Utilizing Bedside Shift Report to Improve the Effectiveness of Shift Handoff

Abstract

Handoff of patient information during shift report between nurses is a time of risk and liability. A quality improvement project was conducted on a 23-bed inpatient unit to measure the value of a bedside change-of-shift report in improving the effectiveness of shift report. Indicators including end-of-shift overtime, call light usage, nurse perceptions, and patient satisfaction were impacted by the change in process.

Nurses Perceptions

“…Regardless of the report method, the literature is consistent regarding the problems associated with change-of-shift report. The problems include a lack of report consistency and structure, potential failures in communication leading to adverse events, and not allowing the patient to be included in their plan of care (Cairns, Dudjak, Hoffmann, & Lorenz, 2013;Friesen et al, 2013;Jeffs et al, 2014). Much of the literature has found that many medical errors involve actual inaccuracies with communication.…”

“…A study by Cairns et al (2013), found a decrease in end-of-shift overtime by 10 minutes per day, or 61 hours per year, demonstrating an overall savings in overtime by 23%. Street et al, 2013 stated "frequent interruptions" as barriers to bedside reporting (p.139).…”

“…Identifying change as a priority therefore can increases the chances of success and sustainability. Cairns et al (2013) indicated that the implementation process is a difficult one and that "sustaining bedside shift report has not been without challenges and requires ongoing monitoring and encouragement" (p. 163) Next the theoretical framework will be discussed.…”

“…Nurses seem to be highly concerned with the breeching of confidentiality and HIPPA violations when other patients or family members are present in the room (Anderson & Mangino, 2006;Cairns et al, 2013;Evans et al,). Cairns et al (2013), continues to say that not only are nurses uncomfortable with the privacy issues associated with bedside reporting, but the nurses also feel uncomfortable talking about tests or results that the physician has not yet discussed with the patient.…”

A Comparison of the Risks and Benefits of Nursing Bedside Shift Report vs. Traditional Shift Report: A Systematic Review of the Literature

“…Proper handoffs may be reliant on the communication skill-level of the nurses providing the information. Cairns, Hoffmann, Dudjak, and Lorenz (2013) suggest "an experienced nurse may provide more in-depth information or may conversely assume a baseline of knowledge among peers that may not be present" (p. 160). Shift report that occurs away from the bedside can lack structure and become lengthy, BSR allows for the patient to add insight and ask questions.…”