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Increasing Nurses' Compliance with Bedside Shift Report
Presenter(s)
Leigh Anne Puckett
Abstract or Description
PROJECT PURPOSE To increase nurses’ compliance with performing handoff at the bedside, while increasing patient satisfaction as a result. BACKGROUND DESCRIPTION To ensure optimal patient safety and outcomes are met, accurate and thorough communication is required at the nurses’ change of shift. A need for implementation of a standardized approach to bedside shift report and its sustainability was identified from the evidence obtained through research, personal communication, and field observations. METHODOLOGY Kurt Lewin’s Change Theory and Change Model guided the implementation of this project and served as the framework for directing change from the current practice of giving handoff at the nurses’ station to performing handoff at the bedside of the patients. Compliance with bedside shift report was monitored through observations of each RN. A core team of individuals assessed the need for a practice change, located the best evidence, conducted a review of aggregated patient satisfaction data, and critically analyzed the correlation between the use of bedside shift report and the patient satisfaction question “nurses always communicated well” for the pre- and post-implementation time frame. OUTCOMES The goal for the unit and the organization on the patient satisfaction survey is 90% overall, which places the unit and organization at the 65th percentile when compared to their benchmark group. Baseline data from the hospital patient satisfaction survey was compared to post-implementation results at monthly intervals: December (baseline month) – 82.5%/68th percentile; January – 98.0%/99th percentile; February – 54.9%/1st percentile; and March – 84%/80th percentile. Direct observation showed registered nurses used bedside shift report 86% of the time during handoff. This was an increase from a reported 81%. IMPLICATIONS FOR NURSING It is crucial for nurses to realize the importance of their role in patient safety and quality of care, as well as patient satisfaction, through standardized bedside shift report. The evidence from this project, as well as the literature, confirms that collaboration between all health care team members, their patients, and administration contribute to the success of implementation of bedside shift report and lead to safe patient care, positive patient outcomes, and increased patient satisfaction.
Comments
Susan Blaine4 years ago
Hi, Dr. Puckett. I am a nursing Ph.D. student at the UTK College of Nursing. I think this is a great study, and you did an outstanding job on the poster. It's very eye-pleasing and draws the viewer in. Just curious if you encountered any initial resistance to staff buy-in to the implemented change of bedside shift reporting, and if you did, what steps you took to overcome that and increase buy-in? -- Susan Blaine
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Leigh Anne Puckett4 years ago
Hi Susan,<br />Thank you very much! I actually did encounter some initial resistance when I began my project, although it was very minimal. To help to overcome the resistance I did encounter, my team (the unit nurse manager, nurse educator, and myself) identified individuals to be "champions" for implementing the change. This really helped because it gave them ownership over the process. When I initially started my project, I provided them with a tool to use when giving bedside shift report. Over the course of the couple of months of implementation, I asked for input from the staff and made the changes they recommended to the form. I wanted it to be something that would be useful to them and something they would actually use. Those things really seemed to increase buy-in from the staff. <br />I wish you good luck in your education journey! It will be over before you know it.
Cameron Haeseker4 years ago
From my experience, each nursing floor/department came up with their own methods of shift change reporting. Some were certainly better than others. Are there any standardized shift change formats that have been studied that you would recommend?
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Leigh Anne Puckett4 years ago
Hi Cameron,<br />This organization had a template they had developed several years ago. Before doing the initial education for my project, I met with the nurse manager, nurse educator, and a couple of the charge nurses on that unit. We make some tweaks to that form before rolling it out, then we made a few more changes that came from the staff nurses once we implemented it. I did a lot of research of specific forms, and ultimately did a combination of the ones I researched to take the most user-friendly areas of those forms to a form that met their specific needs. The form they used seemed to work very well for them.
Shelley Lott4 years ago
Souds like a great project. It has been many years since I was at the bedside. However, I can see where a standarized tool would be beneficial. What did nurses think of your tool?
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Leigh Anne Puckett4 years ago
Hi Shelley,<br />I really enjoyed implementing this project. It had been a good bit of time since I had been at the bedside as well, so I was excited for their input. They actually really liked it. We made some tweaks from the initial form we implemented based upon recommendations from staff. My goal was for them to have a tool they could actually use and benefit from, and I do believe that goal was met.