Bedside Reporting and the Impact on Patient Safety and Nursing Satisfaction

Abstract 

Clinical handovers play a vital role in determining the quality of healthcare services provided to patients. In particular, bedside reporting promotes a culture of mentoring relationships and fosters mutual respect among staff. Positive collaborative working relationships between nurses help to ensure satisfaction and provider efficiency. Additionally, bedside reporting, with patient involvement, is associated with improved patient health outcomes, in turn influencing nurse engagement and motivation at work. Research findings demonstrate the superiority of bedside reporting over non-verbal and traditional shift reporting approaches, although the literature has not sufficiently addressed potential barriers to bedside reporting such as increased time consumption when patients repeatedly interject comments or ask extraneous questions. Nevertheless, findings imply the need for nurses to include patients’ input during clinical handovers helping avoid sentinel events leading to adverse outcomes. 

INTRODUCTION 

Patient safety is one of the metrics upon which the efficiency of healthcare services is evaluated. In order to achieve provider efficiency, health institutions have to consider other factors such as nurse satisfaction, utilization of resources, and application of evidence-based practices, among others . Alongside patient safety, nurse satisfaction plays a fundamental role in determining the attitude of nurses, as well as the level of motivation and engagement at the workplace (Mccay, Lyles, & Larkey, 2018). Therefore, it is vital for nurse leaders to consider what aspects undermines realization of nurses’ full potential as pertaining to delivery of patient care. Nurses work in a cohort environment, intensifying the need for high quality interactions amongst nurses. When it comes to clinical handover, the effective transfer of a patient’s clinical information depends on the quality of relationships between nurses, the manner in which the information is relayed, and the accuracy of the data itself (Cipra, 2016). In this regard, bedside reporting facilitates both safety and continuity of care and delivery. Relative to patient safety and nurse satisfaction, bedside reporting appeals to the need to promote effective communication between nurses and patients. During shift handover, communication must be effective as it determines the quality of care as well as a nurse’s overall satisfaction, a factor upon which a patients’ health outcomes depend (Williams, 2018). Consequently, a closer examination of the effects of bedside reporting on patient safety and nurse satisfaction is warranted. 

Background 

In healthcare settings, there is a need for effective communication especially during patient handover. As a mandatory process, nursing bedside reporting as the method of patient handover provides incoming and outgoing nurses an opportunity to assess patients by examining any safety errors, while al so allowing patients to take part in their care planning. Thus, there is a need for patient input during clinical handover, which helps improve the overall quality of care given and promotes competence in nurses (Mitchel, Gudeczauskas, Therrien, & Zauher, 2018). Therefore, during shift change, outgoing and incoming nurses must communicate effectively to avoid clinical errors that could negatively impact p atient s’ health outcomes. Reseacher H. Shank (2016) emphasized that patients’ health outcomes affect the patients and nurses as well. Shank explained “Negative patient outcomes impact not only nurses, but nurse confidence and satisfaction. Stakeholder identification included first and foremost, the patients and their significant caregivers who have the most to gain from improved nurse to nurse communication” (Shank, 2016, p. 15). For this reason, it is important to address the quality of bedside reporting relative to its effect on patient safety as well as nurse satisfaction. Arguably, the implementation of nurse bedside shift reporting can help improve a patient ’s experience in a healthcare setting relative to the quality of nurse-nurse communication (Dorvil, 2018). 

In a systematic review , Mardis et al. (2016) concluded that 49% of studies reviewed regarding bedside shift report demonstrated an increase in patient satisfaction with care, while only 2% of the literature showed patient complains with the practice in question. Such data emphasizes the potential positive effect of nurse bedside shift report on a patient’s health care experience. However, Dorvil (2018) warned that some challenges exist, that could prevent successful implementation and sustainability of the nurse bedside reporting. These challenges include lack of efficient leadership or employee buy-in, inconsistency with the practice, lack of continuous process management initiatives, and ineffective communication between nurses. 

Corroborating the information given earlier, Roslan and Lim (2016) explained that clinical handovers are associated with positive benefits and give nurses an opportunity to communicate effectively amongst themselves, thereby ensuring patient continuity of care free from error. However, they acknowledged that “… distractions from the environmental factors could cause disruption, leading to insufficient patient information exchange and lack of time to conduct a proper handover to the incoming shift nurses” (Roslan & Lim, 2016, p. 151). With attention to these factors, there is a need for healthcare providers must identify and implement measures that could help promote realization of the potential benefits of bedside reporting. 

