PICOT Question and Justification

Clinical Question 

Does implementing bed-side shift change reports lead to greater satisfaction with care when compared to traditional shift change reports in nurses station every 8 hours shift? 

PICOT Format  

P: Nurses 

In Nursing, the need for effective communication in handling patients and providing care is important. Since it is not possible for one individual nurse to provide care to one patient round the clock, there exists the need to implement shifts between the nursing personnel responsible for the patient. This requires a suitable methodology for the Clinic or Care facility for the exchange of details and information pertaining various patients between the nurses. Previously, there were many issues and errors being reported with Shift Change and care information of the patients being exchanged  (Friesen, White, & Byers, 2008) . Communication gaps were clearly observed between nurses who were changing shifts and thus requiring an innovative and better method to exchange patient information for nurses who are coming in for their shift and those that are exiting their shift in order to guarantee quality patient care delivery  (Wakefiled, Ragan, Brandt, & Tregnago, 2012) . 

I: Implementing bedside shift change report 

To cater to this issue, Hospitals have identified a new way to which nurses are able to exchange information pertaining to the patient with less errors involved. This is the Bedside Shift Change Report. This method was first implemented in Midwestern Academics Health Centre. It was done as an effort to improve the communication between nurses while at the same time improving the patient satisfaction scores within the facility  (The Wall Street Journal, 2015) . 

For the implementation of Bedside Shift reports, an analysis on the previous shift methods and identifying existing areas which prove to be unsatisfactory. During Shift Change Periods, there is a 30 minute period identified where both the ongoing and off going nurses are both on duty. It is during this period where an exchange of information is to be conducted  (Wakefiled et al., 2012) . During this period, the Hospital allows the nurses to meet at the patient’s bedside and discuss the Patient’s information, healthcare records and other details pertaining to the delivery of care to the patient. 

C: Traditional shift change report at nurse’s station 

Traditional Shift Change Reports involved the nurses meeting at a central location, such as a Hallway or the Nurses Station and discussing the details pertaining to the Patient. They would offer a rundown of all the patient’s information. These meetings involved all the off going and incoming nurses. The meetings, since they only have a thirty minute covering period required the nurses to discuss individual patients. This was not enough time and thus left patient information details unsaid  (The Wall Street Journal, 2015) . 

Where such meetings were not possible, the nurse would develop a report with details pertaining to the patient’s care plan and delivery. The report would be left on the patients bed for the next nurse to scheme through and identify how best to handle the patient. However, this method proved to be ineffective where patient’s registered a very low score for satisfaction and nurses were unable to share adequately details pertaining to the patient and the care that is to be provided  (Wakefiled et al., 2012) . Patients, with this Shift Reporting were reporting to experience more problems with their health where the tools being used for medicinal recuperations such as Intravenous lines or Urinary Catheters were problematic for patients. At the same time, family members did not have the opportunity to ask questions regarding the Patient’s condition or provide their own grievances  (Wakefiled et al., 2012) . 

O: Greater satisfaction with care 

With the Implementation of Bedside Shift Reporting, more patients are recording greater satisfaction levels. Family members and patients are able to hear the discussion and the Nursing care plan that has been developed for their recuperation. At the same time, family members are able to convey their grievances and ask any questions they may have pertaining to the Patient’s condition and care to be provided  (Friesen et al., 2008) . 

The implementation of bedside Shift Reporting also leads to effective nurse-to-nurse communication. Where the nurses are able to share the information and crucial details regarding to the management of the patient while at the same time handing over all information on progress and any other medicinal measures that have been implemented in providing care to the patient  (The Wall Street Journal, 2015) . 

T: Every 8hr shift 

For nurses, a normal day shift is supposed to be 8 hours, hence, thirty minutes before the completion of their shift, they are to visit the patients with the incoming nurses and explain to them all the details pertaining to the patient, essentially, report details of the patient. 

Rationale for the question 

In providing the above, it is clear that the implementation of Bedside Shift Change Reports will lead to a greater satisfaction level for both the patients and their family members, while at the same time improving the care quality delivered by nurses to patients and their communication with one another.