Bedside Nursing Report Implementation

Nursing care is defined over a range that deals with the transference of patient well-being from one nurse to another. Formally, voice-taping technology and central nursing station we used to report shift-to-shift nursing; this reports where nevertheless plagued by incorrect data, interruptions and incomplete data findings. However, with the introduction of the bedside reporting procedure, the patients and family members were offered a channel through which information could be presented openly. This new system has improved information accuracy, completeness, and correctness; thus, excelling the process of first-hand care provision. Moreover, the bedside system has eased the transition between home-based and hospital-based care.

The question addressed in this article is; Does patient safety, satisfaction, and outcome as well as nurse satisfaction increases when nurses do bedside report versus report given outside the patient’s room? Bedside shift reports are considerably effective in the enforcement of transparency in care delivery, assurance that the care givers and patient’s family operate as a team, and promotion of corporation amongst nurses. In addition, bedside shift reports ensure that patient safety is promoted.

According to a report file by the Joint Commission in 2013, one of the major reasons that promote poor care provision is miscommunication. Research Studies have demonstrated that bedside shift reporting enhances nurse and patient fulfillment; and capitalize on healthy nurse-patient relationship (Agency for Healthcare Research and Quality, 2013). In one medical study, findings indicated that a failure in communication was to blame for most adverse events observed in care provision (Mason, Derby, Wrobleski, and Foss, 2012).While other studies have affirmed that bedside shift reporting is responsible for elevating patient safety and overall service delivery. For instance, one medical study demonstrated a significant decline in patient falls as a result of changes in shifts; falling from an estimated one to two patient falls monthly to a decent one patient fall per six months (Chaboyer, et al… 2009). Although many benefits of bedside report, from the patient’s as well as from the nurse’s perspective have been shown, there is still a lack of research to support the use of educational interventions to improve handover (McKechnie, 2015).

The design of this study follows a quasi-experimental longitudinal pilot study using a sample of convenience. The study involved 7 med-surge units which implemented a blended bedside shift report model.  Quasi-experiments are non randomized studies used to assess given interventions (Houser, 2015). However, like randomized tests, quasi-experiments seek to establish causality pertaining to observed outcome and the instituted intervention. Quasi-experimental studies can use both pre-intervention and post-intervention measurements as well as non-randomly selected control groups (Houser, 2015). There exist several advantages and disadvantages associated with the utility of quasi-experiments in studies, and medical informatics. The possible methodological shortcomings of quasi-experimental studies in medical informatics are likely to introduce the element of biasness; also demonstrated. Furthermore, a comprehensive summary table detailing a relative hierarchy and nomenclature of utilized quasi-experimental study parameters has also been provided.

A standardized survey employing the Likert-type response metric was performed on significant sample of 154 patients with baseline at three months, and thirteen months after implementation. Patient’ responses were generally positive. Outcomes recorded by the study touched on patient and nursing satisfaction, nursing overtime, medication errors, and patient falls. Researchers suggest that a combination of several bedside shift report designs may enhance patient-nurse communication and improve the quality care given.

Consequently, the higher up the design appears in the hierarchy, the greater its internal validity; which provides information that affirms and strengthens the relationship/association between intervention and observed outcome (Sand-Jecklin & Sherman 2013).

One of the overbearing study weaknesses was attributed to participant sampling; the study utilized a significant sample of medical and surgical patients approved for discharge and all nurses stationed in work areas under the medical and surgical unit. The hereby utilized sample of patient and nurse may have failed to be a “true” representation of the parent population for patients and nurses in the medical and surgical unit. Houser (2015) explains that “the way a sample is selected is the major control for selection bias and is the primary determinant of whether results from a sample can be generalized to a larger population” (p. 182). Although this research is still valid, you must consider it when interpreting the study. By using a convenience sample, the characteristics of the population used are less diverse than a random sample. I complete consider it is important to look at the type of sample when evaluating any study.