Statement of Problem 

The literature reviewed demonstrates the significance of bedside reporting when it comes to patient safety and nurse satisfaction. While various studies have identified the potential benefits of an effective clinical handover between nurses, some have acknowledged the various barriers towards achieving efficiency of the practice in question. For instance, Shank (2016) explained that ineffective communication during bedside reporting could undermine the safety of patients, as well as the satisfaction of nurses. Roslan and Lim (2016) corroborated this particular argument adding that environmental factors such as lack of continuous process management practices, inefficient leadership, and poor communication among nurses (as cited in Dorvil, 2018), undermine patient safety and the satisfaction of nurses. However, controlling for other factors, communication between nurses has been identified as a major factor undermining the efficiency of clinical handover. Thus, there is a need for healthcare providers to develop strategic measures towards optimizing communication between nurses. 

Definition of Terms 

The following wil serve as definition of terms as it pertains to this study. 

Bedside Shift Report (BSR): bedside shidt reporting refers to the process through which one nurse hands over a patient to another nurse during shift change in the presence of the patient. As will be revealed later, BSR enhances patient engagement, minimizes errors and promotes accountability. 

Electronic Health Record (EHR) refers to patient information in digital format. 

Person-Centered Handover (PCH) is a process where the patient and their family are closely involved in shift changes as the incoming nurse takes over from the outgoing nurse. This process is concerned with meeting the needs and empowering the patient. 

Purpose and Significance 

The aim of Bedside Reporting and the Impact on Patient Safety and Nursing Satisfaction 

is to emphasize the significance of beside reporting as a practice that can promote patient safety, as well as nurse satisfaction. For this reason, the project will seek to address: 

The effects of bedside reporting on patient experiences with care and nurse satisfaction levels at work 

Whether type of reporting matters in relation to patient safety and nurse satisfaction at the workplace 

Patient responses and experiences with other forms of reporting 

Nurses’ perceptions and attitudes towards bedside reporting 

The willingness of nurses to use bedside reporting 

LITERATURE REVIEW 

Nurse Satisfaction at Work 

The satisfaction of nurses determines an organization’s productivity as well as overall 

performance. The implication is that a motivated body of nurses helps promote positive patient experiences with care. Consequently, motivated and engaged nurses project a healthcare organization ’ s efficiency. Some of the factors that determine the satisfaction levels of nurses at with their work were such as autonomy, adequate staffing, having control over nursing practice, patient-centered culture, managerial support, and lastly, collaborative working relationships (Kieft, De Brouwer, Francke & Delnoij, 2013). Of the various factors mentioned, collaborative working relationships play a vital role in determining the efficiency of clinical handover and consequently, the quality of bedside reporting. Therefore, investing in promoting quality determining the efficiency of clinical handover and consequently, the quality of bedside reporting. Thus investing in promoting quality relationships among nurses, as well as with other workers, could help revamp bedside reporting thereby ensuring patient safety. Bedside reports encourage a culture of mentoring relationships and fosters mutual respect among staff. Through this particular exercise, nurses are able to visualize patients and implement safety checks during the start of the shift and reduce the amount of time spent at the nurses ’ station as well as away from the bedside (Williams, 2018). Thus, it becomes clear that bedside reporting provides nurses with an opportunity to interact with each other and through this exercise, they are compelled to adopt a culture of mutual respect. 

Assertively, it has been established that bedside reporting influences patient safety and health outcomes and the satisfaction of nurses at the workplace. Such a relationship implies a link between nurses ’ satisfaction and the nature of patients ’ overall experiences in a healthcare institution. From this kind of association, one could develop an argument stating that a patient ’ s experiences is subject to the level of engagement and satisfaction of attending nurses. In order to prove this particular proposition, through an observation study in England, Aiken et al. (2018) noted that in a healthcare setting, the experiences of patients were related to missed nursing care, poor hospital work environments, as well as low patient-nurse ratio. Based on this finding, the implication is that a hospital that invests in sufficient staffing, promotes a culture of managerial support for nurses, and invests in a suitable working environment, is likely to experience positive ratings through patients ’ experiences. However, a particular aspect, s uch as low patient-nurse ratio, would lead to missed care, thereby undermining the quality of bedside reporting. The discussion further implies that staffing influences the engagement of nurses in a healthcare setting and their level of job satisfaction. Providing further insight into the effects of low nurse-patient ratio, Teeter (2014) explained that nurses in understaffed hospitals of healthcare settings complain of burnout and fatigue, which affects their performance and productivity. The author n oted that in care settings where nurses characterize their working units as having adequate, sufficient managerial support, alongside positive working relationships between and among staff, there is significantly lower burnout (Teeter, 2014). As a result, nurses are able to perform to their full potential, which means low cases of missed care for patients. 

