Evidence Based Practice Bedside Report By Kristen Tavares

Evidence Based Practice: Bedside Report By: Kristen Tavares UNH Nursing Student Goal: “Transfer of essential information & responsibility for care of the patient from one health care provider to another is an integral component of communication in health care” (Friesen, 2008). The goal of this evidence based research study was to identify what the literature states on bedside report and the benefits versus report outside of the patient’s room. Problem: According to the Joint Commission (2011), one of the factors leading to sentinel patient events is miscommunication (Sand-Jecklin, 2014). The reason for this research is that handoffs can include unnecessary information like bias feelings towards a patient, side conversations, gaps or discrepancies. The Institute of Medicine (IOM) reported that “it is in inadequate handoffs that safety often fails first” (Friesen, 2008). Expected Outcome: To adopt bedside report for time manageable handoff with pertinent information while involving the patient at bedside in their care and also increasing the safety on the unit. Evidence: A study, A quantitative assessment of patient and nurse outcomes of bedside nursing report Implementation (Sand -Jecklin, 2014), found statistically significant information related to implemented bedside report at a large university hospital • Surveys were given to patients and RN’s at 1, 3 & 13 months post implementation with large sample sizes • Pt falls (during hours of shift change) decreased from 20 pre-implementation to 13 at 3 months and 4 at 13 months • Medication Errors decreased from 20 pre-implementation to 10 at 3 month post-implementation • Typical Bedside Report included: introductions, plan of care, visualization of patient incisions, drains/lines, pain assessment & review of any potential safety issues • Overall findings: Findings are significant for at least 1 year post implementation, increased RN accountability, prevention in safety problems, improved RN teamwork, increased report accuracy, & improved nurse-patient relationship. (Sand-Jecklin, 2014). Recommendations: Based on the research, it was found that bedside report has statistically significant positive outcomes for patients and nurses. I recommend that bedside report be implemented at Exeter Hospital on the unit 4 East to improve patientcentered care and patient safety. An article, Implementing Bedside Shift Report, shows strong support from staff and management related to Transforming Care at the Bedside (TCAB) and found it averted problems and the need for rapid response calls, led to prompt dressing changes and replacement of empty I. V. bags (Ferris, 2013). A study, Investigating Bedside Report : A synthesis of the literature (Sand-Jecklin, 2013), found that 85% of nurses indicated additional information needed to be provided away from the bedside always or some of the time. The process changed to bedside report and exchanged potentially distressing/sensitive information in private. • Nurses found they were more informed about patient’s conditions and patients were more involved in their care • 34 bed PCU: report time decreased from 40 to 10 minutes, saving $8000 in 2 months, patient falls decreased from 8 in 6 months pre-implementation to 1 in 6 months post-implementation. • Decreased the time to seeing their first patient from 30 -60 mins pre-implementation to 11 minutes post. • 32 -bed general surgical unit: increased accountability; improvements in passing information, relationships between staff, accuracy of report and amount of pertinent information conveyed • Surveys found improvements in increased patient satisfaction by being kept informed • Decrease in overtime of over 100 hours in the first two pay periods after implementation and again over next 2 pay periods (Sand-Jecklin, 2013). Clinical Implications: *Ensure Patient safety & confidentiality *Introduce self to patient *Encourage participation *Develop bedside report process *Strong management support *Increased patient satisfaction scores *Evaluate call light use and falls at change of shift Analysis: Research Implications: Strengths of Bedside Report: face-face interaction and involvement with the patient, RN’s can assess the patient together, adds a level of safety and any information that is incorrect can be addressed with the patient (Friesen, 2008). Weaknesses of Bedside Report: Not all want to participate, patient confidentiality, use of medical terminology (Friesen, 2008). Weaknesses of Report on the Unit: verbal only, discrepancies in reported status vs. how the patient actually is, time consuming (Friesen, 2008). *How can handoff contributions to medication errors be addressed and decreased? *Data should be collected pre & post implementation process *More quantitative data is needed

References Ferris, C. (2013). Implementing bedside shift report. American Nurse Today, 8(3), 47 -49. Friesen, M. A. , White, S. V. , & Byers, J. F. (2008, April). Handoffs: Implications for Nurses. Retrieved April 14, 2017, from https: //www. ncbi. nlm. nih. gov/books/NBK 2649/ Sand-Jecklin, K. , Sherman, J. , & Johnson, J. (2013). Investigating Bedside Nursing Report: A Synthesis of the Literature. MEDSURG Nursing, 22(5), 308 -318. Sand-Jecklin, K. , Sherman, J. (2014). A quantitative assessment of patient and nurse outcomes of bedside nursing report implementation. Journal of Clinical Nursing, 23(19 -20), 2854 -2863. doi: 10. 1111/jocn. 12575