AIMS AND OBJECTIVES: To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. BACKGROUND: The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance. DESIGN: Quasi-experimental pre- and postimplementation design. METHODS: Seven medical-surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors. RESULTS: We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented. CONCLUSIONS: Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection. RELEVANCE TO CLINICAL PRACTICE: If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process.
AIMS AND OBJECTIVES: To quantify quantitative outcomes of a practice change to a blended form of bedside nursing report. BACKGROUND: The literature identifies several benefits of bedside nursing shift report. However, published studies have not adequately quantified outcomes related to this process change, having either small or unreported sample sizes or not testing for statistical significance. DESIGN: Quasi-experimental pre- and postimplementation design. METHODS: Seven medical-surgical units in a large university hospital implemented a blend of recorded and bedside nursing report. Outcomes monitored included patient and nursing satisfaction, patient falls, nursing overtime and medication errors. RESULTS: We found statistically significant improvements postimplementation in four patient survey items specifically impacted by the change to bedside report. Nursing perceptions of report were significantly improved in the areas of patient safety and involvement in care and nurse accountability postimplementation. However, there was a decline in nurse perception that report took a reasonable amount of time after bedside report implementation; contrary to these perceptions, there was no significant increase in nurse overtime. Patient falls at shift change decreased substantially after the implementation of bedside report. An intervening variable during the study period invalidated the comparison of medication errors pre- and postintervention. There was some indication from both patients and nurses that bedside report was not always consistently implemented. CONCLUSIONS: Several positive outcomes were documented in relation to the implementation of a blended bedside shift report, with few drawbacks. Nurse attitudes about report at the final data collection were more positive than at the initial postimplementation data collection. RELEVANCE TO CLINICAL PRACTICE: If properly implemented, nursing bedside report can result in improved patient and nursing satisfaction and patient safety outcomes. However, managers should involve staff nurses in the implementation process and continue to monitor consistency in report format as well as satisfaction with the process.
Authors: Alisa Khan; Nancy D Spector; Jennifer D Baird; Michele Ashland; Amy J Starmer; Glenn Rosenbluth; Briana M Garcia; Katherine P Litterer; Jayne E Rogers; Anuj K Dalal; Stuart Lipsitz; Catherine S Yoon; Katherine R Zigmont; Amy Guiot; Jennifer K O'Toole; Aarti Patel; Zia Bismilla; Maitreya Coffey; Kate Langrish; Rebecca L Blankenburg; Lauren A Destino; Jennifer L Everhart; Brian P Good; Irene Kocolas; Rajendu Srivastava; Sharon Calaman; Sharon Cray; Nicholas Kuzma; Kheyandra Lewis; E Douglas Thompson; Jennifer H Hepps; Joseph O Lopreiato; Clifton E Yu; Helen Haskell; Elizabeth Kruvand; Dale A Micalizzi; Wilma Alvarado-Little; Benard P Dreyer; H Shonna Yin; Anupama Subramony; Shilpa J Patel; Theodore C Sectish; Daniel C West; Christopher P Landrigan Journal: BMJ Date: 2018-12-05