A further exploration of the link between nurses’ job satisfaction levels and the quality of bedside reporting demands focus on how nurses, themselves, perceive this particular exercise. Nurses have been found to feel safer when having the patient ready at the start of their shift, they feel better when involved in the care process and that bedside reporting and shift handover is perceived as a way of sharing information (Vermeir et al., 2010). Among these responses, bedside reporting demands sharing of information between nurses. In this respect, it can be argued that the quality of communication between and among nurses determines the overall outcome of clinical handover during bedside reporting. It is important to acknowledge that nurses comprise of “… an intact group of caregivers who are motivated to communicate with each other about the care of patients they are entrusted with” (Vermeir et al., 2017, p. 3). For this reason, nurses are expected to work together and ensure that there are no deficiencies in communication which would undermine patient safety and overall health outcomes. The causes of deficient communication are such as conflicting work relationships, lack of clarity as pertains to roles, as well as failure to communicate critical patient information during clinical handover (Vermeir et al., 2017). Thus, when discussing the efficiency of clinical handover, certain aspects such as the quality of communication between nurses, determines the overall quality of bedside reporting. The implication is that bedside reporting encompasses a number of elements one of which is 

collaborative working relationships, a major factor in promoting nurse satisfaction levels at work. 

Patient Safety 

An importatant aim of bedside reporting is to promote patient safety through improving care. It has become clear that patient safety is contingent on the satisfaction levels of nurses at the workplace, adequacy of staffing, managerial support for nurses, a healthy and suitable working environment for nurses, as well as the quality of information sharing. The demand for bedside reporting is a practical response to continued admission of patients across hospitals daily thereby “… resulting in thousands of shift changes and thousands of opportunities for error ” (Baker, 2010, p. 355). Therefore, the inevitability of shift changes creates a situation where errors can occur such as through lack of sharing critical patient information during clinical handover (Vermeir et al., 2017). 

There is consensus between Baker (2010) and Vermeir et al. (2017) who consider the importance of efficiency during clinical handover and the bedside reporting exercise at large. Therefore, when discussing the potential impact of bedside reporting, there is a need to consider other factors such as the relationship between nurses and how it affects sharing of patient information. It is also critical for nurses to endeavor to develop close and intimate relationships with their colleagues. These relationships help to establish a workplace culture and climate that enhances the effective delivery of care. 

Understandably, bedside shift report is perceived as an activity that can save lives (Ofori-Atta, Binienda & Chalupka, 2015). Based on data gathered by the Health and Human Services Department, incompetent hospital care caused the deaths of 180,000 Medicare patients in 2010. Nevertheless, the actual number might be higher as estimates show that between 210,000 and 440,000 patients admitted in hospitals annually suffer from preventable harm leading to their deaths (Ofori-Atta, Binienda & Chalupka, 2015). Medical errors in the United States alone are the third leading cause of death following cancer and heart disease (Ofori-Atta, Binienda & Chalupka, 2015). However, the application of bedside reporting can help avoid such outcomes through promoting patient safety thereby improving their health outcomes. In the following section, an examination of the impact of bedside reporting on the delivery of quality care is offered. 

Scholars in the field of medicine place a higher emphasis on the vital role that bedside reporting plays when it comes to determining the quality of patient care. Bedside reporting helps prevent medical errors, which could become the third cause of death in America ’ s healthcare sector. However, Ofori-Atta, Binienda and Chalupka (2015) noted that bedside reporting can help to remedy the situation thereby ensuring provision of quality care. The implication is that effective nurse shift-to-shift handover is a prerequisite for quality patient care (Kullberg et al., 2017). 

The practice of clinical handover appeals to the transfer of accountability from the outgoing to the oncoming nurse. As a concept, transfer of accountability (TOA) is defined as 

“… an important opportunity to communicate vital patient care information such as patient diagnosis, hemodynamic stability, procedures performed, plan of care, discharge plans and information to bring forward to interprofessional rounds, while at the same time engaging the patient in the process ” (Miller, Hamza, Metersky & Gaffney, 2018, p. 90). 

