Nursing shift report on the medical-surgical units of a large teaching hospital was modified from a recorded report to a blend of both recorded and bedside components. Comparisons between baseline and postimplementation data indicated increased patient satisfaction and nurse perception of accountability and patient involvement but reduced nurse perceptions of efficiency and effectiveness of report. Patient falls at shift change and medication errors were reduced, whereas nurse overtime remained unchanged.

If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process.

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Domestic violence (DV) screening has become increasingly common in recent years; however, many organizations still do not practice universal screening, and there is considerable debate concerning the best screening tool for detecting DV. The current research suggests that a brief tool would be ideal and that existing brief tools are comparable to more extensive instruments. Per Joint Commission standards, the ambulatory clinics at West Virginia University Hospitals instituted the use of the Functional Health Screening (FHS), a three-item tool that screens for unexplained weight changes, DV, and basic needs deficits. This tool is administered at the beginning of every outpatient clinic visit. This study includes a retrospective chart review to investigate the detection rate of this tool for DV and basic needs deficits, the increased utilization of social services, and nursing attitudes concerning FHS.

Background: Inhospital stroke (IHS) is defined as an acute ischemic infarction that occurs during hospitalization in a patient originally admitted for another diagnosis or procedure. Approximately 4 to 17 percent of all adult strokes are IHS, and most IHS occurs in cardiologic and cardiosurgical patients after catheterization or surgery. Time to brain imaging is longer in IHS vs community onset strokes (COS) due to delayed symptom recognition, and consequently, IHS patients have greater disability and increased mortality comparted to their COS counterparts. Purpose: The purpose of this project was to educate cardiac nurses to more rapidly and accurately recognize symptoms of acute ischemic stroke. We hypothesized that this education would shorten evaluation time for inpatient strokes and result in faster activation of the Code Stroke team. Methods: Two 4-hour “Heart to Brain Connection” seminars were offered. Course objectives targeted development of critical thinking regarding the relationship of cardiovascular and cerebrovascular disease. Content included cardiac and cerebral anatomy, recognition of ischemic stroke syndromes and NIH Stroke Scale review. All cardiac nurses completed NIH Stroke Scale Certification. Nurses were empowered to call a “Code Stroke” and educated on appropriate criteria. NIH Stroke Scale pocket cards and pencils with the code stroke number were distributed through the cardiac units. Results: We compared the median time from stroke symptom recognition to activation of “Code Stroke” before and after our interventions. Prior to the interventions, in 2014, the median time was 20 minutes; however, this time was decreased to 6.5 minutes in 2016 following our interventions. Further, in 2014, only 36 percent of “Code Strokes” were called by nurses. Following the interventions, “Code Strokes” were called by cardiac nurses in 75 percent of cases in 2016. Conclusions: Empowering cardiac nurses to call a “Code Stroke“ through targeted education and training increases the number of “Code Strokes” called by nurses and decreases the time from recognition to activation of the Code Stroke team thereby optimizing the patient’s potential outcome.