Moving Shift Report to the Bedside: An Evidence-Based Quality Improvement Project

Abstract

A Midwestern, 532-bed, acute care, tertiary, Magnet® designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores. Research has shown that the implementation of bedside report has increased patient safety and patient and nurse satisfaction. An evidence-based practice change incorporating bedside report into standard nursing care was implemented and evaluated over a four-month time period on three nursing units. Fall rates, HCAHPS and Press Ganey® scores, and nurses’ response to a satisfaction survey were measured before and after the project implementation. This article begins with the background of the problem and literature review, and then presents the project methods, measures, and data analysis. Results demonstrated 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. HCAHPS and Press Ganey® results demonstrated improvement in Press Ganey® scores on two of the three nursing units. In this project, implementation of bedside report had a positive impact on patient safety, patient satisfaction, and nurse satisfaction. The authors conclude with discussion of findings and implications for nursing management.

Investigating nurses' perception of bedside handoff

“…Some questioned the value of the process. Similar nurse sentiments are also echoed in the literature 3,4…”

“…Similar nurse sentiments are also echoed in the literature. 3,4 Routine patient satisfaction surveys indicated a need to improve communication among caregivers. Specifically, patients and family members have commented that nurse communication about care plans seemed disconnected and that each shift was not communicating important events to the next.…”

Coaching to Bedside Shift Report and Its Correlation to Hospital Consumer Assessment of Healthcare Providers and Systems and Value-Based Purchasing Dimension Scores

“…Bedside nurse involvement will be imperative to make nursing practice changes. In an evidence-based practice change conducted by McAllen et al, 8 BSR was put into practice of nursing care at 1 tertiary Magnet hospital. The nurse-driven implementation of BSR had an impact postimplementation to not only the patients' experience but also the bedside nurse's satisfaction and engagement.…”

Systematic Review of Quality Improvement Projects Related to Intershift Nursing Handover

“…patients were either satisfied or their satisfaction increased relative to baseline after participating in a QI project. 21,24,30,34,39,41 However, Ayaad et al 36 found no difference in patient satisfaction scores.…”

“…Klee et al 40 applied a standardized handover communication tool to all units in the action stage of the PDSA method after examining the successful changes in surgical units during the investigation stage. However, the other 5 studies 24,26,[32][33][34] did not follow the key principles of the PDSA method and most of the QI projects were limited to small-scale studies.…”