From the definition of patient bedside TOA, it is clear that various factors which comprising effective bedside reporting. For instance, the nurses involved should communicate aforementioned vital patient information to prevent medical errors and promote patient safety. In this case, clinical handovers demand that the exercise of transfer of accountability between nurses is efficient. There is sufficient information demonstrating the role that bedside reporting plays in promoting patient safety. Thereby, health intuitions should consider creating working environments that favor collaborative working relationships between nurses help ensure patient safety. 

Type of Reporting 

In order to demonstrate the importance of bedside reporting, it is important to juxtapose it with the traditional shift reporting system. A fundamental aspect which Miller, Hamza, Metersky and Gaffney (2018) cited when defining patient bedside TOA is that the exercise of clinical handover should be done in the presence of the patient. There are different methods of reporting during shift handover. The traditional method takes place at the nurses ’ station away from the patient. While patients have knowledge of the change in shift, they are not allowed to participate in this particular exercise (Ofori-Atta, Binienda & Chalupka, 2015). Individuals should recognize that during this alone time, sentinel patient events are likely to occur, undermining the quality and efficiency of the clinical handover exercise. For instance, a patient might experience a sudden heart attack while alone during change of shift reporting at the nurses’ station, a nurse might not arrive in time to check on the patient, and the outcome could be fatal. Bedside reporting, compared to traditional shift reporting, helps “… eliminate that alone time and gives the patient a feeling of inclusion with the nurses as part of the healthcare team ” (Ofori-Atta, Binienda & Chalupka, 2015, p. 1). Accordingly, during clinical handover, it is imperative that nurses consider the patient as part of the exercise. 

Another kind of reporting exists and involves non-verbal handover which is carried out via electronic health records without a set structure or the presence of the patient. Nurses who use the non-verbal handover approach spend about an hour looking up and reading patients ’ information from the electronic health records (EHR) before beginning the shift work and consulting patients (Kullber et al., 2017). Similar to the traditional shift reporting system, it is evident that the non-verbal handover does not acknowledge the importance of having patients participate in the reporting exercise and causes the patient to be alone for an extended period. It is important to understand that with both non-verbal handover and traditional shift reporting, patient complications such as the patient experience a cardiac arrest or vomiting without timely assistance could occur. The alone time afforded by these two reporting methods allow an increased opportunity for complications and adverse outcomes. Therefore, “ Given this potential for complications and adverse outcomes, the research demonstrates the need to utilize bedside reporting(BSR) over the traditional method of shift handover ” and that “ Ensuring proper communication is an essential component of the practice of nursing ” (Williams, 2018, p. 40). Thus, based on the advice of Williams (2018), traditional shift reporting, and the non-verbal approach expose patients to the risk of adverse clinical outcomes, possibly even death. 

A comparative review of person-centered handover (PCH) against non-verbal and traditional shift reporting demonstrates that PCH is most effective. In a clinical setting, the introduction of the PCH approach led to a change in patient satisfaction compared to patients who were exposed to the non-verbal approach (Kullberg et al., 2017). Furthermore, bedside reporting is effective in decreasing the length of time taken during a change in shift report. This is as compared to the non-verbal approach and traditional reporting system which are responsible for the long stays that patients endure (Cipra, 2016). Patient inclusion during bedside reporting also allows for a complete and exhaustive clinical handover. The patient is given an opportunity to state any changes in their health which could prompt the oncoming nurse, upon consulting the attending physician, to determine whether a change in medicine or other treatment is required. In summary, bedside reporting is considered an effective approach compared to non-verbal and traditional reporting methods. 

THEORETICAL FRAMEWORK 

Bedside reporting is an interactive practice demanding efficient communication between nurses during clinical handover. An evaluation of the manner in which nurses communicate is fundamental towards understanding the benefits of bedside reporting. Kurt Lewin’s theory of change provides a foundation on which communication, being crucial during bedside reporting, can be evaluated. Lewin’s theory involves three change processes: 1) eliminating an existing status quo, 2) promoting movement, and, 3) refreezing to sustain the change acquired (Kritsonis, 2005). In Lewin’s particular model, Lewin proposed that the status quo, for instance, hierarchies at the workplace, undermine effective communication between and among workers. Therefore, Kritsonis (2005) explained that such challenges can be eliminated through establishing an equilibrium whereby there is active participation between and among workers. Putting this into context and the healthcare setting, Lewin’s theory could be used to identify communication challenges affecting nurses during clinical handover. Additionally, the quality of communication with other forms of reporting will also be evaluated. However, Lewin’s theory will be used in this project to help emphasize the importance of effective communication during bedside reporting. 

