The Need for Mandatory One-Hour Complete Bedside Reporting for Nurses

Change Issue: increased safety errors in inpatient clinical settings. 

Currently, miscommunication between caregivers has increased the risk of medical errors in inpatient facilities. Likewise, when caregivers leave patients on their own to go to their stations to exercise shift reporting, they leave patients unattended, which exposed them to safety risks, such as falls. Therefore, the proposed change is to have a mandatory one-hour complete bedside shift reporting for nurses. 

Annotated Bibliography 

Ba Miller, K., Hamza, A., Metersky, K., & Gaffney, D. (2018). Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario community hospitals.  Patient Experience Journal ,  5 (1). https://pxjournal.org/cgi/viewcontent.cgi?article=1163&context=journal 

This article was sponsored by the Canadian Foundation for Healthcare Improvement (CFHI), an agency that seeks to improve quality care delivered to patients across Canada. CFHI works hand in hand with the ministry of health in Canada. That said, Ba Miller et al. (2018) focuses on the transfer of accountability (TOA) for a patient during the nurses' change-of-shift. According to these authors, the change-of-shift report presents the care givers with an opportunity to exchange crucial information about the patient, and also enhances quality care delivery as well as patients’ safety. The authors sought to explore the perceptions of implementing the nursing transfer of accountability at the bedside among the patients, family members, and the nurses themselves. The authors conducted audio-recorded focus groups and divided the findings into positive and negative outcomes. Among the positive outcomes included enhancing communication between the caregivers, enhancing patients’ satisfaction and family members’ engagement, and minimizing clinical errors. On the other hand, some of the negative outcomes included compromising the confidentiality and privacy of the patient’s health information. With these findings, the authors created awareness of healthcare facilities' expectations with the change associated with bedside TOA. 

Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability.  Nursing Management (Springhouse) ,  49 (6), 20–25. https://doi.org/10.1097/01.numa.0000533770.12758.44 

Dorvil (2018) explores why the implementation and sustainability of bedside shift reporting fail in the real world despite the practice gaining momentum in the health care industry. Dorvil (2018) demonstrates that the existing literature proves that the application of bedside shift reporting improves the overall patient outcome. To that end, the author focuses on the four most commonly used bedside report methods. After reviewing the literature, the author found that the sustainability of nurse bedside shift reports is limited by “inconsistency with the new intervention, lack of leadership or employee buy-in, lack of continuous process management practices, and negative nursing feedback and emotions” (P.24). Therefore, Dorvil (2018) recommended using Everett Rogers’ approach to the adoption of innovations. The approach has five phases: knowledge, persuasion, decision, implementation, and confirmation. The application of this approach can lead to a successful implementation and sustainability of bedside shift reporting. 

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: 10.3912/OJIN.Vol23No02PPT22 

This research used an evidence-based approach to study the fall rates and patient and nurse satisfaction scores in a clinical setting. McAllen et al. (2018) based their research on the existing literature that “bedside shift report has increased patient safety and patient and nurse satisfaction” (n.p). Thus, the researchers, being members of the American Nurses Association, proceeded to conduct a four-month evidence-based implementation of bedside shift report. Surveys were conducted to compare the fall rates and patients' and nurses’ satisfaction before and after the project implementation. The research results revealed that “patient fall rates decreased by 24%, and nurse satisfaction improved with four of six nurse survey questions (67%) having percentage gains in the strongly agree or agree responses following implementation of bedside report” (McAllen et al., 2018). Therefore, the researchers concluded that bedside shift reporting is crucial in achieving the overall patients’ care. However, the authors also found that caregivers find it difficult to maintain progress and the overall sustainability of bedside shift reporting. Thus, McAllen et al., (2018) emphasized the use of Kotter’s Eight Stage Process for Major Change for the long-term implementation and sustainability of bedside shift reporting. 

