BSR report is a time consuming activity whose outcome is not instant hence may be neglected. It requires cautious consideration of the current unit, organizational cultures, environments, and people. Another challenge of implementation involves financial capability since nurse training and education is part and parcel of the process (Sand-Jecklin & Sherman, 2013). This may require capital which can be a challenge to the organization. Lastly, it requires corporation among healthcare professionals which may not be achieved as a result of different ideologies and opinions.