METHODOLOGY 

The project was based based on a qualitative secondary analysis of pre- existing data regarding the topic under study. Thus, the approach used invovled conducting a review of peer-referred studies addressing the impact of bedside reporting on patient safety and nurse satisfaction. A key consideration is that some of the literature reviewed did not provide sufficient data regarding the topic in question. For that reason, article inclusion and exclusion criteria will be based on the following factors: 

Whether a study addresses qualitative aspects associated with bedside reporting and its association to patient safety and nurse satisfaction 

The recency of the studies reviewed 

The validity and reliability of findings. 

Offered below is a description of the process that was employed as part of the methodology. 

Selection of Sources 

I adopted a rigorous process for selecting the sources used for this study. All the sources that I consulted were relevant, timely and credible. To ensure relevance, I used such keywords as bedside reporting, patient centered handover and electronic health records. Quality and safety are other keywords that guided the search for sources. Thanks to these keywords, I was able to find sources which related directly to the study. In a bid to ensure currency, I limited my search to publications released within the last 10 years. The various databases that I visited have a tool for defining the time period to which the search should be limited. I found this tool to be remarkably useful. I strived to confirm that the sources were credible. The qualifications and credentials of the researchers who authored the sources guided my efforts to establish the credibility of these sources. For example, nearly all the researchers have some background in healthcare or are affiliated with reputable academic institutions. 

As part of efforts to further enhance the credibility of the research process, limits were imposed on the databases that were consulted. Only sources contained in databases that are known for credibility and academic authority were included in the review. For example, Google Scholar and Springer served as the main databases for most of the sources. In addition to being credible, these databases are also rich in that they host huge volumes of relevant scholarly material which enhances the research process. Google Scholar and Springer were also included because of their ease of use. While there are other databases that contain relevant sources, it was witnessed that they imposed restrictions which introduced complications into the review process. 

The literature review process extended beyond identifying databases. With the databases determined, focus shifted to ensuring that the identified sources related directly to the question. As will be revealed in a later section, focus was given to sources which contained insights that mirrored the research question that this research process sought to answer. Restrictions were imposed and consequently, sources which addressed the link between the bedside reporting method that nurses use and such factors as patient and nurse satisfaction and the quality of care, were included in the final review. It was determined that these sources would have the most beneficial impact on the research process. There is confidence that the source selection process that was employed is in line with established research practice and had an enriching effect on the research. 

Ethical Issues 

As part of this research process, it was felt important to examine ethical issues and how they can be addressed so that they do not compromise the quality of the study. The research process borrowed heavily from existing literature. As a result of its design, a number of ethical issues were encountered. When conducting secondary analyses, researchers grapple with such ethical questions as the privacy of participants (Long-Sutehall, Sque & Hall, 2010). They are obligated to ensure that their analysis does not violate privacy by refraining from seeking or sharing highly personal or sensitive information. To comply with this requirement, the literature review was limited to research that did not contain any personal or sensitive information. For example, none of the articles reviewed contained such details as the names and addresses of the participants. Accuracy and credibility are other ethical issues that arise when researchers perform secondary analysis (Long-Sutehall, Sque & Hall, 2010). The researchers are expected to verify the sources that they consult are both credible and accurate. If there were errors in the primary research, the researcher is likely to repeat these errors in the secondary analysis. It is therefore critical for the researchers to perform a rigorous credibility check on the primary research. In full compliance with this requirement, all the sources consulted were verified and found to be accurate, recent and credible. 

The discussion on the ethical issues encountered would not be complete without a mention of the challenges that frustrated the literature review. Access to data is among these challenges. In their text, Cheng and Phillips (2014) note that secondary analysis is usually derailed by inadequate access to the data used for the primary research. Since the literature review involved an examination of sources found in digital databases, it was impossible to obtain the raw data that the primary researchers used. However, this challenge does not appear to have eroded the quality of the literature review. As already noted above, great care was taken to establish that all the consulted sources were credible and accurate. Therefore, the findings shared in a later section can be regarded as being equally credible. 