Another limitation identified was the present of inconsistencies in the utility of the blended bedside reporting system admitted by both sample patients and nurses. The study on the nurse responses did not employ identifiers, and no limitations were instituted on the number of surveys submitted/availed from one-computer’s ISP address; it is therefore probable that nurses may have completed more than the required single survey. The study also did not take into account the degree or frequency of these inconsistencies. In further studies, I would recommend to include one or more items in both the patient and nurse surveys that would be able to quantify any inconsistencies in implementation.

Researchers have identified bedside shift reporting as an effective strategy that allows care givers to create the desired results/outcomes. Desired outcomes are defined as the improved audible report between nurses that allows for ample information sharing and inquisitions. Desired outcome is also described by the improvement of staff satisfaction observed when nurses leave work on time or as scheduled. Secondary outcomes referred to improved patient satisfaction as demonstrated through reduced utility of call right by ailing patients, increased patient-centric care, and fulfilling interaction between patients and the care giving teams.

Mixed forms of bedside reports have yield numerous positive outcomes in large hospitals; such as the one used in this study. Nurses employ their professional skills and interpersonal skills to assess the behavior of different patient in light of given perceptions and emotions (Sand-Jecklin & Sherman 2013). By so doing, nurses are able to formulate the best work schedule that will optimize time utility and maximize patient satisfaction.

According to the research findings patients perceived the presence of improved communication amongst staffers, excelled patient care, and betterment on shift reporting as a result of computerized rounds reports and nursing perceptions (Sand-Jecklin & Sherman 2014). In this study, validation of the findings is don using the data collected from the patients during the bedside segment of the nurse’ shift handoff. Incentives by the nursing staff have seen the number of patient fall decline substantially in a time interval of thirteen months. The number declined from 20 to 13 after 3 month post implementation; and eventually, dropped to 4 after 13 months post-implementation. The number of recorded medication errors also decreased by half after three month of strategy implementation; settling at 10 medication errors (Sand-Jecklin & Sherman 2014).

In spite of the evidence presented above concerns exist pertaining to the sustainability of bedside shift reports; some nurses feel that the reports violate patient confidentiality and present the nurses with a difficult task of detailing the medical problems to the patients (Sand-Jecklin & Sherman 2014). Nurses also fear that the patients may ask for some services that many undermine the integrity of the report. No matter how useful the scripts are to the nurses and the institution of care-giving continued support and leadership from management is required to keep the intervention running smoothly. Moreover, some nurses argue that the deliberation of report matters in a semi-private environment many indeed violate set Protected Health Information parameters provided for by the Health Insurance Portability and Accountability Act (HIPAA) (Sand-Jecklin & Sherman 2014). To manage this issue, management staffs employing the reporting intervention were asked to address the limitation. As a result of staff outcry several amendments we made with regard to matters of private concern and potentially sensitive subject; for instance, infectious diagnosis and perceptions of psychosocial behavior, such issues were to be discussed in a completely private hospital environment.

In the field of nursing, the extent of patient safety and well-being is directly linked to the provision of correct, complete, and supporting information during the commencement of shift-to-shift staff interchange (Sand-Jecklin & Sherman 2014). Information gained from bedside reports is used by nursed to make assessments on patient planning, well-being, needs, and the delivery of care. After completion of the literature review, it is apparent that the does exist some degree of correlation/association between patient satisfaction and institution of bedside shift reporting (Sand-Jecklin & Sherman 2014). Survey data revealed a need for betterment of variable scores linked to patient confidence in quality care, patient’s opinion on safety and security, being informed at all times, patient participation in the decision-making process that influences health care, and attitudes on how nursing staffers work as a team. Lastly the survey data also asked for improvement to be made on nurse satisfaction, with regard to nurse-to-nurse interaction, corporation among nurses, and nurse-patients relationship (Sand-Jecklin & Sherman 2014).