Description of the Proposed Project
Nurses are a crucial part of the medical team that ensures patient safety and quality of care. However, one area of nursing where there is a possibility of causing medication errors is handing over a shift from one nurse to another (Eklund et al., 2019). Conventionally, nurses usually hand over reports of the change of the nursing stations away from the patients. However, patient safety errors have been occurring due to human errors that happen when nurses leaving shifts, omit some crucial information, or nurses on change forget some issues reported in the handoff shift. However, such errors can be eliminated or minimized by involving the patients in the care process and handing over shifts among medical staff.
Therefore, I propose a bedside nursing report, especially when handing over shifts to colleagues. Using bedside handoff shift reports would ensure the patient is part of the caring process, and their input might help prevent adverse medical events before they occur (McAllen et al., 2018). In the proposal, the departing nurse would start by acquainting the nurse taking over the shift to the patient, a brief medical history, and assessing the patient’s environment, including visual examination of the patient. Then the departing nurse would take the nurse taking over on the patient’s electronic health record assessment with emphasis on the patient’s treatment plan such as scheduled medications, fluids, blood transfusions, or lab reports (McAllen et al., 2018). The patient acts as a reminder of the nurse leave out some crucial plans that they feel the nurse taking over should know.
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Stakeholders Impacted by the Project
Since the proposed change involves changing a part of a routine at the facility, the primary stakeholders would be nurses, especially nurse leaders and patients. The nurse leaders would play a key role in ensuring patients understand what entails bedside reporting by demonstrating how ward rounds are undertaken (McAllen et al., 2018). The patients could be educated on their role as reminders of the nurses if they forget reporting crucial information. Additionally, patients would act as the immediate source of information for nurse leaders the following day when finding out if the nurse conducted bedside reporting before handing over the shift to the night duty nurses.
Since the proposed plan does not involve significant changes in the management protocols or hospital policies, nurses would be expected to follow the project without supervision or consequences. However, if nurse leaders feel the nurses are not complying, they can involve the hospital administration to develop disciplinary actions for nursing staff that deliberately ignore bedside reporting when handing over shifts (McAllen et al., 2018). Additionally, other cadres such as doctors, lab technicians, and pharmacists working in the wards would provide another source of information to remind the nurses about following the proposed project and reporting those who intentionally ignore the guidelines of handing over shifts (Wibrandt & Lippert, 2020). Even though the plan is small, it has significant positive outcomes that would attract the Board of Trustees and local communities to take up the initiative of motivating and rewarding nurses committed to the project.
Patient Outcome(s) or Patient-Care Efficiencies the Project Will Improve
As mentioned above, a successful handing over a shift to another nurse involves the successful transfer of information. Additionally, the involvement of the patient ensures the departing nurse does not forget crucial details about their management plan. Patients with caretakers or family members can act as the third party in providing the complete transfer of all the necessary information about the patient’s treatment plan (Wibrandt & Lippert, 2020). As a result, there are minimal chances of leaving out information, a leading contributor to medication errors, among other serious medical events. Initiating engagement between the patient and the incoming nurse helps build trust, understanding, and cooperation throughout the subsequent shift (Eklund et al., 2019). Additionally, the patient gets to know about the progress in their condition that can work as a motivating factor to push them further into believing they would get well soon.
During the handing over process, the incoming nurse gets an opportunity to address concerns about the patient’s environment. At that point, the incoming nurse can assess and question the colleague why the patient’s domain is set based on what the nurse observes (Eklund et al., 2019). For instance, the bed’s head might be elevated for GERD patients; the room might be kept dark for tetanus or rabies patients. Such factors require clarification so that a nurse promotes positive patient outcomes instead of interfering with the care process. Patient care is a continuous process, and changing from one shift to another should not create breaks in the cycle. However, through bedside change of shifts, nurses can continue the treatment process initiated in the previous shifts (McAllen et al., 2018). As a result, it guarantees fewer medication errors and improved quality of care due to maintenance of the management continuum.
Technologies Required for Implementing the Project
Technology plays a significant role in the healthcare system, especially when it comes to improving the efficiency and quality of patient care. The most useful technology in implementing the project would be using electronic health records (EHR). Nurses can be availed portable electronic gadgets preinstalled with the EHR system, which they would use to access the patient information when reporting at bedside (Mastrian & McGonigle, 2019). The devices would be useful to create reminders and document important information during shifts. The gadgets would also come with a functionality that can track and warn against medication errors, mostly wrong doses, and medication. Unlike traditional paper recording, electronic systems come with doses and formulation already preinstalled, minimizing the errors of dosing (Mastrian & McGonigle, 2019). As a result, nurses can prioritize patient safety while improving the quality of care and minimizing mistakes that lead to adverse medical events.
Members of the Project Team and Roles
Members of the project team would include frontline nurses that would carry out the project and see it through to ensure it succeeds. Secondly, hospital leaders or administration seek permission for implementing a new projecting and for assistance to reinforce the application process, especially when some frontline nurses deliberately refuse to abide by the set guidelines (Nilsen et al., 2020). A quality management team might be useful in the training process to ensure they conduct their research and advice if the project is feasible based on the firm’s financial status. The training would entail equipping nurses with adequate knowledge of the crucial things to look out when taking upshift from a colleague. For example, the patient’s environment, medication schedule, and the treatment plan, including lab tests to follow up, entail a treatment plan. The nurse managers of all the departments would be part of the project team to follow up on the nurses and provide a weekly report on the compliance of the nurses during bedside reporting (Nilsen et al., 2020). Additionally, the implementation process involves utilizing EHR technology where the nurse informatics comes in to assist with handling the project and ensuring the users of the technology are conversant with both the platform and operating the gadgets.
In conclusion, nurses are best placed to push for patient advocacy agenda. Effective collaboration between nurses and the utilization of technology are two essential items useful in improving the quality of care. Nurses can ensure the change of shifts is a continuum that involves maintaining the cycle when handing over shits. The commitment of every stakeholder involved in the implementation process of the proposed project is the key to increasing the provision of patient safety and satisfaction that are crucial in a speedy recovery process.
References
Eklund, J. H., Holmström, I. K., Kumlin, T., Kaminsky, E., Skoglund, K., Höglander, J., ... & Meranius, M. S. (2019). “Same same or different?” A review of reviews of person-centered and patient-centered care. Patient Education and Counseling , 102 (1), 3-11.
Mastrian, K., & McGonigle, D. (2019). Informatics for health professionals . Burlington, MA: Jones & Bartlett Learning.
McAllen, E. R., Stephens, K., Swanson-Biearman, B., Kerr, K., & Whiteman, K. (2018). Moving shift report to the bedside: An evidence-based quality improvement project. OJIN: The Online Journal of Issues in Nursing , 23 (2). https://doi.org/10.3912/ojin.vol23no02ppt22
Nilsen, E. R., Stendal, K., & Gullslett, M. K. (2020). Implementation of eHealth Technology in Community Health Care: the complexity of stakeholder involvement. BMC Health Services Research , 20 , 1-13. https://doi.org/10.1186/s12913-020-05287-2
Wibrandt, I., & Lippert, A. (2020). Improving patient safety in the handover from the intensive care unit to the general ward: a systematic review. Journal of patient safety , 16 (3), 199-210. https://doi.org/10.1097/PTS.0000000000000266