Analysis of Sources 

In their article, Corti, Witzel and Bishop (2005) describe secondary analysis as a process that allows researchers to use existing data to expand knowledge and draw fresh conclusions and perspectives. However, these scholars underscore the importance of placing the existing data in its proper context. To ensure that this research process benefited fully from existing data, steps were taken to enhance relevance and contextualize the data within the frame of this research. It was ensured that the consulted sources related directly to this research and that new insights could be drawn from these sources. The review of these sources involved determining thematic patterns. It was observed that all the sources shed light on how the reporting method that nurses adopt affects their own experiences and the wellbeing of their patients. All the sources confirmed that as they adopt the bedside reporting approach, nurses establish an environment where patients experience enhanced levels of safety and satisfaction. Additional details of this and other findings are provided in the section below. 

Given the qualitative nature of the data that was reviewed, it was felt that the application of statistical analysis was unnecessary. However, to imbue the research process with higher credibility and authority, basic statistical techniques were adopted. Specifically, the research sought to establish the proportion of existing research which has endorsed bedside reporting as the most appropriate and effective. Nearly all of the sources confirmed that compared to other approaches, bedside reporting has the most significant impacts as regards such measures of patient wellbeing as safety and satisfaction (Baker, 2010; Dorvil, 2018; and Miller et al., 2018). None of the sources raised questions about the effectiveness of bedside reporting. However, as will be revealed below, there are some sources which highlighted the challenges that could hamper the adoption of bedside reporting. For example, Cipra (2016) observed that there are some nurses who are opposed to the adoption of bedside reporting as they are concerned about such problems as being bothered with too many questions that patients raise. With the exception of Cipra’s article, all the sources confirm that if implemented, bedside reporting has tremendous impact on the effective delivery of safe and high quality care. 

Findings 

The primary purpose of this research initiative was to determine the effectiveness of bedside reporting as compared to other approached used for shift changes. Before the literature review was conducted, the working thesis was that bedside reporting is the most effective technique as it enhances communication among nurses while promoting patient wellbeing. The literature review and the larger research process confirmed this expectation. Among the sources that were consulted were those that examined the effect that bedside reporting had on patient outcomes. All the sources established that this approach delivers improved communication among nurses, enhances patient satisfaction and challenges medical facilities to move away from traditional methods. For example, Baker (2010) noted that as they adopt bedside reporting, nurses are able to minimize errors. These errors are responsible for complications and could even cause death. By integrating bedside reporting into their routines, nurses help medical institutions to achieve their objective of safeguarding human health. Another issue that the literature review revealed is that bedside reporting empowers patients and allows them to participate in the delivery of care. This is one of the benefits that sets bedside reporting apart from the traditional approaches. These approaches reduced patients to mere recipients of care. On the other hand, bedside reporting recognizes that patients are integral stakeholders whose views and input bolsters healthcare delivery. 

The literature review offered a resounding endorsement of bedside reporting. As stated above, through the review, bedside reporting emerged as a preferable strategy as it delivers benefits for patients. Additionally, the review also highlighted the numerous benefits that nurses enjoy when they embrace bedside reporting. Poor communication and lack of proper coordination are among the hurdles that nurses grapple with as they attempt to attend to patients. Bedside reporting addresses these challenges. For example, when engaged in bedside reporting, the outgoing nurse needs to share details of the patient with the incoming colleague. For the information sharing to occur seamlessly, collaboration and communication are needed. As noted above, bedside reporting allows patients to participate. Therefore, as the two nurses share information, the patient is able to become involved in such ways as raising concerns or seeking clarification. Given that it presents benefits for both the patient and nurses, bedside reporting is an approach that transforms nearly all aspects of healthcare delivery. Providers that are keen on improving the quality of care that they offer should embrace this method. 

Among the aims of the research project was to determine the effect of bedside reporting on nurse satisfaction. This goal was underlain by the observation that many nurses find their work to be stressful with most reporting burnout and fatigue. It was hoped that the research process would shed light on whether bedside reporting reduces the burden that nurses shoulder. This desire was fulfilled as the literature review confirmed that the adoption of bedside reporting as a matter of practice sets the stage for enhanced levels of satisfaction and fulfilment among nurses. For example, Williams (2018) observed that thanks to bedside reporting, nurses spend less time attending to patients. Consequently, they experience improved levels of satisfaction since their workload is reduced. The significance of the improved satisfaction cannot be overstated. In the US, many hospitals grapple with biting staff shortages. Low levels of 

engagement and satisfaction are among the factors that can be blamed for these shortages. Since it fuels engagement and satisfaction, bedside reporting indirectly helps to address the staff shortage problem.