Mitchell, A., Gudeczauskas, K., Therrien, A., & Zauher, A. (2017). Bedside Reporting is a Key to Communication.  Journal of Healthcare Communications ,  03 (01). https://doi.org/10.4172/2472-1654.100124 

Mitchell et al. (2017) sought to explore the impacts of bedside shift reporting. According to the authors, lack of communication between the caregivers has been a great contributor of safety errors in the US. Mitchell et al. (2017) cites the Joint Commission’s report indicating that “80% of serious medical errors involve miscommunication between caregivers during the transfer of patients” (p.1). As a result, most health care facilities in the US have implemented bedside reporting practices; however, due to various reasons, change-of-shift report is not conducted at the bedside of the patient. Nurses often cites challenges with these practices, including creation of a disruptive environment, time consuming, and that the practice might compromise the confidentiality of patient’s information. However, the authors conclude that bedside reporting “increases patient satisfaction, patient safety and nurse 

Satisfaction” (p.2). Therefore, the authors conclude that bedside shift reporting is a crucial practice in the health care industry. 

Ofori-Atta, J., Binienda, M., & Chalupka, S. (2015). Bedside shift report: Implications for patient safety and quality of care.  Nursing ,  45 (8), 1-4. https://doi.org/10.1097/01.nurse.0000469252.96846.1a 

The authors focuses on the implications of BEDSIDE SHIFT REPORT (BSR) for patient safety and quality of care. The authors base his article on a report by the Health and Human Services Department indicating that over 180,000 Medicare patients died in 2010 as a result of less-than-competent hospital care. Ofori-Atta et al. (2015) focuses on how BSR has changed from the traditional practices, where change-of-shift report was done in the nurse stations, to meet the requirements set by the Joint Commission, conducting the exercise at the patients’ bedsides. Ofori-Atta et al. (2015) define BSR as a “change-of-shift report between the off going nurse and the oncoming nurse” (p.1). The authors cite problems with the traditional practices, such as caregivers leaving patients on their own to go and conduct change-of-shift reports at their stations can be detrimental as anything can happen with the patients when they are left alone. Therefore, Ofori-Atta et al. (2015) conclude that BSR enhances communication between the caregivers, enhances patients’ satisfaction, and also minimizes clinical errors. Likewise, the authors also recommend the use of SBAR plus T (Situation, Background, Assessment, Recommendation, and Thank you) communication tool for BSR. 

Roslan, S. B., & Lim, M. L. (2016). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study.  Proceedings of Singapore Healthcare ,  26 (3), 150–157. https://doi.org/10.1177/2010105816678423 

Roslan & Lim (2016) sought to explore the perceptions of the nurses’ bedside clinical handover. The authors conducted their research in an inpatient acute-care ward in Singapore using focus group interviews with semi structured questions. The authors found that bedside clinical handovers have both advantages and disadvantages. Some of the advantages included enhancing communication amongst the caregivers, the patients, and the family members. On the other hand, the authors also found that bedside clinical handovers practices are time consuming and can create an interruptive environment to the patient. Moreover, the authors also found that it can compromise the confidentiality of the patient’s health information. Thus, this article formed a basis through which health care facilities can improve their bedside clinical handover practices. 

References 

Ba Miller, K., Hamza, A., Metersky, K., & Gaffney, D. (2018). Nursing transfer of accountability at the bedside: partnering with patients to pilot a new initiative in Ontario community hospitals.  Patient Experience Journal ,  5 (1). https://pxjournal.org/cgi/viewcontent.cgi?article=1163&context=journal 

Dorvil, B. (2018). The secrets to successful nurse bedside shift report implementation and sustainability.  Nursing Management (Springhouse) ,  49 (6), 20–25. https://doi.org/10.1097/01.numa.0000533770.12758.44 

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: 10.3912/OJIN.Vol23No02PPT22 

Mitchell, A., Gudeczauskas, K., Therrien, A., & Zauher, A. (2017). Bedside Reporting is a Key to Communication.  Journal of Healthcare Communications ,  03 (01). https://doi.org/10.4172/2472-1654.100124 

Ofori-Atta, J., Binienda, M., & Chalupka, S. (2015). Bedside shift report: Implications for patient safety and quality of care.  Nursing ,  45 (8), 1-4. https://doi.org/10.1097/01.nurse.0000469252.96846.1a 

Roslan, S. B., & Lim, M. L. (2016). Nurses’ perceptions of bedside clinical handover in a medical-surgical unit: An interpretive descriptive study.  Proceedings of Singapore Healthcare ,  26 (3), 150–157. https://doi.org/10.1177/2010105816678423