Moving Shift Report to the Bedside: A Planned Change solution 1

Moving Shift Report to the Bedside: A Planned Change

Description/Paper Instructions

Moving Shift Report to the Bedside: A Planned Change

A Midwestern, 532-bed, acute-care, tertiary, Magnet-designated teaching hospital identified concerns about fall rates and patient and nurse satisfaction scores.

Because evidence suggests that the implementation of bedside report (BSR) increases patient safety and patient and nurse satisfaction, the implementation of BSR was planned and implemented over a 4-month time on three nursing units.

The team completed a gap analysis to determine evidence-based best practices for shift report as compared to the current practice.

At baseline, shift report was done in a conference room, at the desk, or in the hallways. BSR was not a practice on any of the units. Report was not standardized, although all nurses had some preferred form of communication.

Moving Shift Report to the Bedside: A Planned Change

An organizational assessment completed using the strengths, weaknesses, opportunities, threats (SWOT) format revealed that the practice change to BSR was feasible and congruent with the hospital’s nursing model.

Tests of change in plan, do, study, act (PDSA) cycles were used to evaluate the practice change in real time and make necessary adjustments throughout implementation.

Moving Shift Report to the Bedside: A Planned Change

Moving Shift Report to the Bedside: A Planned Change

Scripted reports were created with input and consensus of staff, using on the introduction, situation, background, assessment, recommendation, question (ISBARQ) format. In addition, all nursing staff members (n = 67) completed education prior to implementation of BSR.

Performance audits revealed a combined compliance rate of 94% (n = 157). There was no statistically significant difference between mean time for report before and after implementation of BSR. Patient falls, however, decreased by 24% in the 4 months after BSR implementation compared to reimplementation falls.

The orthopedic unit experienced the greatest reduction in the number of falls at 55.6%, followed by the neuroscience unit at 16.9%, and the general surgery unit at a 6.9% reduction.

Patient satisfaction also increased after implementation of BSR with the average Press Ganey score for the eight questions producing a result that increased the average score from 87.7% to 91.6%. Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) showed improvement, but the changes were not statistically significant.

Moving Shift Report to the Bedside: A Planned Change

The researchers also found that sharing success stories (such as the “good catch” of a patient who had deteriorated on rounds or improving fall rates) helped to encourage continued participation in BSR but noted the need for nursing leadership to continue to monitor performance and reinforce consistent expectations for

Moving Shift Report to the Bedside: A Planned Change

refreezing to occur.

Moving Shift Report to the Bedside: A Planned Change

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