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Inconsistencies with bedside shift report (BSR) can have negative impact on patient outcomes, including patient satisfaction. A quality improvement initiative increased BSR rates by 42%, improved patient satisfaction scores by 3.9%, and increased staff nurse knowledge and understanding of BSR.
Keywords: bedside shift report, patient outcomes, patient satisfaction, quality improvement
Effective communication be tween clinical nurses and patients at shift change can be critical to achieving positive patient outcomes. Nurses play a notable role in relaying essential, accurate information about the patient to incoming nurses. Conveying appropriate information while including the patient during the shift handoff process may promote patient safety. Gaps in the communication process during transition of care between nurses can lead to loss of essential information and harm to the patient. In addition, communication failures can be costly to healthcare organizations. The Joint Commission (2017) concluded these failures in U.S. hospitals and medical practices were at least partly responsible for 30% of malpractice claims, leading to 1,744 deaths and $1.7 billion in malpractice costs over 5 years.
Handoff communication was established as a National Patient Safety Goal in 2006 and became an accreditation standard in 2010 (The Joint Commission, 2017). In efforts to improve communication pro cesses and patient safety, many nurse leaders have supported use of bedside shift report (BSR).
Project Site and Reason for Change
The project site suspended the practice of BSR during the COVID19 pandemic based on guidelines that limited frequent rounding and exposure to COVID-19 at that time. Notably, the oncology unit struggled with meeting its goals for fiscal year 2020-2021 in the following nurse-sensitive domains of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey: communication with nurses, communication about medicines, discharge information, and responsiveness of staff. Scores had declined substantially during the pandemic. The unit manager discussed concerns with the Unit Advisory Council (UAC), a team of nurses who oversee quality im provement. Consensus was to restructure BSR because inconsistencies in communication (directly impacted by BSR) were evident in previous scores, and because new clinical nurses may not have used BSR. They wanted to ensure all nurses understood BSR before reimplementing the process on the project unit.
The project leader conducted approximately 20 informal interviews with oncology clinical nurses. They considered BSR...