In order to understand the full impact of bedside reporting, it was felt necessary to examine the thoughts and perspectives of patients. Some of the scholars whose articles were reviewed shared details on the sentiments that patients hold. These scholars report that most of the patients find that bedside reporting elevates them to a position of authority and allows them to exercise some control. For instance, Ofori-Atta, Binienda and Chalupka (2015) found that patients complain that traditional techniques deny them the opportunity to become involved in healthcare delivery. On the other hand, bedside reporting creates an interactive climate with a platform from which the patient can air concerns and direct the healthcare delivery process. The insights that Ofori-Atta and his team share underscore the beneficial impacts of bedside reporting. If a provider is truly committed to offering patient-centered care, they would adopt bedside reporting. Through this approach, the provider manages to place patients in charge of their own health instead of the current practice where patients are inactive players whose concerns and opinions are dismissed. 

This research process was extensive as it sought to answer multiple questions. How nurses feel about bedside reporting was among the questions.. While seeking to answer this question, inspiration was drawn from the need to understand the obstacles that could hamper the integration of bedside delivery into practice. For the most part, nurses are excited and ready to adopt bedside delivery. This readiness and enthusiasm can be seen in the work of such scholars as Williams (2018). Williams asserts that bedside reporting minimizes the amount of time that nurses spend with patients. Since it makes their work easier, it is not surprising that most nurses respond to the invitation to adopt bedside reporting with enthusiasm. However, it is worth noting that there is a small group of nurses who are reluctant and have raised fears that bedside reporting could make it difficult for them to fulfill their mandate. For example, as noted earlier, Cipra (2016) shared the concerns of nurses who feel that bedside reporting exposes nurses to the risk of having to suffer through too many questions that patients raise. It is true that the concerns of these nurses are significant and valid. However, these concerns should not be regarded in isolation. Instead, they should be viewed through the lens of the overall effects of bedside reporting. t can be argued that these benefits outweigh the isolated negative outcomes, thereby establishing bedside reporting as an intervention whose adoption translates to massive improvements in how care is delivered. 

Overall, all the aims of this research were accomplished. It was determined that bedside reporting enhances quality and safety. Furthermore, this approach provides nurses with reason to feel satisfied and become more committed to their mandate. Another issue that the research made clear is that bedside reporting boosts collaboration and communication among nurses. These positive impacts should inspire hospitals to aggressively adopt and champion for the integration of bedside reporting. However, even as they embrace this technique, the hospitals should consider the perspectives of nurses who fear that bedside reporting could overburden nurses. Unless buy-in from all stakeholders is secured, it will be nearly impossible to achieve the smooth and full adoption of bedside reporting. 

DISCUSSION 

When it comes to the satisfaction of nurses, other factors found to be important are the quality of relations between and among nurses, perceived managerial support, adequate staffing, as well as the inclusion of patients during clinical handover. Some of the literature consulted emphasizes the role and quality of collaborative working relationships between and among nurses (Vermeir et al., 2017; Kieft, De Brouwer, Francke & Delnoij, 2013). Thus, the relationship between nurses is critical in determining the quality of information sharing, which is a major factor in relation to patient safety. Putting Lewin ’ s theory into context, the main focus falls on the obstacles that undermine effective nurse-nurse relationships at the workplace. 

However, in order to apply Lewin ’ s theory effectively, there is a need to delineate its key points. As an advocate for change, Lewin ’ s change model promotes a shift from a known state to an unknown state which is also described as the desired state. Understandably, the uncertainty of the future “… may concern the people ’ s worth, coping abilities, and competency, and so the people in the organization do not support change unless they are convinced against that status quo ” (Hussain et al., 2018, p. 125). The implication is that a change is important for workers to understand why it is necessary.. Compared to non-verbal and traditional reporting methods, bedside reporting has been found to be more effective. This particular finding, in the context of Lewin ’ s model of change, is sufficient evidence to persuade health institutions to shift towards adopting bedside reporting during clinical handover exercises. 

