Bedside Shift Reporting Discussion Paper

Area of interest

Currently, shift-to-shift reports are presented at the nurses’ station, with the patients offered no opportunity to provide their input into the care plan. In fact, it is correct to assert that shift change reports have typically been conducted among nurses at their station without visualization or even the patient’s inclusion, with the process continuing until the whole report is presented and the off-duty nurse signs off. However, new evidence from Ford, Heyman and Chapman (2014) suggest that while this is the standard practice in the medical-surgical unit, it has been matched by low satisfaction levels among the patients. The evidence goes on to show that using bedside shift-to-shift report would improve patient satisfaction by prompting an inclusive discussion where the patient giving his input in regard to care and other issues associated with the case. The implication is that conducting bedside shift-to-shift report could be enough to improve the patients’ satisfaction by involving patients in the discussions regarding their care Bedside Shift Reporting Discussion Paper.

The problem addressed by this research is the low patient satisfaction levels, postulated to be resultant of the patients’ non-inclusion in the shift-to-shift report. The traditional end-of-shift report has been viewed as conveying too little information regarding the patients (James, 2013). The incoming nurse may not receive the necessary information to enable her to deliver the needed quality care. Such a problem decrease the time spent at the bedside while increasing the time spent on reviewing the patient’s chart for the pertinent information relating to the patient. That being said, there are other nurses who tend to include too much information which lead to irrelevant reports which are likely to be inconsistent in quality and limit the chance for the newly joined nurse to ask the essential questions (James, 2013). The nurse-to-nurse reporting runs the risk of giving incomplete information regarding the patient care. Another problem is that questions arising after the nurse has gone cannot be addressed. Such nursing issues can lead to poor patient care and risky outcomes.

One significant feature of the non-inclusion of patients is that reporting has been linked to a surge in the general cost of care, mortality, and morbidity. In fact, inaccurate communication at transition of care leads to readmissions that cost more than $26 billion a year. Every year, between 210,000 and 440,000 patients suffer from some type of preventable harm that leads to their death. Inaccurate communication between providers, as well as, between healthcare professionals and patients plays a role in these adverse events (James, 2013). If patients were involved in their own care by being allowed to offer input that would then be used to advance care quality, there is a heightened possibility that the costs, mortality and morbidity rates would be considerably reduced (Wrobleski et al., 2014). It is evident that the medical-surgical unit does not offer a good environment where patients can be part of their care. Reversing this perception to improve patient satisfaction will not be easy to achieve since it will require significant changes in the standard operating procedures concerning handover instructions (Maxson et al., 2012). Besides that, there is no guarantee that bedside shift-to-shift report would improve patient satisfaction levels although the literature review makes a strong argument for correlation existing between patient satisfaction and involvement. Thus, it is essential for nurses to understand that failure to include patients in the care planning and holding meaningful communication with them lowers medical care efficiency and outcomes that have a primary influence on reducing their satisfaction levels and secondary effect in increasing costs, as well as the morbidity and mortality rates.

From the patients’ perspective, it can be argued that medical-surgical unit patients are faced with a lot of issues, ranging from those associated with care quality, costs, and so on. As such, they are apprehensive that the medical personnel are not doing enough to improve their welfare, thereby lowering their satisfaction levels. This evidence-based practice project intends to improve surgical inpatient satisfaction levels via carrying out the bedside shift report compared with nursing station shift report over a three-month period Bedside Shift Reporting Discussion Paper.

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Generated questions based on feasibility

How does shift-change reporting at the nurse station affect care outcomes in surgical units? This question explores the shortcomings of reporting at the nurse station.
Do patients have an opinion about their care? This question explores the cause of patients being dissatisfied with their care.
Can patients contribute meaningfully to their care? This question tries to address patients’ dissatisfaction with care.
Is there an opportunity for patients to contribute towards their care? This question identifies the forums in which patients can contribute to their care, particularly when they come into contact with medical personnel.
Does bedside shift reporting offer an opportunity for patients to contribute towards their care? This questions explores the bedside as a good forum in which patients can engage medical personnel to discuss care options.
PICOT question

Shift change report at the nursing station of the medical-surgical unit has been linked to reduced patient satisfaction levels. In this case, despite evidence that bedside shift-to-shift change report that includes patients in care planning and discussions increase their satisfaction, the medical-surgical unit still continues to organize shift change report at the nursing station. Thus, the question is; for the medical-surgical unit patients (P), does the enactment of the bedside shift report (I) increase patient satisfaction levels (O) when contrasted with the shift change report at the nurses’ station (C) over a three-month period (T)Bedside Shift Reporting Discussion Paper?

The presented question identifies patients who are admitted to the medical-surgical unit as the population of interest. The intervention is the application of bedside shift-to-shift report whereby the patient is allowed to provide input to inform care choices. The comparison is shift change report at the nursing station in the medical-surgical unit and the bedside shift-to-shift report. The anticipated outcome is improved patient satisfaction levels. The evidence-based practice results are anticipated to be felt within three months of application.

Keywords

The keywords to be used in the literature search include shift-to-shift, patients’ opinion, reporting format, bedside, nursing station, handover, inpatient, patients’ satisfaction, care outcome, and evidence-based practice. This is intended to guarantee that relevant information is collected for analysis and to draw conclusions thereby guaranteeing the research reliability and validity.

References

Ford, Y., Heyman, A. & Chapman, Y. (2014). Perceptions of patients regarding the Bedside Handoff: The need for a culture of always, Journal of Nursing Care Quality, 29(1), 371-378.

James, J. (2013). A new, evidence-based estimate of patient harms associated with hospital care. Journal of Patient Safety, 9(3), 122-128. doi: 10.1097/PTS.0b013e3182948a69

Maxson, P., Derby, K., Wrobleski, D. & Foss, D. (2012). Bedside nurse-to-nurse handoff promotes patient safety. Medsurg Nursing, 21(3), 140-145.

Wrobleski, D., Jowiak, E., Dunn, D., Maxson, P. & Holland, D. (2014). Discharge planning rounds to the bedside: a patient- and family-centered approach. MedSurg Nursing, 23(2), 111-116 Bedside Shift Reporting Discussion Paper.

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