Literature reviewed reveals various issues associated with both traditional and non-verbal approaches of reporting. For instance, through EHR clinical handover, the outgoing nurse might fail to record vital patient information thereby undermining patient safety. Similarly, during traditional shift reporting, conflicting relationships among nurses could affect the quality of information sharing as well. The outcome of these deficiencies is that the patient’s health will be put at risk which could lead to adverse outcomes such as death. Research by Ofori-Atta, Binienda and Chalupka (2015) explained that medical errors due to inefficient clinical handover exercises could become the third leading causes of death in the United States. It is therefore, critical that hospitals realize the damage that traditional methods of reporting could have not only on patients’ safety and health outcomes, but also on provider efficiency. In contrast, bedside reporting, through PCH, helps ensure that vital information about a patient’s condition is shared as well as promote a culture of mutual respect and collaborative relationship between and among nurses. In this regard, Lewin’s model of change could be used to emphasize the rationale behind shifting towards bedside reporting in healthcare settings. 

The barriers towards the effective provision of healthcare services were found to be a low nurse-patient ratio, poor managerial support, deficient communication among staff members, which lead to unfavorable working environments (Aiken et al., 2018). However, there is a deficiency in Lewin’s theory, as its main focus is on demonstrating the potential benefit of adapting to a particular change. Understandably, dealing with the factors that undermine, for instance, effective nurse-nurse relationships, is as important as justifying the efficacy of bedside reporting over non-verbal and traditional reporting methods (Cipra, 2016). For instance, some of the potential challenges that one can anticipate during bedside reporting are such as patients and nurses asking too many questions, interruptions, all promote the length of the report at the bedside. Nurses 

consider the length of bedside reporting as a concern (Cipra, 2016). Thus, this demonstrates the limitation in the current study as it overlooks the inherent challenges associated with bedside reporting. In such a case, the efficacy of Lewin ’ s model of change in advocating for the adoption of bedside reporting is undermined. In summary, the study was effective as it addressed the first three aims. For instance, literature consulted showed that the type of reporting matters in relation to patient safety and nurse satisfaction levels at work; there are high ratings in patient experiences when it comes to bedside reporting; and lastly, compared to other methods of reporting has been found to be effective. 

Study Limitations. 

One of the limitations has been identified earlier which is that Lewin ’ s theory of change emphasizes on justifying change while overlooking the deficiencies associated with it. The theory advocates for the inevitability and importance of change from one state to another. However, as has been noted, it does not address the issues associated with the proposed change. This limitation hampers the appeal and quality of this study since the study’s recommendations are based largely on Lewin’s model. Another significant limitation is that this study relied heavily on the perspectives of other researchers and scholars. The study would have benefited from some form of empirical research. Despite these limitations, the study remains relevant, accurate and credible. By adopting the insights obtained through the study, nurses can improve how they operate. 

Nursing Implications 

Bedside reporting is an exercise that has the potential of not only improving patient safety and health outcomes, but also promoting nurse satisfaction levels at work. Through bedside reporting, nurses are compelled to establish a culture of mutual respect which allows for effective communication when sharing patient information. A comparative view of bedside reporting and other methods such as non-verbal and traditional reporting approaches shows the effectiveness of the former approach. Nurses should notice the dangers of not including patients during the clinical handover process. Sentinel events such as health complications could occur leading to adverse outcomes. Therefore, patient inclusion during bedside reporting helps alleviate such scenarios, which undermine patient safety and hence the satisfaction of nurses with their work. It is important to acknowledge the relationship between patient health outcomes and the level of satisfaction among nurses. In this case, nurses should focus on prioritization patient safety hence ascertain positive health outcomes. However, they have to anticipate challenges associated with bedside reporting such as interruptions which make the process of clinical handover lengthy. 

CONCLUSION  

T he discussion has explored the potential impact of bedside reporting on patient safety and nurse satisfaction at the workplace. When it comes to patient safety, the literature reviewed demonstrates the efficacy of bedside reporting over non-verbal and traditional shift reporting approaches. The rationale is that bedside reporting allows for patient inclusion as well as face-to-face communication between oncoming and outgoing nurses. Consequently, an atmosphere whereby nurses can exchange information directly and in the presence of the patient is created compared to when a nurse accesses patient records via EHR or at the nursing station. Therefore, this emphasizes the need to include patients’ input during clinical handover. 

While that is the case, various barriers have been identified such as nurses and patients asking too many questions which lengthens the process of bedside reporting. Unfortunately, the study did not address this particular issue thereby implying a need for future researchers to explore it further. By examining the role of bedside reporting further, researchers can help to address the shortcomings of this study. Moreover, it is imperative to understand that there are numerous other factors which determine the level of satisfaction of nurses at work such as burnout and fatigue due to inadequate staffing or lack of managerial support. 

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